Cardiac nuclear imaging

"Nuclear stress tests" have been developed to provide perfusion data in a broader spectrum of patients. The most longstanding of these is single photon emission computed tomography (SPECT), which uses a radioactive tracer and gamma camera to obtain images. Positron emission tomography (PET) scanners are also used with a radiotracer, and are felt by some to provide better image resolution in heavier patients and those with dense breast tissue. Additionally, combination modalities, originally developed for cancer detection and imaging, have also been applied to cardiac imaging to provide both perfusion and anatomic data (e.g., PET/CT, SPECT/CT) and/or to compare perfusion measurement methods (e.g., PET/MRI).

Status: Decision completed

Why is cardiac nuclear imaging being reviewed?

The above tests differ in terms of their diagnostic accuracy, cost, availability, and impact on downstream testing, potential to harm, and other relative advantages and disadvantages. There is therefore significant benefit in conducting a comprehensive evaluation of the evidence on the comparative clinical effectiveness and comparative value of nuclear myocardial perfusion tests.

Primary criteria ranking

  • Safety = Medium
  • Efficacy = Medium
  • Cost = High

Documentation

Assessment timeline

  • Draft key questions published: March 21, 2013
    • Public comment period: March 21 to April 8, 2012
  • Draft report published: June 24, 2013
    • Public comment period: June 24 to July 22, 2013
  • Final report published: August 19, 2013
  • HTCC public meeting: September 20, 2013