With the increasing availability of positron emission tomography (PET)
myocardial perfusion imaging (MPI), PET MPI and the absolute quantification of
myocardial blood flow (MBF) have become popular in clinical settings [1]. PET MPI
shows higher diagnostic accuracy than that of single-photon emission computed
tomography (SPECT) and shows predictive value for cardiac events [2, 3]. Quantitative
MBF assessment also provides important additional diagnostic or prognostic
information over that attained through conventional visual assessment [4]. The success
of MBF quantification using PET/computed tomography (CT) has increased demand
for this quantitative diagnostic approach to be more accessible. In this regard, MBF
quantification approaches have been developed using several other diagnostic imaging
modalities including SPECT, dynamic CT perfusion imaging, and cardiac magnetic
resonance (CMR). In the United States (US), the Food and Drug Administration (FDA)
has approved 13N-ammonia (13N-NH3) and 82rubidium (82Rb) for clinical use [5]. The
Japanese Ministry of Health, Labour and Welfare (JMHLW) approved 13N-NH3 PET
MPI for diagnosis of coronary artery disease (CAD) in March 2012 but has not
approved other PET MPI tracers [6, 7]. Since 13N-NH3 PET MPI will be addressed
elsewhere in this e-book, this review will address the clinical aspects of PET/CT MPI
using other PET flow tracers.
Keywords: Blood Flow, Coronary Artery Disease, Endothelial Function, Flow
Reserve, Positron Emission Tomography, Quantification.