Module 13a. Low Dose CT with Cardiac PET Perfusion-Low Dose CT with Cardiac PET Perfusion (Slides)

Low Dose CT with Cardiac PET Perfusion (Slides)

Pdf Summary

Module 13a of the PET Perfusion Imaging course covers the topic of low dose CT with cardiac PET perfusion. The module aims to help participants understand the differences between CT and Line Source PET attenuation and the diagnostic content of the relevant attenuation maps. It also focuses on the value of visually estimated coronary artery calcium scoring and the limitations of low dose CT attenuation maps.<br /><br />The module discusses various aspects such as introduction to low dose CT with PET, acquisition techniques, processing, and quality control. It covers what to interpret from the CT attenuation maps, including coronary calcium and common cardiovascular findings. Limitations of non-diagnostic CT are also discussed.<br /><br />Cardiac PET is commonly performed on a dedicated PET scanner or a hybrid PET-CT scanner. Attenuation correction is utilized in both cases, with a PET source used for attenuation correction in dedicated PET scanners and a CT source used in hybrid PET-CT scanners. A low dose attenuation map is sufficient for the purpose of cardiac PET studies, and radiation dose should be kept as low as reasonably achievable (ALARA).<br /><br />The module also provides information about the different CPT codes and reimbursements for cardiac PET studies performed on PET-CT scanners compared to those performed on dedicated PET scanners.<br /><br />It emphasizes the importance of acquiring CT attenuation maps in a low dose setting and inspecting them for diagnostic content. The maps can provide useful information, such as identifying large pleural effusions, hiatal hernias, and lung cancers. Quality control and proper registration of the emission/transmission images, as well as inspection for coronary and thoracic aortic calcifications, are recommended.<br /><br />The module highlights the importance of combining coronary artery calcium scoring with MPI for improved diagnostic and prognostic value. Inspecting coronary artery calcifications on the CT attenuation map can enhance the accuracy of MPI studies. It also mentions the association between the absence of coronary artery calcium and very low risk of cardiac events.<br /><br />Various clinical findings that can be identified on low dose CT attenuation maps are discussed, including coronary and thoracic aortic calcifications, aortic aneurysms, pericardial effusions/calcifications, pleural effusions, lung masses, breast masses, and lung and interstitial lung diseases.<br /><br />The module concludes by emphasizing the need for a systematic approach to interpreting CT findings, mentioning that the CT review should be mentioned in the study summary/conclusion of the report. The billing codes for cardiac PET-CT studies include the review of the CT attenuation map, and relevant CT findings should be mentioned in the report.<br /><br />Overall, the module provides comprehensive information about low dose CT with cardiac PET perfusion, its benefits, limitations, and key considerations for interpretation and reporting.

Keywords

PET Perfusion Imaging

low dose CT

cardiac PET perfusion

CT attenuation maps

coronary artery calcium scoring

acquisition techniques

processing

quality control

CPT codes

reimbursements