The Role of Nuclear Cardiology in Heart Disease

Taylor Rhoades

Heart disease is the leading cause of death in the United States. During the past two decades, we have made great strides in the diagnosis and treatment of heart disease and nuclear cardiology has played a pivotal role. 

Nuclear cardiology is special technology that provides imaging of the heart and its function.  It can be used to assess heart blood flow, evaluate the pumping function of the heart, and visualize the size and location of a heart attack.

One of the most widely used procedures in nuclear cardiology is Myocardial Perfusion Imaging (MPI).  This study can identify areas of the heart muscle that have an insufficient blood supply. It can also detect areas of heart muscle that are scarred from a heart attack.

MPI combined with exercise assess the blood flow to the heart muscle. This test is often performed with the patient walking on a treadmill. However, in patients who are not able to use the treadmill, a “chemical” stress test can be used to simulate exercise and provide similar information about the heart’s blood flow.

During MPI, a small amount of an imaging agent is injected into the blood stream. A special camera then uses something called SPECT imaging to measure the heart’s uptake of the imaging agent during exercise and when at rest. If there is significant blockage of a coronary artery, the heart muscle may not get enough blood when under stress. That decrease in blood flow is visible in the images.

MPI is superior to routine exercise stress testing and provides vital information that allows us to identify which patients are at an increased risk for a heart attack. These patients may be candidates for other procedures for heart disease, such as coronary angiography, angioplasty and heart surgery.

Advances in Nuclear Cardiology

Imaging studies expose patients to radiation. However, advances in the technology involving the gamma cameras has allowed next-generation SPECT cameras to decrease patient radiation dose and even shorten exam times. Some exams have decreased from 25 minutes to less than 10 minutes of acquisition time, making it a better and safer experience.

Additionally, SPECT has been combined with CT on these next-generation systems to allow for what is known as “hybrid imaging.” The hybrid imaging allows the CT to provide anatomy overlay, so reading physicians can visualize the coronary anatomy and better pinpoint where blockages causing perfusion defects are located. This will help in providing a better diagnosis, as well as prognosis, for patients with heart disease.

First in the nation

All these advances in technology are available at The Miriam Hospital and Rhode Island Hospital. In fact, in April of 2018, The Miriam Hospital became home to the first and only globally installed GE Discovery 860 unit. As a result, The Miriam Hospital has become a National Show Site for GE, which invites other health care facilities across the nation to witness the advancement in the field of nuclear cardiology.

Nuclear cardiology is part of our cardiovascular testing and diagnostics. Learn more about this technology and our department here.

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