Chronic stable angina positron emission tomography (PET)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Smita Kohli, M.D.

Overview

Positron emission tomography is of particular value in the assessment of regional coronary blood flow reserve, myocardial perfusion, and the presence and extent of hibernating myocardium.

PET Modalities

• Rubidium-82 or ammonia (N13) can be used for assessment of myocardial perfusion.
• Labeled carbohydrates such as fludeoxyglucose F-18, lipids, and some amino acids can be used to asses myocardial metabolism and viable ischemic myocardium.

Indications

PET is of value principally in difficult situations where in myocardial perfusion by thallium scintigraphy and assessment of left ventricular systolic function by echocardiography do not reveal the extent of hibernating myocardium.

Sensitivity and Specificity

With combined assessment of myocardial perfusion and metabolism, the sensitivity and specificity for the detection of CAD may approach 95%.

Disadvantages

Positron emission tomography is a very expensive noninvasive test and not readily available in every cardiac diagnostic care center.

For more information on techniques used to assess myocardial viability, click here.

References

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