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Nuclear Cardiology

Save, Noninvasive Heart imaging

Cardiac nuclear stress testing is a standard noninvasive procedure for determining the diagnosis, extent and prognosis of coronary artery disease. These tests, however, are often limited by high radiation exposure and multiple artifacts. The MFA’s cardiac nuclear laboratory has the only facility in Washington, DC that uses UltraSPECT, a new technique that minimizes both of these concerns. UltraSPECT is a new analytic tool added to our nuclear scanning system that enhances image quality, allowing studies to be performed either with half the standard isotope dose or with a standard dose at half the usual scan time. After validating study quality, our lab now uses UltraSPECT in over 80% of cases.

GW UltraSPECT rest/stress Tc-99m SPECT protocol - 5 mSv

Standard rest/stress Tc-99m SPECT protocol - 10 mSv

Standard rest/stress Dual Isotope (Thallium/Sestamibi) protocol - 24 mSv

Diagnostic cardiac catheterization (average exposure) - 7 mSv

Radiation Exposure in Cardiac Testing

The MFA's Cardiac Nuclear Laboratory is under the supervision of Brian Choi, MD, Co- Director of Advanced Cardiac Imaging and Esma Akin, MD, Director of Nuclear Medicine. Dr. Choi is an Assistant Professor of Medicine (Cardiology) who trained at the Mount Sinai Hospital in New York. He is board-certified in cardiovascular disease and nuclear cardiology. Dr. Akin is an Associate Professor of Radiology who is an internationally regarded clinician and researcher in nuclear cardiology imaging techniques.

All MFA cardiac nuclear studies are read jointly by cardiology and nuclear radiology.

Individualized Patient Testing:

Our staff reviews each patient to determine the best and safest nuclear test approach. Factors considered include patient age, gender, body habitus, history of radiation exposure and radiation risks, comfort with imaging under the camera, ability to exercise, and other potential scan artifacts. Particular advantages of UltraSPECT imaging include:

  • Patients needing low radiation exposure: UltraSPECT lowers radiation dose by 50% for patients, especially for those who are younger or those who have had multiple nuclear tests or other radiation exposure.
  • Patients claustrophobic or uncomfortable on the nuclear table: UltraSPECT reduces scan time from 12 to 6 minutes, thereby allowing the study to be complete without motion artifact.
  • Obese patients or those women likely to have breast attenuation artifact: UltraSPECT enhances perfusion images.

In addition to treadmill and pharmacologic nuclear stress testing, the GW MFA Nuclear Laboratory also provides nuclear ventricular function testing (MUGA) and myocardial viability assessment. Our physicians are always available for test review or consultation at (202) 741-2323.

Non-Invasive Cardiac Testing

The GW Medical Faculty Associates offers a full range of non-invasive tests for diagnosis of cardiac diseases including echocardiography, stress testing, vascular ultrasound, ambulatory electrocardiography, and nuclear cardiac testing. The MFA noninvasive cardiac imaging specialists work in integrated teams with cardiologists, nuclear radiologists, vascular surgeons, certified technologists and technicians to provide patients in-depth, high-quality diagnostic evaluations for heart and vascular problems.

Advantages of Non-Invasive Cardiac Testing at The MFA

  • Fully accredited non-invasive laboratory for Cardiac Nuclear, Echocardiography, and Vascular Ultrasound testing
  • Multidisciplinary quality control and test evaluation with laboratory oversight and joint test analysis by cardiologists, nuclear radiologists, and vascular surgeons
  • Physician availability for prompt test review or consultation at (202) 741-2323
  • Individualized testing tailored to specific patient needs
  • All testing utilizes a direct EMR interface which enables more accurate analysis and faster reporting

Stress Testing

  • Stress echocardiography: Treadmill or pharmacologic
  • Stress nuclear study: Treadmill or pharmacologic (UltraSPECT reduces radiation exposure)


  • 2D
  • Doppler
  • Color flow
  • Speckle tracking

Vascular Ultrasound

  • Carotid ultrasound
  • ABI-resting and exercise
  • Peripheral vascular ultrasound (lower & upper extremity)
  • Abdominal aorta
  • Venous ultrasound

Ambulatory Electrocardiography

  • Holter monitoring
  • Event monitoring
  • Long term (30 day) monitoring

Nuclear Stress Testing

  • MUGA testing
  • Myocardial viability
  • Treadmill or pharmacologic stress with UltraSPECT imaging
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