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February 2010 Issue

UC Health University Hospital offers PET-ammonia cardiac imaging tests.
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University Hospital Among First to Offer Cardiac Imaging Test

By Amanda Harper
Published February 2010

UC Health University Hospital is among the first in the region to offer an innovative cardiac imaging test that results in more accurate diagnosis of coronary artery disease and fewer unnecessary invasive tests and surgical procedures.

Led by nuclear medicine division chief Mariano Fernandez-Ulloa, MD, the University Hospital-based team began offering ammonia-guided positron emission testing (PET) cardiac perfusion scans in October 2009.

Fernandez-Ulloa expects to utilize the testing technique routinely in targeted patients moving forward.
The nuclear medicine imaging test combines targeted PET scanning technology with a trace amount of radioactive ammonia injected through the patient’s vein. This allows physicians to take pictures of blood flow in a patient’s heart muscle when at rest and during medically induced stress.

The test takes about two hours, less than half the time of traditional perfusion imaging tests.

Cardiologist Myron Gerson, MD, says there are multiple advantages to ammonia-PET scans, including the availability of higher resolution images that are easier to interpret compared to standard methods.

“With traditional perfusion imaging tests, the only way we can determine whether a specific area of the heart is receiving sufficient blood flow is to compare it to a normal area of the heart. This does not work well when all the walls of the heart are receiving reduced blood flow,” says Gerson, a cardiologist with UC Health University of Cincinnati Physicians and professor of medicine at the UC College of Medicine.

Ammonia-PET scanning allows physicians to measure what is known as “absolute blood flow,” a precise calculation of the blood volume within the heart muscle per unit of time and muscle mass. The measurement can help pinpoint specific areas of compromised blood flow and identify patients with more severe disease.

“This is very beneficial for coronary artery disease treatment planning and can result in the patient avoiding unnecessary invasive cardiac catheterization procedures as well as major heart surgery,” adds Fernandez-Ulloa, a nuclear medicine physician with University of Cincinnati Physicians and radiology professor at the College of Medicine.

Ammonia-PET scanning is also helpful in diagnosing small vessel heart disease, a condition commonly linked to sporadic chest pain that often goes undetected on standard heart (myocardial) perfusion tests.
Gerson and Fernandez-Ulloa hold elite qualifications in nuclear medicine from the Certification Board in Nuclear Cardiology.

This certification recognizes physicians who have demonstrated knowledge and skills in their respective fields by documenting appropriate training and/or experience and successfully passing a computer-based examination.

For more information about ammonia-PET imaging tests, call (513) 584-1335. To schedule an appointment at University Hos-pital, call (513) 584-TEST.

The procedure is covered by the Centers for Medicare and Medicaid Services, as well as most private insurance companies.

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