Table 2.

Some examples of nuclear cardiology studies and selection

Indication	Urgency	Notes
Myocardial perfusion imaging for ischemic heart disease
Recent acute coronary syndrome: evaluation of ischemia in moderate- to high-risk patients considered for urgent coronary revascularization	Priority 1	Perform test using precautions
New or accelerating symptoms: Canadian Cardiovascular Society Class II–IV where diagnosis of CAD is uncertain (intermediate pretest likelihood), or where suspicion of CAD, is high but coronary angiography has greater risk	Priority 1	Perform test using precautions
Preoperative evaluation: evaluation of ischemia in moderate- to high-risk patients in whom surgical procedure is urgent and revascularization is an option	Priority 1	Perform test using precautions
Stable angina: for evaluation of ischemia follow-up when there is no urgent revascularization plan	Priority 2 or 3	Postpone test
18F-FDG PET viability
Patient with ongoing symptoms being considered for CABG in the next 2 weeks where viability imaging will impact revascularization decision (such as patients with multiple co-morbidities)	Priority 1	Perform test using precautions
Stable chronic ischemic cardiomyopathy evaluation prior to cardiac transplant listing	Priority 2 or 3	Postpone test
99mTc-PYP imaging for transthyretin cardiac amyloidosis
Heart failure where transthyretin cardiac amyloidosis is suspected	Priority 1 or priority 2 or 3	Perform test in select cases or postpone test
18F-FDG PET for sarcoidosis
Initial evaluation: Heart block or VT and suspected cardiac sarcoidosis	Priority 1 or 2	Perform test using precautions
Follow-up evaluation: Known cardiac sarcoidosis on therapy	Priority 2 or 3	Postpone test
18F-FDG PET for infective endocarditis
Initial evaluation: Suspected prosthetic or device infection	Priority 1	Perform test using precautions
Follow-up evaluation: FDG PET prosthetic valve infective endocarditis	Priority 2 or 3	Postpone test
MUGA scan for LVEF estimation
Assessment of left ventricular function, as an alternative to echocardiography with short duration of patient–staff interaction	Priority 1	Perform test using precautions
Initial evaluation: Prior to initiation of cardiotoxic chemotherapy	Priority 1	Perform test using precautions
Follow-up evaluation: Prior to subsequent chemotherapy	Priority 1	Perform test using precautions
Organ transplanta
Liver transplant: preoperative evaluation in patient with intermediate or high cardiovascular risk and poor life expectancy from liver disease without transplantationa	Priority 1 or priority 2	Perform test using precautions or postpone test
Kidney transplant: preoperative evaluationb	Priority 2 or 3	Postpone test
Heart transplant: Routine evaluation for transplant vasculopathy	Priority 2 or 3	Postpone test

Priorities in this table are based on consensus. Laboratories should follow the principle that for tests that are performed as scheduled (Priority 1), the test should be expected to drive a meaningful treatment change that could be implemented in the immediate future and would have a clear short-term benefit. This might necessitate a discussion with the referring provider. Where multiple priorities are listed for a single indication, clinical judgment, and discussion with referring provider is recommended

Priority 1: perform test as scheduled. Priority 2: postpone test by 2–4 months. Priority 3: postpone test by > 4 months

This applies primarily for subjects who are not COVID-19 positive

^aThis applies to centers where active transplant surgeries are proceeding and a patient is listed with a status sufficient that they may receive an organ in the next few weeks

^bMost centers are temporarily not performing kidney transplantation at this time

CAD coronary artery disease, FDG fluoro deoxy glucose, LVEF left ventricular ejection fraction, COVID coronary virus disease, VT ventricular tachycardia