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Clarity at the point of Cardiac PET MPI referral

Practical guidance to help referring clinicians understand when to consider cardiac PET myocardial perfusion imaging (MPI) and what to expect from the referral process.

PET MPI Education Hero - desktop

When diagnostic uncertainty exists, referral confidence matters

Greater clarity when evaluating coronary artery disease* 

Cardiac PET MPI is a guideline-supported, noninvasive functional test that evaluates myocardial perfusion at rest and during stress in patients with known or suspected coronary artery disease (CAD).1,2,7
Physician evaluating coronary artery disease

CAD is changing — So is diagnostic complexity

CAD evaluation increasingly includes clinical scenarios involving non-obstructive disease, diffuse disease, multivessel disease, and coronary microvascular dysfunction; PET MPI supports more nuanced ischemia assessment beyond relative perfusion.4,5
Advancements in CAD

Cardiac PET MPI benefits

Why consider cardiac PET MPI?

Diagnostic confidence

High-quality perfusion imaging with attenuation correction may reduce uncertainty and repeat testing

Myocardial flow metrics

PET MPI provides incremental diagnostic value beyond relative perfusion, supporting confident clinical evaluation

Reliable across patient types

Consistent performance across body habitus, sex, and complex profiles

Efficient workflows

Shorter* imaging may support faster diagnosis and improved patient experience (*vs. SPECT MPI)

Cardiac MPI Referrals - Desktop
Cardiac PET MPI referrals

When to consider referring

PET MPI may be considered when image quality, physiologic clarity, or reliable risk stratification is needed in patients meeting stress imaging criteria.1,2,9

  • Prior inconclusive or nondiagnostic stress imaging.1,2
  • Obesity or high BMI affecting image quality.1,8
  • Breast attenuation (e.g., dense tissue or implants).1,2,9
  • Known CAD or prior revascularization requiring ischemia assessment.1,2,4
  • Suspected multivessel, diffuse, or microvascular disease.4,5,9
  • Clinical scenarios where clearer risk stratification may guide management.1,9

Case Studies

FAQs

How does cardiac PET MPI fit into current guidelines?

How does cardiac PET MPI fit into current guidelines?

How does PET MPI improve diagnostic confidence?

How does PET MPI improve diagnostic confidence?

How does PET MPI fit into current guidelines?

How does PET MPI fit into current guidelines?

What should I know about access to newer tracers like Flyrcado?

What should I know about access to newer tracers like Flyrcado?

How should I instruct patients prepare for Flyrcado PET MPI studies?

How should I instruct patients prepare for Flyrcado PET MPI studies?

Is there reimbursement coverage for Flyrcado?

Is there reimbursement coverage for Flyrcado?

References

  1. Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC guideline for the evaluation and diagnosis of chest pain. Circulation. 2021;144(22):e368–e454.
  2. Schindler TH, Bateman TM, Berman DS, et al. Appropriate use criteria for PET myocardial perfusion imaging. J Nucl Med. 2020;61(8):1221–1265. doi:10.2967/jnumed.120.246280 [snmmi.org]
  3. Dorbala S, Di Carli MF, Delbeke D, et al. SNMMI/ASNC/SCCT guideline for cardiac SPECT/CT and PET/CT 1.0. J Nucl Med. 2013;54(8):1485-1507. doi:10.2967/jnumed.112.105155
  4. Murthy VL, Bateman TM, Beanlands RS, et al. Clinical quantification of myocardial blood flow using PET. J Nucl Cardiol. 2018;25(1):269–297.
  5. Chareonthaitawee P, Bateman TM, Beanlands RS, et al. Atlas for reporting PET MPI and myocardial blood flow in clinical practice. J Nucl Cardiol. 2023;30:2850–2906.
  6. Patel KK, Spertus JA, Chan PS, et al. Myocardial blood flow reserve assessed by PET identifies patients with survival benefit from early revascularization. Eur Heart J. 2020;41(6):759–768.
  7. Maddahi J, Agostini D, Bateman TM, et al. Flurpiridaz F‑18 PET myocardial perfusion imaging in patients with suspected coronary artery disease. J Am Coll Cardiol. 2023;82(16):1598–1610. doi:10.1016/j.jacc.2023.08.016
  8. Flyrcado (flurpiridaz F 18 injection) , for Intravenous Use. Prescribing information. GE HealthCare; 2024. Arl.ington Heights, IL
  9. Bateman TM, Al-Mallah MH, Alnabelsi TS, et al. Clinical indications for positron emission tomography myocardial perfusion imaging and myocardial blood flow quantification: An American Society of Nuclear Cardiology position statement. J Nucl Cardiol. 2025: 102619. Doi: 10.1016/j.nuclcard.2025.102619.

Have a question? We would love to hear from you.

JB14080US June 2026
IMPORTANT SAFETY INFORMATION

FLYRCADO™ (flurpiridaz F 18) injection, for intravenous use 

 

Indications and Usage
FLYRCADO is a radioactive diagnostic drug indicated for positron emission tomography (PET) myocardial perfusion imaging (MPI) under rest or stress (pharmacologic or exercise) in adult patients with known or suspected coronary artery disease (CAD) to evaluate for myocardial ischemia and infarction.
Contraindications
None

Warnings and Precautions

  • Risk associated with exercise or pharmacologic stress: Patients evaluated with exercise or pharmacologic stress may experience serious adverse reactions such as myocardial infarction, arrhythmia, hypotension, bronchoconstriction, stroke, and seizure. Perform stress testing in the setting where cardiac resuscitation equipment and trained staff are readily available. When pharmacologic stress is selected as an alternative to exercise, perform the procedure in accordance with the pharmacologic stress agent’s prescribing information.
                • Radiation risks: FLYRCADO contributes to a patient’s overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk of cancer. Ensure safe handling to minimize radiation exposure to patients and health care providers. Advise patients to hydrate before and after administration and to void.Adverse Reactions Most common adverse reactions occurring during FLYRCADO PET MPI under rest and stress (pharmacologic or exercise) (incidence ≥ 2%) are dyspnea, headache, angina pectoris, chest pain, fatigue, ST segment changes, flushing, nausea, abdominal pain, dizziness, and arrhythmia.



                Adverse Reactions Most common adverse reactions occurring during FLYRCADO PET MPI under rest and stress (pharmacologic or exercise) (incidence ≥ 2%) are dyspnea, headache, angina pectoris, chest pain, fatigue, ST segment changes, flushing, nausea, abdominal pain, dizziness, and arrhythmia.

                Use in Specific Populations

                Pregnancy

                There are no data on use of flurpiridaz F 18 in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes. If considering FLYRCADO administration to a pregnant woman, inform the patient about the potential for adverse pregnancy outcomes based on the radiation dose from flurpiridaz F 18 and the gestational timing of exposure

                Lactation

                Temporarily discontinue breastfeeding. A lactating woman should pump and discard breastmilk for at least 8 hours after FLYRCADO administration.

                Pediatric Use

                Safety and effectiveness of FLYRCADO in pediatric patients have not been established.

                 

                To report SUSPECTED ADVERSE REACTIONS, contact GE HealthCare at 800-654-0118 (option 2 then option 1) or by email at GPV.drugsafety@gehealthcare.com or FDA at 800-FDA-1088 or www.fda.gov/medwatch

                IMPORTANT SAFETY INFORMATION

                FLYRCADO™ (flurpiridaz F 18) injection, for intravenous use 

                 

                Indications and Usage
                FLYRCADO is a radioactive diagnostic drug indicated for positron emission tomography (PET) myocardial perfusion imaging (MPI) under rest or stress (pharmacologic or exercise) in adult patients with known or suspected coronary artery disease (CAD) to evaluate for myocardial ischemia and infarction.
                Contraindications
                None

                Warnings and Precautions

                • Risk associated with exercise or pharmacologic stress: Patients evaluated with exercise or pharmacologic stress may experience serious adverse reactions such as myocardial infarction, arrhythmia, hypotension, bronchoconstriction, stroke, and seizure. Perform stress testing in the setting where cardiac resuscitation equipment and trained staff are readily available. When pharmacologic stress is selected as an alternative to exercise, perform the procedure in accordance with the pharmacologic stress agent’s prescribing information.
                              • Radiation risks: FLYRCADO contributes to a patient’s overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk of cancer. Ensure safe handling to minimize radiation exposure to patients and health care providers. Advise patients to hydrate before and after administration and to void.Adverse Reactions Most common adverse reactions occurring during FLYRCADO PET MPI under rest and stress (pharmacologic or exercise) (incidence ≥ 2%) are dyspnea, headache, angina pectoris, chest pain, fatigue, ST segment changes, flushing, nausea, abdominal pain, dizziness, and arrhythmia.



                              Adverse Reactions Most common adverse reactions occurring during FLYRCADO PET MPI under rest and stress (pharmacologic or exercise) (incidence ≥ 2%) are dyspnea, headache, angina pectoris, chest pain, fatigue, ST segment changes, flushing, nausea, abdominal pain, dizziness, and arrhythmia.

                              Use in Specific Populations

                              Pregnancy

                              There are no data on use of flurpiridaz F 18 in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes. If considering FLYRCADO administration to a pregnant woman, inform the patient about the potential for adverse pregnancy outcomes based on the radiation dose from flurpiridaz F 18 and the gestational timing of exposure

                              Lactation

                              Temporarily discontinue breastfeeding. A lactating woman should pump and discard breastmilk for at least 8 hours after FLYRCADO administration.

                              Pediatric Use

                              Safety and effectiveness of FLYRCADO in pediatric patients have not been established.

                               

                              To report SUSPECTED ADVERSE REACTIONS, contact GE HealthCare at 800-654-0118 (option 2 then option 1) or by email at GPV.drugsafety@gehealthcare.com or FDA at 800-FDA-1088 or www.fda.gov/medwatch

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