cardiac PET viability study

I am thinking of coming to the CCF from West Virginia for cardiac PET viability study.My cardiologist thinks that I have had several small heart attcks and wants me to have the above test. 1. Would you,please explain (step by step procedure) how's this test done and who performs it at the CCf? 2.What and how many injections are used during the test?On one of the cardiac websites says that cardiolite (SPECT) scan can't detect old heart attacks that are less than 2 cm in size,but rubidium (PET) scan can detect heart attacks that are even less than 0.5 cm (half of one cm) in size. 3.Is the above true?Thanks

[CCF-M.D.-RCJ]

Billy!,

Thanks for the post.

The sequencing of the test depends on what is ordered once you get here.

The basic idea is that you have an iv placed and are then administered agents to image the heart while lying under a camera.

The rubidium agent is like potassium -- so it is a flow agent.  If blood flow gets to a particular area of the heart, then so does rubidium, and it can be seen by the detectors.  FDG is used for the viability portion of the test.  FDG is a sugar, so it goes to metabolically active heart muscle.  So if the heart muscle is alive, then it takes up FDG, which can be imaged by the cameras.  We use persantine as a stress agent, if a stress test is ordered.

The resolution of PET scanners is limited to the distance that a positron can travel in matter before colliding with an electron to form photons -- about 7 mm.  So detecting scar less than 7mm is not possible.

Hope that helps.