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How Cardiac PET Reaches Rural Communities

Living far from a major medical center shouldn't determine the quality of your cardiac care. Cardiac PET is coming to patients who need it most, no matter where they live.

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The diagnostic gap

Distance Shouldn’t Determine a Diagnosis

For patients in rural and underserved communities, advanced cardiac care has long meant one thing: a long drive or going without.

Rural counties have higher cardiovascular mortality than urban ones, and significantly fewer cardiologists per capita. When specialized cardiac imaging isn't available locally, patients face an impossible choice: travel hours for a test or skip it entirely. Many skip it. And for those living with undetected coronary microvascular disease, that decision can be life-altering.

EKG, Echocardiography, exercise stress testing, and SPECT nuclear stress testing (the types of cardiac testing most commonly available in rural areas) cannot fully detect and evaluate all forms of cardiovascular disease, including blockages of the major coronary arteries and coronary microvascular disease, a condition that disproportionately affects women and Blacks. For rural patients, that diagnostic gap is compounded by distance.

The gap in what standard coronary artery disease testing misses is significant.

In a prospective head-to-head study, SPECT missed 81% of high-risk cases that cardiac PET identified. Among patients with severe ischemia on PET and obstructive disease who may have benefited from revascularization, nearly three in four had less-than-severe ischemia on SPECT. For rural patients who already face barriers to testing and follow-up care, an inaccurate first result carries especially high stakes.

46.3% of US counties, home to 22 million residents, have no practicing cardiologist.

86.2% of rural counties have no cardiologist at all.

Counties without cardiologists have a 31% higher cardiovascular risk index and one year shorter life expectancy on average.

Rural counties have higher cardiovascular mortality than urban counties and fewer cardiologists per capita.

CMD accounts for 30–50% of the burden of ischemic heart disease.

Undiagnosed CMD is associated with up to a 5-fold increase in major cardiac events when left untreated.

Kim JH, et al. Geographic Disparities in Access to Cardiologists in the United States. Journal of the American College of Cardiology. 2024;84(3):315–316. PMID: 38986673. View Study →



Pierce JB, et al. Rural/Urban Disparities in Cardiovascular Disease in the US — What Can be Done to Improve Outcomes for Rural Americans? American Journal of Cardiology. 2025;248:10–15. PMID: 40185220. View Study →



Del Buono MG, et al. Coronary Microvascular Dysfunction Across the Spectrum of Cardiovascular Diseases: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2021;78(13):1352–1371. PMID: 34556322. View Study →

WHY CARDIAC PET IS DIFFERENT

Advanced Care That Comes to Patients

Mobile cardiac PET/CT units are changing what's possible for rural patients. These fully equipped imaging units travel directly to communities that would otherwise have no access to advanced cardiac diagnostics, bringing the same technology available at major medical centers to patients who would otherwise have to drive hours or skip the test entirely.

Cardiac PET measures myocardial blood flow, detecting coronary microvascular disease that standard imaging cannot see. It also uses significantly less radiation than standard nuclear imaging (approximately 3–4 mSv compared to 7–15 mSv with SPECT), making it a safer option for patients.

And the cost picture matters for rural health systems, too. In one study, patients who underwent cardiac PET had 50% fewer invasive coronary procedures than those who received SPECT. In this study, the use of PET was associated with 30% lower costs.

For rural patients, mobile cardiac PET affords access to the best form of myocardial perfusion stress testing for diagnosing coronary artery disease.

Alam L, et al. Improved Performance of PET Myocardial Perfusion Imaging Compared to SPECT in the Evaluation of Suspected CAD. Current Cardiology Reports. 2023;25:281–293. PMID: 36826689. View Study →

Merhige ME, et al. Impact of myocardial perfusion imaging with PET and (82)Rb on downstream invasive procedure utilization, costs, and outcomes in coronary disease management. Journal of Nuclear Medicine. 2007. PMID: 17607038. View Study →