PET/CT is poised to become an important tool for imaging coronary arteries. Experts say clinical imaging tests can reveal early warning signs of a potentially fatal condition when a patient shows symptoms of chest pain.

‘Hybrid’ scans that combine molecular PET and anatomical CT images may have the greatest potential for visualizing early signs of so-called ‘perfusion defects’ (areas where blood flow is blocked). said Dr. Marcelo Di Carli, a professor at the university. in radiology and medicine at Harvard Medical School in a recent interview. Aunt Minnie.com.

“[PET/CT] “This helps distinguish between patients who have chest pain due to coronary artery blockage and other patients who also have chest pain but whose chest pain is not due to coronary artery blockage,” he said.

Coronary artery disease (CAD) is the leading cause of death in the United States, killing approximately 610,000 people annually, and this number is increasing, according to estimates. Obesity, lack of exercise, unhealthy diet, and smoking are risk factors.

In a recent editorial published in Journal of Nuclear CardiologyDi Carli, the journal’s editor-in-chief, described a study that represents the largest validation to date of PET myocardial perfusion imaging (MPI) for detecting high-risk CAD.

In a cohort of 1,282 patients who underwent invasive coronary angiography for suspected disease, noninvasive PET MPI performed within 6 months revealed large perfusion defects (>10% of left ventricular myocardium) in 82% of patients. ) was identified.

Di Cari pointed out that currently, SPECT MPI (also a nuclear medicine imaging test, but with a higher radiation dose to the patient and lower resolution) remains the mainstay in the field. A game-changer, he said, could be pending U.S. approval of new PET radiotracers like F-18 flupiridaz.

“Access to PET is mainly hampered by the availability of radiopharmaceuticals for myocardial perfusion,” Di Carli said.

Beyond PET MPI, the use of F-18 FDG PET/CT in the evaluation of inflammatory cardiomyopathy and large vessel vasculitis is increasing, and its role in the evaluation of patients with suspected or known cardiac sarcoidosis is now expanding. It is incorporated into national and national guidelines, Di Cari noted.

Additionally, 11 medical societies recently jointly recommended PET/CT as the best method for diagnosing infections in people with ventricular assist devices such as automatic defibrillators; Heart implants are on the rise.

Finally, apart from developing advanced machines used in PET/CT scans, industry is also active in the effort. Earlier this month, three manufacturers of the technology formed a new coalition to push for federal policies that would increase access to images. Di Carli noted that manufacturers are recognizing the need to lower the cost of PET/CT scanners as the technology becomes more available.

So what does the near future hold for cardiac PET/CT? De Carli is quite optimistic.

“I think PET emerges as a very powerful technique for patients who are at higher risk, older patients who have more cardiometabolic risk factors,” he said.

Click below to listen to the full audio of the interview.