Mississippi’s Only PET/CT Scanning Technology Reveals Superior Cardiac Imaging

Since Baptist Medical Center became Mississippi’s first hospital to use PET/CT scanning technology for cardiac imaging last August, more than 400 cardiac tests have been done with the specialized imaging system, which fuses Positron Emission Tomography (PET) and Computerized Tomography (CT) into a single unit, revealing blood flow and disease in coronary arteries.

For cardiologists, viewing much clearer images produced by the PET/CT scan is the difference between “watching a football game on a fuzzy TV versus high-def,” describes Alfredo Figueroa, MD, director of cardiovascular nuclear medicine for Baptist Health Systems.

“The PET/CT is definitely a superior exam in terms of imaging the heart by comparison to the cardiac stress test, which has been the traditional test for imaging the heart,” he explained. “It makes it possible to interpret the data much more quickly to determine the best option for treatment.”

Testing via PET/CT scanning technology is considered the best noninvasive method of providing superior images for accurate diagnosis of coronary artery disease and heart function. For patients, the process translates to an expedited procedure. Instead of three hours required for cardiac SPECT stress testing, often spread over two consecutive days, the PET/CT method takes only 30 to 45 minutes.

The move to performing cardiac PET/CT scans began in September 2009, when Al Padgett, BSRT, director of radiology for Baptist Health Systems, alerted cardiologists of a looming global shortage of the radioisotope, molybdenum-99, the parent radioisotope of technedium-99, which is used in Single Photon Emission Computed Tomography (SPECT) cardiac stress testing. In anticipation of the supply deficit, global researchers had begun seeking alternatives for nuclear-produced medical isotopes.

“There are two nuclear reactors in the world—one in Canada, another in the Netherlands—that produce the bulk of molybdenum-99,” Padgett pointed out. “The one in Canada went down first, and then the other, creating a significant shortage in the supply of molybdenum-99, which led to the shortage of technedium-99. We felt that with the shortage, it would probably create the need for more patients going to the cardiac PET/CT testing because a different radioisotope is used—rubidium-82.”

Because PET/CT scans use the traceable isotope to light up organs or areas of disease, it’s considered more accurate and safer because it exposes patients to less radiation.

When the isotope shortage began making an impact, Judy Henderson, RN, director of cardiovascular diagnostics for Baptist Health Systems, began exploring options. A team of administrators and clinical professionals agreed that having a PET/CT scanner was the optimal choice. Already, oncology and cardiology patients were sharing the SPECT scanning equipment.

“If the hospital upgraded the existing machine to PET/CT specifics, which we had determined could be done, we could only squeeze in two cardiac patients a day because the SPECT scanner was already at maximum capacity with oncology patients,” Henderson said.  “After analysis, we decided that oncology patients could benefit from a newer, faster scanner, so we acquired one for oncology and upgraded the existing one for cardiology PETs.”

With a carefully crafted phased-in approach, and no disruption in patient service for cardiac or oncology patients, the scanners were adjusted. With the additional scanner, Baptist can test 16 cardiology patients in an eight-hour day. Also, the PET/CT scanner fills a niche for obese patients and patients with large breasts needing cardiac imaging tests.

“The PET/CT scan produces a much clearer image penetrating tissue through the chest to see the heart,” explained Figueroa.

Jackson Heart Clinic cardiologist James L. Warnock, Jr., MD, was the first physician to access Baptist’s PET/CT scan. Fittingly, the first patient was a fellow physician, James Lampton Burkhalter, MD, of the Radiological Group in Jackson.

“The ability to do cardiac PET/CT scans for cardiac/coronary evaluation expands the number and types of patients that can be evaluated noninvasively,” noted Burkhalter. “As an imager/radiologist, one always wants to be able to be as definitive about the exam conclusions as possible. This modality allows that, especially in patients that have been challenging for the other types of nuclear heart scans, such as large body types.  As a patient, additional benefits seen are the relatively short exam time and being able to do both the exam at rest and pharmacologic ‘exercise’ within a very short time period.  To have a state-of-the-art modality available to the central Mississippi area is such a blessing.”

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