Nuclear Cardiology – PET


1. Define what is physiologic testing for anomalous coronary arteries? 2. What stress test is best to create mechanical compression? 3. Use of treadmill PET and Dobutamine PET for risk stratification 4. Disadvantage of vasodilator PET

1. A balanced view and experience from the Principal investigator of the imaging CoreLab for the much anticipated ISCHEMIA trial. 2. Lessons on how this trail learned from the past and will influence our future practice. 3. What groups benefit from ischemia evaluation?

Challenges with prior CABG 1. Anatomic “landmarks” of various coronary arteries are not applicable 2. Segmental defects that are not contiguous 3. ECG changes that are not specific for ischemia 4. Abnormal septal motion 5. Flows and flow reserves are not well validated 6 Correlation with angiographic results may be challenging

Role of Echo, cardiac MRI id diagnosing and risk stratification of patients with cardiac Sarcoid. Strength and shortfalls of each modality. Importance of complementary/layered imaging.

Avoid the occulo-stenotic reflex. Review other imaging data if available. Severely fixed defects can be scar or hibernation. Unwise to open a coronary vessel to dead myocardium. Differentiate between LAD and diagonal/ramus.

Compare and contrast the value and images of PET and SPECT-CT in the setting of LBBB.

Identify the “fingerprints” of scarred myocardium on a cardiac PET in contrast to ischemic or hibernating myocardium.

Explain why we assess for hibernating myocardium, instances when assessment for hibernating myocardium is not indicated, and finally patient preparation and mini-tutorial on image display and reporting of findings.

We will guide you on the process we use for reading cardiac perfusion and metabolic PETs to evaluate myocardial hibernation. This process will allow you to identify myocardium at risk even when rest and stress perfusion images show a fixed perfusion defect.

Describing PET findings of “ischemia” and correlating the finding with unusual LV morphology.

Step by step review of identifying ischemia on cardiac PET and recognizing high risk markers.

A brief primer on PET and SPECT cardiac tracers, imaging systems, and stress protocols.

This tutorial will walk you step by step through an abnormal PET study and help you identify high risk markers.

Identify areas of ischemia, correlate the ischemia to a coronary/ies territory, recognize TID and assign the scan a risk score.

Step by Step interpreting and reporting a normal cardiac PET scan.

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