ASNC/SNMMI Position StatementAmerican Society of Nuclear Cardiology and Society of Nuclear Medicine and Molecular Imaging Joint Position Statement on the Clinical Indications for Myocardial Perfusion PET
Section snippets
Preamble
Many patients with suspected or known coronary artery disease (CAD) benefit from the information provided by a noninvasive cardiac imaging test. Cardiac imaging tests can provide information regarding the presence, extent, and severity of CAD, estimate risk for early and late major adverse cardiac events, and assist in determining the most appropriate treatment, including medical therapy and/or coronary revascularization. Valuable information can also be provided from a normal scan result that
Important Properties of Myocardial Perfusion PET
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High diagnostic accuracy: Myocardial perfusion PET has high sensitivity and specificity for angiographically significant obstructive CAD, and has been shown in meta-analyses to outperform other noninvasive approaches. Its high sensitivity improves recognition of multivessel CAD, and its high specificity improves recognition of absence of multivessel CAD. Furthermore, the combination of information gained from consistent and high-quality perfusion images, peak stress regional and global
Clinical Indications
The American Society of Nuclear Cardiology and the Society of Nuclear Medicine and Molecular Imaging have concluded that the properties of myocardial perfusion PET according to the published literature are sufficient to advance recommendations for its use in clinical practice. These recommendations are general in intent and should not be interpreted as either inclusive or exclusive of specific clinical scenarios. However, they reflect the current understanding based on extensive clinical
Conclusion
The purpose of this joint Society Position Statement is to highlight the attributes that make rest/stress myocardial perfusion PET both Preferred and Recommended in the era of high value initiatives for appropriate patients. Myocardial perfusion PET image quality, high diagnostic accuracy that is relatively independent of body habitus, ability to accurately risk stratify patients with a wide array of clinical presentations, short acquisition times, safety by virtue of low radiation exposure,
Disclosures
Timothy Bateman
Research Grant: Astellas, GE Healthcare
Advisory Board: Lantheus
Royalty: ExSPECT II Attenuation Correction, Imagen Pro/MD/Q/3D
Salaried Employee/Owner: CVIT
Vasken Dilsizian
Research Grant: Siemens, GE Healthcare
Robert Beanlands
Consultant: Lantheus, Jubilant DRAXImage
Research Grant: GE Healthcare, Lantheus, Jubilant DRAXImage
Gordon DePuey
Advisory Board: Adenosine Therapeutics
Gary Heller
Consultant: FluoroPharma
Advisory Board: Lantheus, Adenosine Therapeutics
Salaried Employee: IAC
Selected References
Centers for Medicare and Medicaid Services. Clinical quality measures basics. https://www.cms.gov/regulations-and-guidance/legislation/ehrincentiveprograms/clinicalqualitymeasures.html
Dilsizian V, Bacharach SL, Beanlands SR, Bergmann SR, Delbeke D, Dorbala S, Gropler RJ, Knuuti J, Schelbert H, Travin M. ASNC imaging guidelines/SNMMI procedure standard for positron emission tomography (PET) nuclear cardiology procedures. J Nucl Card 2016. doi:10.1007/s12350-016-0522-3.
Heller GV, Beanlands R,
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