Cardiac PET: Myocardial Perfusion Imaging- Appropriate Use Criteria
Detection of CAD in the symptomatic patient:
▪️ Evaluation of Ischemic Equivalent (Non-Acute)
▪️ Acute Chest Pain
▪️ Acute chest pain (rest imaging only )
Risk Assessment: Preoperative Evaluation for Non-Cardiac Surgery without Active Cardiac Conditions*
▪️ Intermediate-Risk Surgery
▪️ Vascular Surgery
Detection of CAD/Risk Assessment without Ischemic Equivalent
▪️ Asymptomatic- High CHD Risk (ATP III Risk Criteria)
▪️ New-Onset or Newly diagnosed Heart Failure with LV Systolic Dysfunction without Ischemic Equivalent
▪️ Ventricular Tachychardia
▪️ Syncope with Intermediate or High CHD risk (ATP III Risk Criteria)
▪️ Troponin elevation without additional evidence of acute coronary syndrome
Risk Assessment: Within 3 months of an Acute Coronary Syndrome
1. STEMI
2. UA/NSTEMI
3. Risk Assessement: Post Revascularization (PCI or CABG)
▫️ Symptomatic
▫️ Asymptomatic- Incomplete Revascularization or greater than or equal to 5 years post CABG
Assessment of Viability/Ischemia
▪️ Ischemic Cardiomyopathy
▪️ Assessment of Viability for patient eligible for revascularization.
Evaluation of Left Ventricular Function
▪️ In absence of recent reliable diagnostic information from another imaging modality
▪️ Baseline and serial measures after key therapeutic milestones or evidence of toxicity from potentially cardiotoxic therapy
Risk Assessment with prior test results and/or known chronic stable CAD
▪️ Equivocal, borderline or discordant stress testing where obstructive CAD remains a concern. An inconclusive test is a test(s) whose results are equivocal, technically uninterpretable, or discordant with a patient’s other clinical data
▪️ New or worsening symptoms- Abnormal coronary angiography OR abnormal prior stress imaging study
▪️ Coronary stenosis or anatomic abnormality of uncertain significance
▪️ Asymptomatic, High CHD risk, Agatston score between 100-400
▪️ Asymptomatic, Agatston score greater than 400
▪️ Asymptomatic, Intermediate-Risk Duke Treadmill Score
▪️ Asymptomatic, High-Risk Duke Treadmill Score
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