RDx Day: Cardiac Imaging Momentum; PET & FFR-CT Taking Share

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RDx Day: Cardiac Imaging Momentum; PET & FFR-CT Taking Share

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USA | Medical Supplies & Devices EquityJuneResearch9, 2026

RDx Day: Cardiac Imaging Momentum; PET &

FFR-CT Taking Share

We hosted Dr Andrew Einstein & Dr Carlos Santos-Gallego, who manage large

NYC cardiac imaging practices. Key takes: 1) the cardiac imaging toolkit is

expanding, led by PET & FFR-CT growth; 2) PET is the gold standard and will

gain share at SPECT's expense; 3) FFR-CT (HTFL ~90% share) is a valuable

diagnostic add-on, also taking SPECT volume; 4) Flyrcado uptake has been

slow on supply & reimbursement frictions, but could meaningfully unlock lower

volume centers.

Cardiac imaging encompasses a range of non-invasive modalities, from stress testing (ECG,

echo, SPECT, PET, cardiac MRI) to anatomical CT angiography and functional add-ons like FFR-

CT, with the overarching goal of diagnosing and risk-stratifying patients while avoiding invasive

catheterization.

While both KOLs noted that referring cardiologists largely dictate the imaging modality, and the

practice will honor those preferences, Dr Einstein in particular emphasized the importance of

educating referring physicians to help optimize modality selection on a case-by-case basis.

PET is widely viewed as the gold standard for cardiac imaging, offering superior resolution, flow

quantification, and unique capabilities such as microvascular assessment. Capacity remains a

key bottleneck, with backlogs extending to ~8 weeks. Despite these constraints, both KOLs were

confident PET will continue to gain share, primarily at SPECT's expense.

ASNC has endorsed PET over SPECT in its position statement, but notably takes no stance on CT

vs nuclear MPI, unsurprising given its identity as a nuclear society. Importantly, both KOLs noted