In the U.S., the use of myocardial perfusion positron emission tomography (PET) is underutilized as a noninvasive cardiac imaging option for patients with coronary artery disease, according to a position statement from the American Society of Nuclear Cardiology (ASNC) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI).

The ASNC and SNMMI published the statement as well as updated guidelines on myocardial perfusion PET online in The Journal of Nuclear Cardiology on Aug. 19. They noted that myocardial perfusion PET had high diagnostic accuracy, high-quality images, low radiation exposure, short acquisition protocols, quantification of myocardial blood flow and strong prognostic power.

After reviewing the available literature, the societies said that rest-stress myocardial perfusion PET was a first-line preferred test for patients with known or suspected coronary artery disease who meet the criteria for stress imaging and are unable to complete the diagnostic level exercise stress imaging study.

They also recommended myocardial perfusion PET for patients who meet the criteria for stress imaging and one or more of the following clinical situations: poor quality, equivocal, or inconclusive prior stress-imaging study; patients with certain body characteristics that commonly affect image quality; higher-risk patients; younger patients to minimize accumulated life-time radiation exposure; or when myocardial blood flow quantification is identified by clinicians to be a needed adjunct to the image findings.

“For diagnosing coronary artery disease, myocardial perfusion PET imaging out performs other tests because of its high diagnostic accuracy, low radiation exposure, short image acquisition time and its ability to accommodate ill or high-risk patients and those with large body habitus,” Vasken Dilsizian, MD, lead author of the guideline, said in a news release.