Cardiovascular Nuclear Medicine

Cardiovascular nuclear medicine, a subspecialty of nuclear medicine and cardiology, uses noninvasive techniques to assess blood flow, evaluate heart function, determine the extent and location of a heart attack, assess inflammation within the heart muscle and vessels, and investigate potential infection in the heart. Images are produced by injecting small amounts of safe chemical tracing agents, called radiotracers. The gamma rays emitted by the radiotracers in the heart are scanned by single photon emission tomography (SPECT) or positron emission tomography (PET) scanners. Nuclear cardiology imaging may be performed at rest, during physical exercise, or during medication-induced (pharmacological) stress.

Brigham and Women’s Hospital (BWH) offers one of the few multidisciplinary cardiovascular imaging programs in the country that includes cardiologists, radiologists, and other imaging experts. The BWH Cardiovascular Imaging Program combines the treatment, education, and research expertise of multiple disciplines – cardiology, radiology, nuclear medicine, molecular biology, medical physics, and chemistry – and incorporates the use of all available imaging types, including echocardiography, cardiac CT, cardiac MRI, nuclear cardiology, PET/CT, CT/MRI, and ultrasound.

Our patients with heart and vascular conditions have access to top specialists throughout the fields of cardiovascular medicine, cardiac surgery, cardiac imaging, vascular surgery, and cardiac anesthesia. These physicians practice at the BWH Heart & Vascular Center, consistently ranked as one of the top 10 “Cardiology & Heart Surgery” providers in U.S. News and World Report’s annual “America’s Best Hospitals” survey.

Cardiovascular Nuclear Medicine

Why Have Cardiovascular Nuclear Medicine Tests?

Cardiovascular nuclear medicine tests are usually performed in patients with known heart disease or symptoms suggestive of heart disease. With cardiovascular nuclear medicine, we can study: blood flow to the heart muscle in individuals with symptoms suggestive of heart disease; damage to the heart muscle from a heart attack; the pumping function of the heart muscle; the presence and severity of inflammation in the heart muscle and vessels; infection of the heart valves or devices (pacemakers, defribillators); and the presence and severity of amyloid infiltration in the heart.

Cardiovascular Nuclear Medicine Tests

Cardiovascular nuclear medicine imaging may be performed after exercise or pharmacological stress, or while at rest. An exercise stress test is performed with physical exercise on a treadmill (most common) or a bicycle. In individuals who are unable to exercise adequately, we induce stress by using a medication (pharmacological stress test).

There are two main types of nuclear cardiology imaging tests – single-photon emission computed tomography (SPECT) and positron emission tomography (PET) scans. Both of these tests can provide information about blood flow to the heart muscle at rest and during stress, assess damage to the heart muscle from a prior heart attack, and provide information about the pumping function of the heart.

Myocardial Perfusion Scan

This test is used to assess the blood supply to the heart muscle and for detecting coronary artery disease. The test can be performed with a SPECT or PET/CT scanner.

At Brigham and Women’s Hospital, we offer state-of-the-art SPECT imaging with two types of scanners:

  • DSPECT: This open scanner images patients while they are sitting upright on a chair. It is well-suited for individuals who are claustrophobic.
  • SPECT/CT: This newer-generation technology combines a SPECT scanner with a CT scanner.  The CT functionality is used to measure soft tissue density and improve image quality.

Likewise, we perform PET imaging with state-of-the-art PET/CT scanners. A PET scan is performed for the same reasons as a SPECT scan. However, a PET scan may be a better test for individuals who are large or unable to perform physical exercise.

Other Cardiovascular Nuclear Medicine Tests

Fluorodeoxyglucose (FDG) positron emission tomography (PET) cardiology viability imaging is used in patients with known heart disease or those who have had a heart attack. The test assesses the level of heart muscle damage by injecting glucose (sugar) into the heart and then determining which areas of the heart are using the glucose. Damaged heart muscle will not use glucose, while healthy (or recovering) heart muscle will.

Cardiac sarcoid FDG PET imaging is used in individuals with known or suspected sarcoidosis, an autoimmune disease that can cause inflammation and arrhythmias. This test helps to detect areas of sarcoid inflammation.

MUGA (Multigated acquisition) scan is used to study the pumping function of the heart. It is generally used in patients with known heart disease or in those without heart disease, but undergoing cancer treatment that can weaken the heart’s pumping function.

Pyrophosphate imaging is used to assess the presence of amyloid in the heart. This test helps to differentiate the different types of amyloid in the heart.

What You Should Expect

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of cardiovascular services in one location, fostering seamless and coordinated care for all patients.

Prior to your imaging procedure, you will check in at the Cardiovascular Imaging Center in the Shapiro Cardiovascular Center. During your procedure, family and friends can wait in the Shapiro Family Center.

Multidisciplinary Care

In addition to our cardiovascular imaging experts, patients also benefit from the teamwork of cardiologists, interventional cardiologists, cardiac surgeons, cardiac electrophysiologists, and anesthesiologists, all experts in cardiovascular disorders. These specialists work alongside nurses, physician assistants, physical therapists, dietitians, and social workers to achieve better outcomes for patients.

Resources

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families.

Access a complete directory of patient and family services.

Learn about the Watkins Clinic in the Shapiro Cardiovascular Center.

LEARN MORE ABOUT BRIGHAM AND WOMEN’S HOSPITAL


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