Noninvasive Diagnostic Tests

Posted By on December 29, 2008

Coronary heart disease causes nearly half of deaths and disability in Americans between the ages of 35 and 64. Now Positron Emission Tomography (PET) diagnoses heart disease non-invasively with 96-98% accuracy in individuals with or without symptoms of heart disease, permitting treatment even before symptoms appear. Since its diagnostic accuracy is much higher than standard tests at comparable cost per study, PET reduces expense and risk by avoiding unnecessary tests and procedures, thereby providing more efficient diagnoses.

Coronary artery disease can be substantially reversed or its progression stopped by improving risk factors and by cholesterol lowering pharmaceuticals. This comprehensive medical approach decreases heart attacks, sudden death, the need for bypass surgery and balloon dilation or improves outcome of these procedures if needed.

Individuals with coronary heart disease with or without symptoms can be identified or evaluated and treated by a comprehensive, non-invasive, economical approach based on PET. Health care is thereby optimized with substantial reduction in costs to health care payors.

February 1995:
American College of Cardiology – American Heart Association – American Society of Nuclear Cardiology Guidelines: Classified PET MPI with Rb-82 a Category I Procedure “appropriate & useful” in management of CAD
HCFA Medicare / Medicaid Approved Reimbursement for Medicare & Medicaid Patients

March 14, 1995:

PET Myocardial Perfusion Imaging was introduced in November of 1995 to Buffalo by Dr. Merhige guided by his experience with the national expert in cardiac PET imaging, Dr. K. Lance Gould.

  • Clinical studies have shown that PET scans are more accurate than other widely used tests such as ECG (electrocardiogram), stress testing and SPECT (single photon emission computed tomography). These tests are associated with “false positive” and “false negative” results. False positives are results that show coronary heart disease where none really exists. False positives can lead to people undergoing unnecessary procedures. Because PET scans are so accurate, they are often used to confirm other tests if a false positive or false negative is suspected. “False negatives” are normal results when coronary heart disease really exists. False negatives can lead to undetected heart disease. PET myocardial perfusion imaging offers superior diagnostic accuracy resulting in a more definitive non-invasive assessment of coronary artery disease without the need for a coronary angiogram.

Technical Advantages of PET vs. SPECT (Single Photon Emission Computed Tomography)

  • Accurate Photon Attenuation Correction
  • Superior Spatial Resolution Which is Depth Independent
    SPECT: 20 mm FWHM
    PET: 10 mm FWHM
  • Improved Image Contrast
    Sestamibi: 1.5 Million Counts per Image
    82 Rubidium or 13 N Ammonia: 30 – 45 Million
  • Superior Temporal Resolution
    Permits Imaging of Dynamic Processes
  • In vivo, Noninvasive Measurement of Absolute Coronary Flow in ml/min/g

Echocardiogram

This non-invasive test translates sound waves from your chest into pictures of your heart. It provides information about how the heart is pumping, how blood flows in the heart and blood vessels, how large the heart is and how the valves are working. Learn more about echocardiography.

Electrocardiogram

The electrocardiogram (ECG or EKG) records the heart’s electrical activity. Small patches called electrodes are placed on your chest, arms and legs, and are connected by wires to the ECG machine. Learn more about electrocardiography.

Stress/Exercise Electrocardiogram

Stress tests are performed to see how the heart performs under physical stress. The heart can be stressed with exercise on a treadmill or in a few instances, a bicycle. Learn more about exercise electrocardiography.

Stress Thallium Test

Stress thallium tests have two components — a treadmill stress test and heart scan after injection of a radionuclide material, such as thallium, which allows doctors to see the coronary arteries and the shape and function of the heart. It has been used in this manner safely for many years to demonstrate the amount of blood the heart is getting under various conditions — rest and stress.  Learn more about Stress Thallium Scans.

Cardiac MRI

Cardiac MRI uses a powerful, high-strength magnet to help diagnose heart problems and guide treatment. With this advanced technology, physicians can now obtain amazingly detailed three-dimensional images of the heart never seen before. With the images produced by cardiac MRI, physicians can see how well the heart muscle is contracting as well as any areas of damaged tissue. This radiation-free technique is especially useful for evaluating such conditions as coronary artery disease, heart failure and congenital heart disease.

Source: UC San Diego Medical Center

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