Cardiac PET

Cardiac PET
Diagnostics
ICD-10-PCS	C23G, C23Y
OPS-301 code	3-741

Cardiac PET (or cardiac positron emission tomography) is a form of diagnostic imaging in which the presence of heart disease is evaluated using a PET scanner. Intravenous injection of a radiotracer is performed as part of the scan. Commonly used radiotracers are Rubidium-82, Nitrogen-13 ammonia and Oxygen-15 water.^[1]

The requirements to perform Cardiac PET imaging include:

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

This form of diagnostic imaging has traditionally been perceived as cost-prohibitive in comparison to general nuclear medicine cardiac stress testing using single photon emission computed tomography (SPECT). However, due to significant gains in access to scanners, related to the widely accepted role of PET/CT in clinical oncology, cardiac PET is likely to become more widely available, particularly given various clinical and technical advantages that might make this a potential test of choice in the diagnosis of coronary artery/heart disease.^[2]

Cardiac PET imaging has now been expanded to mobile services to facilitate all healthcare providers by a company called Cardiac Imaging, Inc. located in Wheaton, Illinois. They now have the only Medicare approved mobile Cardiac PET scanner available for patient use.

References

↑ Ghosh, N; Rimoldi OE; Beanlands RS; Camici PG (December 2010). "Assessment of myocardial ischaemia and viability: role of positron emission tomography". European Heart Journal 31 (24): 2984–2995. doi:10.1093/eurheartj/ehq361. PMID 20965888.
↑ K Nandalur, B Dwamena, A Choudhri, et al., "Diagnostic Performance of Positron Emission Tomography in the Detection of Coronary Artery Disease: A Meta-analysis" Academic Radiology, Vol 15, No 4, April 2008

Medical imaging (ICD-9-CM V3 87–88, ICD-10-PCS B, CPT 70010–79999)

X-ray/
medical radiography/
Industrial radiography

Medical:	Pneumoencephalography Dental radiography Sialography Myelography CXR Bronchography AXR KUB DXA/DXR Upper gastrointestinal series/Small-bowel follow-through/Lower gastrointestinal series Cholangiography/Cholecystography Mammography Pyelogram Cystography Arthrogram Hysterosalpingography Skeletal survey Angiography Angiocardiography Aortography Venography Lymphogram

Industrial:	Radiographic testing

3D / XCT

Medical:	CT pulmonary angiogram Computed tomography of the heart Computed tomography of the abdomen and pelvis Virtual colonoscopy CT angiography Computed tomography of the head Quantitative computed tomography Spiral computed tomography High resolution CT Whole body imaging Full-body CT scan X-ray microtomography Electron beam tomography

Industrial:	Industrial computed tomography

Other

Fluoroscopy

MRI

Ultrasound

Radionuclide

2D / scintigraphy

Cholescintigraphy Scintimammography Ventilation/perfusion scan Radionuclide ventriculography Radionuclide angiography Radioisotope renography Sestamibi parathyroid scintigraphy Radioactive iodine uptake test Bone scintigraphy Immunoscintigraphy

full body:	Octreotide scan Gallium 67 scan Indium-111 WBC scan

3D / ECT

SPECT gamma ray: Myocardial perfusion imaging

PET (positron):	Brain PET Cardiac PET PET mammography PET-CT

Optical laser

Thermography

Surgery and other procedures involving the heart (ICD-9-CM V3 35–37+89.4+99.6, ICD-10-PCS 02)

Surgery and IC

Heart valves and septa	Valve repair Valvulotomy Mitral valve repair Valvuloplasty aortic mitral Valve replacement Aortic valve repair Aortic valve replacement Ross procedure Percutaneous aortic valve replacement Mitral valve replacement production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal defect in heart Blalock–Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan procedure left ventricle to aorta Rastelli procedure right ventricle to pulmonary artery Sano shunt compound procedures for transposition of great vessels Jatene procedure Mustard procedure for univentricular defect Norwood procedure Kawashima procedure shunt from blood vessel to blood vessel systemic circulation to pulmonary artery shunt Blalock–Taussig shunt SVC to the right PA Glenn procedure

Cardiac vessels	CHD Angioplasty Bypass/Coronary artery bypass MIDCAB Off-pump CAB TECAB Coronary stent Bare-metal stent Drug-eluting stent Bentall procedure Valve-sparing aortic root replacement

Other	Pericardium Pericardiocentesis Pericardial window Pericardiectomy Myocardium Cardiomyoplasty Dor procedure Septal myectomy Ventricular reduction Alcohol septal ablation Conduction system Maze procedure Cox maze and minimaze Catheter ablation Cryoablation Radiofrequency ablation Pacemaker insertion Left atrial appendage occlusion Cardiotomy Heart transplantation

Diagnostic
tests and
procedures

Electrophysiology

Electrocardiography

Vectorcardiography

Holter monitor

Implantable loop recorder

Cardiac stress test

Bruce protocol

Electrophysiology study

Cardiac imaging

Angiocardiography

Echocardiography

TTE

TEE

Myocardial perfusion imaging

Cardiovascular MRI

Ventriculography

Radionuclide ventriculography

Cardiac catheterization/Coronary catheterization

Cardiac CT

Cardiac PET

sound: Phonocardiogram

Function tests

Pacing

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