ARRS 2022 Abstracts

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E1690. Cardiac PET Without "Sweat"
Authors
  1. Santoshi Indrakanti; Massachusetts General Hospital
  2. Kenechukwu Mezue; Massachusetts General Hospital
  3. Taimur Abbasi; Massachusetts General Hospital
  4. Samantha Harrington; Massachusetts General Hospital
  5. Michael Osborne; Massachusetts General Hospital
  6. Yingbing Wang; Massachusetts General Hospital
  7. Thomas Ng; Massachusetts General Hospital
Background
Cardiac PET/CT is a non-invasive form of cardiac imaging that is based on the coincidence detection of photons emitted from the decay of radiolabeled tracers introduced into the body to map cardiac perfusion. Cardiac PET/CT allows accurate measurement of qualitative myocardial perfusion, quantitative myocardial blood flow, and function at stress and rest. The cardiac PET/CT study has higher specificity and sensitivity for diagnosing significant ischemic heart disease compared to single-photon emission CT (SPECT). It can also diagnose microvascular disease (as it quantifies blood flow and coronary reserve) and provides better image quality, especially in patients with a high BMI. This educational abstract aims to quickly summarize the key concepts involved in cardiac perfusion PET/CT with a focus on the clinical workflow, quality control assessment, and interpretation of cardiac PET/CT studies.

Educational Goals / Teaching Points
The goals of this exhibit are as follows. Understand the role of cardiac perfusion PET/CT in the diagnostic work-up of coronary artery disease to generate the most clinically relevant report. Be aware of cardiac PET/CT quality control issues for efficient troubleshooting. Be familiar with normal cardiac PET/CT imaging findings and/or normal cardiac functional quantification. Identify abnormal cardiac PET/CT imaging findings and/or abnormal cardiac functional quantification that is suggestive of underlying clinically significant coronary artery disease.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Key points of this include the following: indications for cardiac perfusion PET/CT, radiotracer selection, and rest/stress examination as well as PET/CT imaging protocol. Quality control considerations will include representative example studies demonstrating motion correction and attenuation correction artifacts, and examples of normal PET/CT examinations with normal functional quantification. We also review representative findings from abnormal PET/CT examinations with normal imaging findings but abnormal functional quantification suggestive of diffuse microvascular disease, subsequently confirmed through cardiac catheterization and findings from abnormal PET/CT examinations with abnormal imaging findings as well as abnormal cardiac functional quantification, subsequently confirmed through cardiac catheterization.

Conclusion
Cardiac CT/PET is a formidable tool in the management of coronary artery disease as it provides an excellent assessment of cardiac perfusion and myocardial blood flow.