PET and the Heart / Explanation of PET
Coronary Heart Disease
Coronary Heart Disease, the most common form of heart disease in this country and the primary cause of heart attacks, is the single largest killer of American men and women. Coronary Heart Disease occurs when the arteries carrying blood to the heart are blocked. Every 30 seconds, an American suffers a heart attack because of such a blockage, and 40 percent die within a year. More than 12 million Americans have been diagnosed with the disease and many more, an estimated 25% of the middle-aged population, are unaware of their illness until they succumb to an attack. In the U.S., coronary heart disease accounts for one-third of all deaths each year.
Positron Emission Tomography (PET) diagnoses heart disease non-invasively with 96-98% accuracy in individuals with or without symptoms of heart disease, permitting treatment even before symptoms appear. Furthermore, at our center, PET can help streamline efficient treatment of coronary heart disease, using quantitative coronary flow software to determine when invasive procedures such as stents or bypass surgery are absolutely necessary.
What is PET?
A cardiac PET scan is a type of stress test in which blood flow to the heart muscle is visualized with a radiotracer and a special scanner. PET provides an accurate non-invasive assessment of the coronary arteries. Pictures of the myocardial blood flow are taken before and after pharmacologic stress instead of exercise to determine if maximum blood flow is restricted by narrowing of the coronary arteries.
Why do a PET scan?
Since its diagnostic accuracy is much higher than standard tests at comparable cost per study, PET reduces expense and risk by avoiding unnecessary tests and procedures, thereby providing more efficient diagnoses. PET can be an alternative to invasive tests such as cardiac catheterization, in which a thin tube is threaded to the coronary arteries through an artery in the leg and X-ray pictures are taken after dye is injected into the heart. Even after an angiogram, PET can determine when a blockage is significant and a stent or coronary bypass surgery is necessary or whether medical management might be a better option.
There are 4 main reasons to have a cardiac PET scan:
- To be screened for early heart disease in patients who have no symptoms or have chest discomfort and have high cholesterol levels or a strong family history of heart disease.
- To check on the status of the coronary arteries in patients who have known coronary artery disease or who want to check on the progress of reversal treatment or other interventions (every 3-5 years or sooner if new symptoms develop).
- To determine the need for a coronary stent or coronary bypass surgery when blockages are found on an angiogram.
- To check on the viability of the heart muscle. If a large amount of heart tissue is scarred because of a heart attack, the heart will not pump well. The amount of damage and percentage of the heart affected will help doctors determine appropriate treatment including whether or not bypass surgery will be helpful.
How is a PET scan done?
The PET scan is a non-invasive outpatient test that is performed at the Weatherhead PET Imaging Center in Memorial Hermann Hospital. After a brief interview with a registered nurse, the patient is positioned in the donut-shaped camera while pictures of the heart are taken at rest and under a medication induced stress condition. The test itself takes about 1½ hours. Patients referred by their private physician will be released and a full report of the results will be sent to their physician.
For an additional consultation fee, or for self-referred patients, the visit will include a detailed medical evaluation, review of the PET results, review of any other medical data brought in, and review of potential treatment needed by medical director K. Lance Gould, MD. If the consultation is included, the complete visit will take approximately 3 hours.
How do PET scans differ from other tests?
Clinical studies have shown that PET scans are more accurate than other widely used tests such as ECG (electrocardiogram), treadmill testing and standard nuclear stress tests such as SPECT (single photon emission computed tomography). These tests are associated with “false positive” and “false negative” results. False positives are results that show coronary heart disease where none really exists. False positives can lead to people undergoing unnecessary invasive procedures. Because PET scans are so accurate, they are often used to confirm other tests if a false positive or false negative is suspected. “False negatives” are normal results when coronary heart disease really exists. False negatives can lead to undetected heart disease.
Heart Scans (Fast CT) can detect the presence of calcium in the coronary arteries but can’t tell you if the calcium is affecting blood flow in the arteries. PET gives you both; information on the presence of calcium and an accurate quantitative measurement of the blood flow in the coronary arteries.
Medical Insurance Coverage
A PET Scan can be ordered by your physician and billed to insurance.
The ordering physician should send an order for the PET along with patient insurance information. The ordering physician who has the patient’s medical history should do pre-authorization. Orders should be faxed to 713-500-6615 and our office will contact the patient to schedule and review the financial coverage. A full report will be sent to the ordering physician. The Weatherhead PET Center has contracts with the following insurance companies:
- Blue Cross – HMO, PPO, Traditional
- United Healthcare
- Cigna (MedSolutions)
Our billing office will let you know if any payment is due before your appointment is scheduled. Patients will be responsible for their deductible and for the remainder of the charges not reimbursed by insurance. (Not to exceed the insurance allowable charge).