Economic analysis of clinical positron emission tomography of the heart with rubidium-82

Journal Article · Mon May 01 00:00:00 EDT 1989 · J. Nucl. Med.; (United States)

OSTI ID:5964461

Gould, K L; Goldstein, R A; Mullani, N A

This report describes a cost analysis for clinical positron emission tomography (PET) of the heart using generator produced rubidium-82 (/sup 82/Rb). Considered sequentially are the clinical problem, current noninvasive radionuclide methods, positron emission tomograph, and the cost of PET per study. Also analyzed are the costs of PET versus thallium imaging in the management of chest pain, for screening asymptomatic men at high risk for coronary artery disease and for evaluating myocardial viability after myocardial infarction or thrombolytic therapy. Noninvasive assessment of coronary artery stenosis and myocardial ischemia/viability in symptomatic or asymptomatic subjects remains a major medical problem because the sensitivity and specificity of thallium imaging are only 70-85% and 50-70%, respectively, in recent studies. Cardiac positron imaging has an accuracy for noninvasive diagnosis of coronary artery disease in symptomatic or asymptomatic patients with a sensitivity and specificity of 95-98%. It can also be used for assessing physiologic stenosis severity, for imaging myocardial infarction and viability, for assessing effects of interventions such as thrombolysis, percutaneous transluminal coronary angioplasty (PTCA) or bypass surgery on myocardial perfusion, metabolism or coronary flow reserve, for assessing collateral function noninvasively in man, and for diagnosing cardiomyopathy not due to coronary artery disease. Although the cost for cardiac PET with /sup 82/Rb may be modestly higher than for /sup 201/Tl, the greater diagnostic yield of PET results in comparable or lower overall medical management costs than no diagnostic tests/interventions and lower overall costs compared to thallium imaging for evaluating patients with chest pain, asymptomatic high risk males, and patients after acute myocardial infarction/thrombolysis for myocardial viability.

• Research Organization: Univ. of Texas Health Science Center, Houston (USA)
• OSTI ID: 5964461
• Journal Information: J. Nucl. Med.; (United States), Vol. 30:5
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARDIOVASCULAR DISEASES
DIAGNOSIS
HEART
POSITRON COMPUTED TOMOGRAPHY
COST
PATIENTS
RADIOISOTOPE SCANNING
RUBIDIUM 82
SENSITIVITY ANALYSIS
THALLIUM 201
ALKALI METAL ISOTOPES
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
HEAVY NUCLEI
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ODD-ODD NUCLEI
ORGANS
RADIOISOTOPES
RUBIDIUM ISOTOPES
SECONDS LIVING RADIOISOTOPES
THALLIUM ISOTOPES
TOMOGRAPHY
550601* - Medicine- Unsealed Radionuclides in Diagnostics