View source for Engineering:Cardiac PET

{{Infobox diagnostic |
  Name        = Cardiac PET |
  Image       = |
  Caption     = |
  ICD10       = C23G, C23Y |
  ICD9        = |
  MeshID      = |
  OPS301      = {{OPS301|3-741}} |
  OtherCodes  = |
}}
'''Cardiac PET''' (or ''cardiac [[Physics:Positron emission tomography|positron emission tomography]]'') is a form of [[Medicine:Medical imaging|diagnostic imaging]] in which the presence of [[Medicine:Cardiovascular disease|heart disease]] is evaluated using a PET scanner. Intravenous injection of a radiotracer is performed as part of the scan. Commonly used radiotracers are [[Physics:Rubidium-82|Rubidium-82]], [[Physics:Nitrogen-13|Nitrogen-13]] ammonia and [[Physics:Oxygen-15|Oxygen-15]] water.<ref>{{Cite journal | last=Ghosh | first=N |author2=Rimoldi OE |author3=Beanlands RS |author4=Camici PG  | title=Assessment of myocardial ischaemia and viability: role of positron emission tomography | journal=European Heart Journal | volume=31 | issue=24 | pages=2984–2995 |date=December 2010 | pmid=20965888 | doi=10.1093/eurheartj/ehq361 | doi-access= }}</ref>

==Uses==
Cardiac PET-CT scan can assess blood flow, [[Biology:Metabolism|metabolism]], inflammation, innervation, and receptor density accurately. Besides, it is also useful to detect heart conditions such as [[Medicine:Coronary artery disease|coronary artery disease]], [[Medicine:Cardiac amyloidosis|cardiac amyloidosis]], and cardiac sarcoidosis.<ref name="Di Carli 2022">{{Cite book |url=https://link.springer.com/10.1007/978-3-662-64499-7 |title=IAEA Atlas of Cardiac PET/CT: A Case-Study Approach |date=2022 |publisher=Springer Berlin Heidelberg |isbn=978-3-662-64498-0 |editor-last=Di Carli |editor-first=Marcelo F. |location=Berlin, Heidelberg |language=en |doi=10.1007/978-3-662-64499-7 |s2cid=248368314 |editor-last2=Dondi |editor-first2=Maurizio |editor-last3=Giubbini |editor-first3=Raffaele |editor-last4=Paez |editor-first4=Diana}}</ref>

==Radiopharmaceuticals==
Rubidium-82 is produced from the decay of Strontium-82 through [[Physics:Electron capture|electron capture]] in a generator. It is used to access the blood vessels supplying the heart. Strontium-82 has a half-life of 25.5 days while Rubidium-82 has a half-life of 76 seconds. Heart muscles can take up Rubidium-82 efficiently through [[Biology:Sodium–potassium pump|sodium–potassium pump]]. Compared with [[Physics:Technetium-99m|Technetium-99m]], Rubidium-82 has higher uptake by the heart muscles. However, Rubidium-82 has lower uptake by heart muscles when compared to N-13 ammonia. But the positron energy emitted by Rubidium-82 is higher than N-13 ammonia and [[Chemistry:Fluorodeoxyglucose (18F)|Fluorodeoxyglucose (18F)]]. On the other hand, the [[Physics:Positron|positron]] range (the distance travelled by a positron from its production site until its [[Physics:Annihilation|annihilation]] with an electron) is longer when compared to other radiopharmaceuticals, causing reduced [[Image resolution|image resolution]].<ref name="Di Carli 2022"/>

Myocardium has higher uptake for N-13 ammonia when compared to Rubidium-82, thus useful for [[Chemistry:Myocardial perfusion imaging|myocardial perfusion imaging]]. However, its half-life is only 9.96 minutes. Therefore, on-site facilities such as [[Physics:Cyclotron|cyclotron]] and radiochemistry synthesis facilities should be available. There may be patchy uptake if the subject has defects in lateral ventricular wall. N-13 ammonia may occasionally be degraded by liver, thus causing reduced visibility of the inferior wall of the heart. N-13 ammonia uptake by the lungs is minimal.<ref name="Di Carli 2022"/>

== Indications ==
* Patients with many risk factors e.g. [[Medicine:Hypertension|hypertension]], high cholesterol, smoking habit, [[Medicine:Diabetes|diabetes]], obesity, high stress occupation, family history of heart attack
* Patients who are unable to exercise
* Patients suspected of heart attack
* Patients newly diagnosed with heart failure
* Patients with abnormal ECG or [[Engineering:Treadmill|treadmill]]

== Requirements ==
* Facility: taking into consideration clinical workflow, as well as regulatory requirements such as requisite shielding from radiation exposure
* Capital equipment: PET or PET/CT scanner
* Radiopharmaceutical: Rubidium-82 generator system or close access to cyclotron produced isotopes such as Nitrogen-13 ammonia
* Personnel: including specially trained physician, radiographers, radiation safety supervisors and optional nursing support
* Operations: stress test monitoring, as well as emergency response equipment, processing and review workstations, administrative and support personnel are additional considerations

==References==
{{reflist}}

{{Medical imaging}}
{{Cardiac procedures}}

{{DEFAULTSORT:Cardiac Pet}}
[[Category:3D nuclear medical imaging]]
[[Category:Cardiac imaging]]



{{Sourceattribution|Cardiac PET}}