Can I get a PET (Positron Emission Tomography) scan with a new pacemaker?

PET Scans for Patients with New Pacemakers

Yes, patients with new pacemakers can undergo PET scans safely when appropriate precautions are taken and the scan is performed under controlled conditions. While pacemakers were traditionally considered an absolute contraindication for MRI, this restriction does not apply to PET scanning.

Safety Considerations for PET Scans with Pacemakers

• PET scanning uses radioactive tracers and does not involve strong magnetic fields that could interfere with pacemaker function, making it generally safe for patients with pacemakers 1
• Unlike MRI, which uses powerful magnetic fields that can potentially affect pacemaker function, PET scans do not pose the same risks to cardiac implantable electronic devices 1
• PET scans are commonly used for cardiac and non-cardiac indications in patients with implanted cardiac devices without specific contraindications related to the pacemaker 1

Precautions and Protocols

• Before the PET scan, inform the medical team about your pacemaker so they can document this in your medical history 1
• The patient should be able to lie still for at least 5 to 20 minutes during the scan, depending on the sensitivity of the PET scanner 1
• For [18F]FDG PET imaging specifically, patients should:
  • Fast for 6 hours before the scan 1
  • Have glycemia measured (should be <160 mg/dl or <8.9 mmol/L) 1
  • Empty their bladder before scanning for maximum comfort 1

PET/CT Considerations

• When PET is combined with CT (PET/CT), the CT component is used for attenuation correction and anatomical localization 1
• The CT portion of a PET/CT scan does not pose any risk to pacemaker function 1
• PET/CT with various tracers (like [18F]FDG) can be safely performed in patients with pacemakers for diagnosis of various conditions including cancer, infection, and cardiac issues 2

PET/MR Special Considerations

• If the PET scan is performed with a PET/MR scanner (rather than PET/CT), additional screening is required due to the MR component 1
• For PET/MR, patients should be prescreened for MRI contraindications using a standardized checklist 1
• Most traditional pacemakers are contraindicated for MRI (and thus PET/MR), but newer MR-conditional pacemakers may be compatible under specific conditions 1
• If you have a new pacemaker, it's important to verify whether it is MR-conditional before undergoing a PET/MR scan 1

Clinical Applications

• PET scans can be particularly valuable for patients with pacemakers for:
  • Evaluation of suspected pacemaker infections when other diagnostic methods are inconclusive 2
  • Assessment of myocardial perfusion and viability 1
  • Cancer diagnosis and staging 1
  • Brain imaging for various neurological conditions 3

Important Caveats

• While the PET scan itself is safe with a pacemaker, if the scan is being performed as part of a PET/MR study, special considerations apply due to the magnetic field 1
• Newer pacemaker systems specifically labeled as "MR conditional" may be safe for MRI under certain controlled conditions, but this should be confirmed with the cardiologist who implanted the device 1, 4
• For patients with suspected pacemaker infections, PET scanning may actually be beneficial in identifying infection along pacing leads 2

In summary, patients with new pacemakers can safely undergo PET scans. The radiotracer-based imaging used in PET does not interfere with pacemaker function. However, if the PET scan is combined with MRI (PET/MR), additional screening and precautions are necessary.