Assessment of myocardial ischaemia and viability: role of positron emission tomography.
In developed countries, coronary artery disease (CAD) continues to be a major cause of death and disability. Over the past two decades, positron emission tomography (PET) imaging has become more widely accessible for the management of ischemic heart disease. Positron emission tomography has also emerged as an important alternative perfusion imaging modality in the context of recent shortages of molybdenum-99/technetium-99m ((99m)Tc). The clinical application of PET in ischaemic heart disease falls into two main categories: first, it is a well-established modality for evaluation of myocardial blood flow (MBF); second, it enables assessment of myocardial metabolism and viability in patients with ischaemic left ventricular dysfunction. The combined study of MBF and metabolism by PET has led to a better understanding of the pathophysiology of ischaemic heart disease. While there are potential future applications of PET for plaque and molecular imaging, as well as some clinical use in inflammatory conditions, this article provides an overview of the physical and biological principles behind PET imaging and its main clinical applications in cardiology, namely the assessment of MBF and metabolism.
National Cardiac PET Centre, Division of Cardiology and the Molecular Function and Imaging Program, University of Ottawa Heart Institute, Ottawa, ONT, Canada.
Nina
N
Ghosh
Ornella E
OE
Rimoldi
Rob S B
RS
Beanlands
Paolo G
PG
Camici
D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000401:mortality; D055414:Myocardial Perfusion Imaging / Q000379:methods; D009204:Myocardial Revascularization / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18