Quantitative 13N-Ammonia Cardiac Rest/Stress Digital PET/CT

Cardiac imaging using standard-of-care Nuclear Medicine techniques assess the relative
radiopharmaceutical distribution from coronary arteries to cardiac tissue. This standard
interpretation however, lacks the clinical utility of modern quantitative techniques that are
now routinely obtained during cardiac catheterization, such as fractional flow reserve (FFR).
Cardiologists routinely base critical management decisions, including the choice for
revascularization, stenting, or angioplasty, on these measurements.

Non-invasive measurements of MBF (Myocardial Blood Flow), CFR (Coronary Flow Reserve) and RFR
(Relative Flow Reserve) using PET/CT have been investigated, but have yet to reach clinicl
use. Given the inherent gains in sensitivity and resolution, digital PET/CT, may allow for a
more robust and accurate platform to obtain quantitative measurements of MBF, CFR and RFR
which may greatly enhance the clinical utility of cardiac PET/CT for management of coronary
artery disease.

Inclusion Criteria:

- Patient is ≥ 18 years old at the time of the scan

- Patient has known or suspected coronary artery disease

- Patient has had a recent or will be scheduled for a diagnostic coronary angiogram

- Patient provides written informed consent

- Patient is referred for myocardial perfusion scan

- Patient is capable of complying with study procedures

- Patient is able to remain still for duration of imaging procedure (approximately 60
minutes total for both PET/CT)

Exclusion Criteria:

- Patients who are pregnant or breast feeding

- Patients with contraindications to regadenoson