Quantification of myocardial blood flow with PET: Ready for clinical application

摘要

The limitations of our currently performed myo-cardial perfusion imaging (MPI) studies have been well recognized for decades. Certainly, high- and low-risk subsets of patients can adequately be separated by assessment of the combination of exercise stress test and SPECT scintigraphic variables. Similarly, vasodilator stress SPECT or PET have shown good sensitivity and specificity for CAD detection and risk stratification. Yet, despite this proven clinical value of conventional MPI using semiquantitative methods for scan analysis, we have appreciated for some time that evaluating solely relative tracer uptake in the myocardium following exercise or pharmacologic stress underestimates extent of CAD. MPI studies in some patients with three-vessel or left main CAD can appear normal with uniform tracer uptake due to balanced ischemia.