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How Cardiac PET Helps Women

For too long, women's heart symptoms have been dismissed, minimized, or misdiagnosed. Cardiac PET is changing that by finding what every other imaging test misses.

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THE DIAGNOSTIC GAP

Ischemic Heart Disease Looks Different in Women

Obstructive or flow-limiting coronary artery disease of the major epicardial arteries (the large arteries that run along the outer surface of the heart) is more common in men. Women are disproportionately affected by coronary microvascular disease (CMD), a condition that affects the small vessels of the heart rather than the large ones.

The problem is that commonly performed stress tests—including exercise stress tests and SPECT nuclear stress tests—are best suited to detect blockages of the large arteries. When a woman with CMD undergoes one of these tests, the results often come back normal or non-diagnostic, even when something is seriously wrong.

She's told her heart is fine. She's told her chest pain is anxiety. She goes home without answers, or alternatively, undergoes an invasive coronary angiogram, a procedure that comes with risks and additional financial cost. The result is a diagnostic gap with very real stakes.

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.

SPECT misses 81% of high-risk cases that cardiac PET identifies, with women disproportionately represented in that diagnostic gap.

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 →



Patel FS, et al. Reclassification of Severe Ischemia on PET Versus SPECT MPI Using a Same-Patient Simultaneous Imaging Protocol. JACC Cardiovascular Imaging. 2022;15(6):1158–1159. PMID: 35680222. View Study →



Luu JM, et al. Long-Term Adverse Outcomes in Black Women With Ischemia and No Obstructive Coronary Artery Disease: A Study of the WISE Cohort. Circulation. 2023;147:617–619. PMID: 36780383. View Study →

WHY CARDIAC PET IS DIFFERENT

A Test Built for the Full Picture

In addition to myocardial perfusion imaging, Cardiac PET measures myocardial blood flow: how well blood moves through both the large and small vessels of the heart. That means it can detect CMD that exercise stress tests, echocardiograms, and traditional SPECT nuclear imaging cannot diagnose.

The gap in detection is significant.

In a prospective head-to-head study, SPECT missed 81% of high-risk cases that PET identified. Among patients with severe ischemia on PET who had obstructive disease and may have benefited from intervention, nearly three in four had less-than-severe ischemia on SPECT.

Cardiac PET also uses significantly less radiation than SPECT nuclear imaging (approximately 3–4 mSv compared to 7–15 mSv with SPECT), making it a safer test.

For women who have spent years being told nothing is wrong, cardiac PET can be the first test that finally provides an answer and a path to treatment.

Sources:

Patel FS, et al. Reclassification of Severe Ischemia on PET Versus SPECT MPI Using a Same-Patient Simultaneous Imaging Protocol. JACC Cardiovascular Imaging. 2022;15(6):1158–1159. PMID: 35680222. View Study →

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 →

How Cardiac PET Has Helped Women

Dr. Toniya Singh

St. Louis Heart and Vascular

Invasive Cardiologist

"Once you join The Cardiac PET Alliance and start doing Cardiac PET, there's no going back."

Dr. Lauren Frost

Mycardiologist

Non-Invasive Cardiologist

"PET Imaging Stress Test has revolutionized the way we read and diagnose patients with coronary disease."