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Review
. 2010 Jun;17(3):498-513.
doi: 10.1007/s12350-010-9223-5.

Assessment of myocardial perfusion and function with PET and PET/CT

Mouaz H Al-Mallah  1 , Arkadiusz Sitek, Stephen C Moore, Marcelo Di Carli, Sharmila Dorbala
Affiliations
Review

Assessment of myocardial perfusion and function with PET and PET/CT

Mouaz H Al-Mallah et al. J Nucl Cardiol. 2010 Jun.
No abstract available

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Figures

Figure 1
Figure 1
Demonstrates the comprehensive imaging data (relative perfusion, rest and stress gated data, absolute perfusion, calcium score, CT coronary angiogram, and fused PET and CT coronary angiogram images) obtained by a list mode acquisition in a case of combined PET and CT coronary angiography.
Figure 2
Figure 2
A sample protocol for clinical cardiac PET/CT imaging with 82Rb takes ~25 minutes. The use of Regadenoson stress makes the protocol ultrashort with completion of rest and stress imaging in ~17 minutes. CT, CT scan for attenuation correction; CTCA, CT coronary angiography; 82Rb, 82Rubidium.
Figure 3
Figure 3
Relative PET perfusion reserve as a tool to assess physiological significance of coronary stenoses. Reproduced with permission from Goldstein et al.
Figure 4
Figure 4
Schematic demonstrating a discrete defect from a segmental coronary stenosis (top), in comparison to the gradual apex to base gradient that may be evident in cases of diffuse CAD. Reproduced with permission from Gould et al.
Figure 5
Figure 5
Relative myocardial perfusion images demonstrate inferior and inferoseptal ischemia, while absolute myocardial perfusion is globally reduced, suggesting balanced ischemia.
Figure 6
Figure 6
Bar graphs demonstrating the relationship between LVEF reserve (peak stress minus rest LVEF) and the magnitude of stress-induced perfusion abnormalities (A) and the extent of angiographic CAD (>70% stenosis) (B). Reproduced with permission from Dorbala et al.
Figure 7
Figure 7
(A) Risk adjusted survival curves demonstrating event free survival based on percent myocardium abnormal. Survival was excellent in patients with normal 82Rb MPI (0% abnormal), and progressively worse survival was noted for patients with mild (1-10% abnormal), moderate (11-20% abnormal), or severely abnormal (≥20% abnormal) scans. (B) Risk adjusted survival curves demonstrating worse event free survival for patients with LVEF reserve <0%. Reproduced with permission from Dorbala et al.
Figure 8
Figure 8
Risk adjusted survival curves in patients with nonischemic relative PET scans demonstrating worse event free survival in patients with a calcium score (CAC) of ≥1000 compared to CAC <1000. Reproduced with permission from Schenker et al.
Figure 9
Figure 9
A hybrid PET CTA examination in a patient with significant LAD ischemia. CT coronary angiogram image is overlaid on volume rendered stress 82Rb perfusion image. CT coronary angiogram was performed to evaluate the patency/caliber of the distal LAD (beyond a known chronic total occlusion of the mid LAD) for consideration of coronary artery bypass surgery.
Figure 10
Figure 10
Myocardial perfusion images using F-18 BMS showing comparable or better image quality compared to 13N ammonia images. Reproduced with permission from Nekolla et al.
See this image and copyright information in PMC

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