Key pitfalls to avoid when using PET imaging for patients with coronary artery disease
New guidelines detail common pitfalls to avoid when using PET imaging for patients with coronary artery disease.
CAD is the leading cause of death worldwide, also contributing to hospitalizations, patients’ functional decline and reduced quality of life for millions. A novel PET radiotracer has demonstrated favorable imaging of heart disease, according to new guidelines from the Society of Nuclear Medicine and Molecular Imaging and other trade groups.
Clinical studies have shown the imaging agent provides superior scan quality, improved diagnostic accuracy and greater sensitivity in detecting significant coronary artery stenosis compared to conventional methods.
To aid in the PET imaging of patients with heart disease, SNMMI and other groups such as the American Society of Nuclear Cardiology have developed new guidelines. They detail recommendations for patient selection, imaging protocols and interpreting results.
SNMMI et al. offered seven potential pitfalls to avoid when using PET imaging for coronary artery disease patients:
- Adequate quality control of the PET/CT imaging data is crucial to optimize clinical results. The most common artifacts are due to patient, processing and/or technical factors.
- Metallic implants, including the components of pacemakers, may give rise to artifacts such as streaks or distortions on CT transmission images.
- Patient positioning is also key to avoiding artifacts. It is always important that the patient has the most comfortable and stable positioning possible to avoid movement artifacts during the exam.
- Registration between CT and PET data should be assessed by inspection of the fused display. Misregistration may introduce artifactual perfusion defect and decreased myocardial blood flow, often affecting the anterior, anterolateral, and lateral regions.
- Additional quality control is critical to ensure the accurate quantitation of MBF. Myocardial and blood pool regions are validated and correction for motion is applied if needed.
- Residual activity correction from rest images to pharmacologic stress images should be applied in same-day studies to avoid overestimation of stress myocardial blood flow and ensuing myocardial flow reserve values.
- Automated motion correction is now routinely applied in commercial software used for time-activity curves processing and myocardial blood flow quantitation and should also be used for 18F-flurpiridaz PET.
You can read the full findings, published Sept. 18 in the Journal of Nuclear Medicine, here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.