Cardiology Indications for PET Scans

(See sidebar for Cardiac FDG PET Requisition Form.)

Indication: PET for myocardial viability assessment

Eligibility criteria

PET in a patient being considered for cardiac revascularization, cardiac transplantation, or other cardiac procedures with either: moderate to severe ischemic left ventricular dysfunction (left ventricular ejection fraction of 40% or less) despite maximal therapy; OR moderate to severe persistent perfusion abnormality without significant (moderate or severe) ischemia.

(See sidebar for Cardiac FDG PET Requisition Form.)

Indication: PET for biopsy proven or clinical diagnosis of pulmonary/system sarcoidosis

Eligibility criteria 

Patients with biopsy proven or clinical diagnosis of pulmonary or systemic sarcoidosis, with cardiac MRI suggestive for cardiac sarcoidosis, to screen for cardiac involvement

Indication: PET for unexplained high grade conduction system disease in patients ≤70 years of age

Eligibility criteria 

Patients (age ≤70 years) presenting with unexplained significant conduction system disease (defined as high grade Mobitz II 2^nd degree or 3^rd degree AV block), to screen for cardiac sarcoidosis as underlying etiology

Indication: PET for response to treatment in patients with known cardiac sarcoidosis

Eligibility criteria 

Patients with proven cardiac sarcoidosis (with a positive baseline FDG PET scan) to assess response to treatment when considering a change in treatment, or to assess for disease relapse. A maximum of 3 follow-up scans may be booked up to 3 years post initial diagnostic FDG PET scan.

Note: for patients who do not meet the above cardiac sarcoidosis indications, apply for a PET scan through the Cardiac Special Access Program using the Cardiac Special Access Program FDG PET Requisition Form

(See sidebar for Cardiac Special Access Program FDG PET Requisition Form and Eligibility Criteria.)

Indication: PET for the diagnosis and clinical management of patients with unexplained cardiomyopathy and associated ventricular tachycardia or fibrillation

(See sidebar for Cardiac Special Access Program FDG PET Requisition Form and Eligibility Criteria.)

Indication: PET for the diagnosis and clinical management of patients with suspected infection of pacemaker, ICD, CRT, or left ventricular assist devices (LVAD) where there is a high clinical suspicion and/or laboratory evidence of infection

(See sidebar for Cardiac Special Access Program FDG PET Requisition Form and Eligibility Criteria.)

Indication: PET for the diagnosis and clinical management of patients where, using modified Duke criteria there is a high clinical suspicion and/or laboratory evidence of infection.

(See sidebar for Cardiac Special Access Program FDG PET Requisition Form and Eligibility Criteria.)

Indication: PET for the diagnosis and clinical management of patients where there is a high clinical suspicion and/or laboratory evidence of myocarditis

(See sidebar for Cardiac Special Access Program FDG PET Requisition Form and Eligibility Criteria.)

Indication: PET for the diagnosis and clinical management of patients where there is a high clinical suspicion or lab evidence of pericarditis

(See sidebar for Cardiac Special Access Program FDG PET Requisition Form and Eligibility Criteria.)

Indication: PET for the diagnosis and determination of clinical management of patients where there is a high clinical suspicion and/or laboratory evidence of vasculitis/aortitis

(See sidebar for Cardiac Special Access Program FDG PET Requisition Form and Eligibility Criteria.)

Compelling evidence may be submitted via the Cardiac PET Special Access Program.

Eligibility criteria

• Stress PET for the assessment of patients with known or suspected coronary artery disease (CAD) with an intermediate (10% to 90%) pre-test likelihood of significant ischemia secondary to coronary stenosis where:

• there is a high likelihood of attenuation artifact with SPECT imaging OR
• a high degree of functional accuracy or quantitative flow measurements is required OR
• functional imaging is required and a low radiation dose is preferable (such as younger patients) OR
• the results of prior non-invasive imaging are equivocal or inconclusive OR
• in patients with known CAD where the need for intervention is uncertain

• Quantitative PET flow imaging may be particularly helpful when there is a need for absolute MBF measurements, such as:

• patients without known CAD who present with symptoms suspect for ischemia
• patients with known CAD, where specific physiological assessment is desired
• identifying patients with an increased suspicion for multivessel CAD
• to assess possible microvascular dysfunction
• heart transplant patients when there is a question of vasculopathy

Locations

Current locations for PET scans for this indication

PET CENTRE LOCATION	PHONE NUMBER	STATUS
University of Ottawa Heart Institute	613-696-7000 ext. 14809	Active
St. Joseph’s Health Care in Hamilton	905-522-1155 ext. 32746	Active
University Health Network	416-946-4501 ext. 3172	Active