The purpose of this book is to provide the outline for the "nuts and bolts" establishment and operation of a nuclear cardiology laboratory. In so doing, the authors have attempted to deal with the relevant issues that a laboratory director must address in either setting up the laboratory or maintaining its competitive edge and clinical competence over time. The authors primarily attempted to identify issues related to outpatient imaging facilities. However, where appropriate issues related to inpatients in hospital-based laboratories are also discussed.


In this new edition, the authors have kept the basic format established in the first edition. In addition to reviewing, modifying and updating each chapter in the first edition, they have added entirely new chapters on PET imaging, hybrid imaging and the clinical appropriateness of nuclear cardiology procedures.
Table of contents

Introduction 3

Chapter 1 Getting Started 6

Chapter 2 Laboratory Logistics 26

Chapter 3 Radiation Safety 35

Chapter 4 Patient Preparation 42

Chapter 5 Stress Procedures 50

Chapter 6 SPECT Myocardial Perfusion Imaging

Acquisition and Processing Protocols 72

Chapter 7 Planar Myocardial Perfusion Imaging

Acquisition and Processing Protocols 89

Chapter 8 Planar Equilibrium Angiocardiography

Acquisition and Processing Protocols 94

Chapter 9 SPECT Equilibrium Angiocardiography

Acquisition and Processing Protocols 103

Chapter 10 Display and Analysis of SPECT

Myocardial Perfusion Images 110

Chapter 11 Acquisition, Processing, Display and

Analysis of PET Imaging 122

Chapter 12 Hybrid Imaging 143

Chapter 13 Display and Analysis of Planar Myocardial

Perfusion Images 149

Chapter 14 Display and Analysis of Planar Equilibrium

Angiocardiography 152

Chapter 15 Display and Analysis of SPECT Equilibrium

Angiocardiography 156

Chapter 16 Cardiac Nuclear Imaging Artifacts 160

Chapter 17 Nuclear Cardiology Reports 179

Chapter 18 Remote Reading and Networking 189

Chapter 19 Quality Assurance 194

Chapter 20 Other Laboratory Protocols and Policies 204

Chapter 21 Emergency Department Imaging 216

Chapter 22 Laboratory Accreditation 221

Chapter 23 Coding and Billing 226

Chapter 24 Appropriateness Guidelines 233