iv drugs

Hi doctor and thanks for your time.A friend had heart viability PET scan test appointment.At the time of test he was told that they do heart viability PET scan with FDG and cardiolite and not with ammonia or rubidium since they don't have them.He cancelled the test because he wanted it done with FDG and either ammonia or rubidiun.Later some doctors told him that only FDG is used during heart viability PET scan (rest not stress part of the test).Other doctors told him that FDG plus rest perfusion drugs,like ammonia or rubidium are used. Last doctor he talked to told him that FDG plus cardiolite are used.He asked me to ask you the following questions: 1. To diagnose damage of all old large and small heart attacks what (isotope) drugs are used during cardiac PET scan? 2.Is and (how!) can cardiolite isotope be used with PET camera? 3.Is test done with FDG and cardiolite considered PET scan test or half SPECT and half PET? 4.If the test was done with FDG and cardiolite, would the results be looked up as not as accurate as if the test was done with ammonia or rubidium? 5.At CCF what drugs are used most often during PET viability (rest part of the test) and stress part of the test? Are FDG,ammonia,cardiolite and rubidium injection drugs FDA approved?Thanks

[CCF-M.D.-RCJ]

Bob!

Thanks for the post.

The first thing to know is that each center does these tests differently.  They have different areas of expertise; therefore if you decide on a given center, you would be well-advised to accept their recommendation regarding which test is best.

(1) Depends on the center.  FDG/ammonia or FDG/rubdium are example choices.

(2) This combination requires a separate filter for the photons produced by the thallium (cardiolite).

(3) This is a matter of semantics, but I suppose half-SPECT/half-PET would be a better description.

(4) No head-to-head comparisons have been done with these protocols.  The gold standard at large centers does not involve the use of thallium -- but this may be the protocol of most experience at some centers.

(5) At the CCF, we typically use rubidium and FDG.  The stress agent used is persantine.

(6) I believe all 4 are, but I'm not certain about this point.

Hope that helps.