Table 2 Patient preparation and protocol for cardiac ¹⁸F-FDG PET, NH4, and Rb-82 scans

Reason

Viability study

Perfusion study

Perfusion study

Tumour/inflammatory lesion assessment

Diet

Low carbohydrate diet

Low carbohydrate diet

Low carbohydrate diet

High-fat, protein-permitted low carbohydrate diet for 24 hours

Fasting for 6–12 hours

Check blood glucose

If blood glucose < 110 mg/dL AND not diabetic, oral glucose loading

Unfractionated heparin loading

If blood glucose 130–200 mg/dL OR diabetic, administer IV insulin depending on blood glucose level

If blood glucose more than 200 mg/dL, notify physician (some institutes reschedule imaging)

If blood glucose more than 200 mg/dL, notify physician (some institutes reschedule imaging)

Radiotracer administration

Administer 5–15 mCi of F-18 FDG when blood glucose below 150 mg/dL (preferable)

Administer 20 mCi NH4

Administer 40 mCi Rb-82

Administer 5–15 mCi of F-18 FDG

¹⁸F-FDG during and after administration

Patient should remain seated or recumbent to avoid muscular uptake

Patient should remain seated or recumbent to avoid muscular uptake

Start imaging

Wait 60 minutes, then scan for 10 minutes

Wait 10 minutes and scan for 5 minutes

Wait 10 minutes and scan for 6:30 minutes

Wait 60 minutes, then scan for 10 minutes