Cleveland-based University Hospitals Harrington Heart & Vascular Institute has become the first site in Ohio to clinically administer Flyrcado for the detection of coronary artery disease and arterial blockages.
Flyrcado is a first-of-its-kind advanced positron emission tomography-scan myocardial perfusion imaging agent. Administered through an injection and utilized during cardiac stress tests, the agent enables physicians to visualize cardiac perfusion more accurately and precisely than standard imaging procedures, according to a June 10 news release from the health system.
James Cireddu, MD, a cardiologist and system director of nuclear cardiology at the UH Harrington Heart & Vascular Institute, shared more about the imaging approach with Becker’s.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What operational and logistical changes were necessary for University Hospitals to implement using this imaging agent?
Dr. James Cireddu: University Hospitals is adapting in order to implement Flyrcado into our clinical practice. Flyrcado impacts supply and distribution logistics as it allows for off-site production due to its 109‑minute half‑life, significantly longer than other PET agents that require hospitals to invest large amounts of capital to generate their own tracers on-site.
University Hospitals also has to manage logistics for rapid delivery, precise inventory tracking, and appropriate storage and handling under radiopharmaceutical safety standards.
In collaboration with GE, we also provide ongoing clinician and technologist training on the agent’s pharmacokinetics, dosing schedules and image interpretation patterns as part of the broader digital radiology education roll-out.
Q: In what ways does the extended imaging window of this new tracer affect care quality, patient throughput and diagnostic confidence for clinicians?
JC: Flyrcado enables true exercise stress testing with PET using treadmills, as opposed to only offering pharmacologic stress testing with vasodilator medications. Exercise stress testing better reflects physiologic stress response and can improve risk stratification over pharmacologic-only methods. The extended imaging window allows for fewer rushed protocols so patients can move or breathe more naturally, improving image quality and there’s time to repeat scans if needed without re-dosing.
Flyrcado shows high first-pass extraction of about 94%. This improves image contrast between healthy and ischemic tissue, as well as quantitative accuracy in myocardial blood flow and flow-reserve assessment. The tracer’s properties lead to sharper images, especially in obese or large-bodied patients. Flyrcado has also been shown to be more accurate in detecting multi-vessel disease, which is more life threatening and may be underestimated by traditional testing.
Q: How does this new imaging approach support University Hospitals’ strategy to decentralize advanced cardiac diagnostics and improve imaging access across the system?
JC: Flyrcado’s longer 110-minute half-life allows centralized production from regional radiopharmacies and delivery to multiple satellite imaging sites. This reduces the need for expensive on-site cyclotrons or radiochemistry units at each location.
Community hospitals and outpatient centers can now perform PET myocardial perfusion imaging previously restricted to central or academic hospitals. Flyrcado expands access to advanced cardiac diagnostics without duplicating infrastructure.
PET MPI with Flyrcado outperforms single-photon emission computed tomography — which was previously the only option in smaller community hospitals — especially in women, obese patients and [those suffering] multi-vessel disease.
Flyrcado-enabled PET studies are quantitative, allowing precise measurement of myocardial blood flow. This enables UH to build a unified cardiac imaging dataset across sites, supporting research, value-based care models, as well as AI-driven triage and follow-up.
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