title: Clinical use of quantitative cardiac perfusion PET: rationale, modalities and possible indications. Position paper of the Cardiovascular Committee of the European Association of Nuclear Medicine (EANM).
abstract: Until recently, PET was regarded as a luxurious way of performing myocardial perfusion scintigraphy, with excellent image quality and diagnostic capabilities that hardly justified the additional cost and procedural effort. Quantitative perfusion PET was considered a major improvement over standard qualitative imaging, because it allows the measurement of parameters not otherwise available, but for many years its use was confined to academic and research settings. In recent years, however, several factors have contributed to the renewal of interest in quantitative perfusion PET, which has become a much more readily accessible technique due to progress in hardware and the availability of dedicated and user-friendly platforms and programs. In spite of this evolution and of the growing evidence that quantitative perfusion PET can play a role in the clinical setting, there are not yet clear indications for its clinical use. Therefore, the Cardiovascular Committee of the European Association of Nuclear Medicine, starting from the experience of its members, decided to examine the current literature on quantitative perfusion PET to (1) evaluate the rationale for its clinical use, (2) identify the main methodological requirements, (3) identify the remaining technical difficulties, (4) define the most reliable interpretation criteria, and finally (5) tentatively delineate currently acceptable and possibly appropriate clinical indications. The present position paper must be considered as a starting point aiming to promote a wider use of quantitative perfusion PET and to encourage the conception and execution of the studies needed to definitely establish its role in clinical practice.
authors: Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134, Florence, Italy. r.sciagra@dfc.unifi.it.
authors: Roberto
authors: R
authors: Sciagrà
authors: Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
authors: Alessandro
authors: A
authors: Passeri
authors: Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.|Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.|Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany.
authors: Jan
authors: J
authors: Bucerius
authors: Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors: Hein J
authors: HJ
authors: Verberne
authors: Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.|Faculty of Science and Technology Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands.
authors: Riemer H J A
authors: RH
authors: Slart
authors: Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany.
authors: Oliver
authors: O
authors: Lindner
authors: Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
authors: Alessia
authors: A
authors: Gimelli
authors: Department of Nuclear Medicine, Bichat University Hospital, Assistance Publique - Hôpitaux de Paris, UMR 1148, Inserm and Paris Diderot-Paris 7 University, Département Hospitalo-Universitaire Fire, Paris, France.|Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors: Fabien
authors: F
authors: Hyafil
authors: Laboratoire de Biophysique Medicale Faculte de Medecine, Siemens Healthcare, Caen, France.
authors: Denis
authors: D
authors: Agostini
authors: Department of Clinical Radiology, Ludwig-Maximilians Universität München, Munich, Germany.
authors: Christopher
authors: C
authors: Übleis
authors: Department of Radiology and Nuclear Medicine, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria.
authors: Marcus
authors: M
authors: Hacker
mesh_terms: D002319:Cardiovascular System / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009683:Nuclear Medicine; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012955:Societies, Medical
chemical_list: D019275:Radiopharmaceuticals
keywords: Coronary flow reserve; Myocardial blood flow; Positron emission tomography