Nuclear & Stress Testing Service

The Nuclear Cardiac Imaging program at Yale is a high-volume lab (more than 4000 SPECT, PET and gated blood pool studies per year) that employs state-of-the-art technology to provide critical diagnostic and prognostic information. Our lab performs both inpatient and outpatient stress testing, optimizing the stress protocol and imaging protocol for each patient. In addition, we perform gated blood pool imaging, which we employ in the monitoring of left ventricular function in patients receiving potentially cardiotoxicity chemotherapy and in the evaluation of patients for ICD implantation.

In addition to performing myocardial perfusion imaging and gated blood pool studies, the Nuclear Cardiac Imaging lab at Yale performs PET metabolic imaging studies using fluorodeoxyglucose to evaluate myocardial viability both in patients with severely depressed left ventricular function and in patients with chronic total occlusions to guide surgical and percutaneous revascularization. We also employ metabolic imaging to evaluate cardiac sarcoidosis.

With the increasing attention being focused on reducing radiation exposure, Yale has been a leader in dose reduction. Every stress test is evaluated to determine if resting imaging is required. In addition, the Nuclear Cardiac Imaging lab has high-sensitivity cadmium-zinc-telluride cardiac-specific SPECT cameras that allow for dose reduction while maintaining excellent image quality.

Complementing the clinical excellence of the Nuclear Cardiac Imaging lab, Yale is involved in basic, translational and clinical research in noninvasive imaging. These studies include:

1. A Phase II Study of 99mTc-glucarate in Chest Pain Patients Suspected with Acute Coronary Symptoms (ACS) with No Obvious Signs of Acute Myocardial Infarction (AMI) and with Known Previous Coronary Artery Disease (CAD). Study involves dual isotope 99mTc-glucarate/201Tl imaging of patients presenting to our emergency department and chest pain center (CPC). (PI: A. Sinusas, NHLBI-sponsored)
2. Dynamic 82Rb PET imaging of absolute blood flow in patients post cardiac transplantation to detect early graft vasculopathy and optimization of immunosuppression (PI: A. Sinusas, ASNC-sponsored fellowship, A. Srivastava)
3. Regadenoson stress first pass and SPECT perfusion imaging in comparison with 3D echocardiography in patients at high risk for CAD to improve diagnostic accuracy (PI: A. Sinusas, Astellas-sponsored)
4. Dynamic 82Rb PET imaging of absolute blood flow in patients before and after implantation of a biventricular pacemaker for prediction of long term outcome (PI: S. Tandon, AHA-sponsored)
5. Phase 2 and 3 studies with a new F-18 labeled PET perfusion agent (18F-BMS747158-01). (PI: A. Sinusas, Lantheus-sponsored)
6. Validation of the Gated Blood Pool Single Photon Emission Computed Tomography (SPECT): Comparison to ERNA and 3D echocardiography (PI: A. Sinusas, investigator-sponsored)
7. A Phase I Open Label Pilot Study to Evaluate the Safety, Efficacy, and Tolerability of Anginera for Adults with Left Ventricular Dysfunction and Reversible Myocardial Ischemia undergoing CABG Surgery (PI: G. Tellides; Imaging PI: A. Sinusas, Theragen-sponsored)
8. Yale Fitness Intervention Trial (FIT) for health promotion in cancer survivors. (PI: T. Knopf, NIH NCI sponsored)
9. Measurement of matrix metalloproteinase activation post myocardial infarction. Evaluation of MR infarct size in relation to post-MI remodeling. (PI: A. Sinusas, investigator-sponsored)