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Review
. 2013 Nov;27(6):452-9.
doi: 10.7555/JBR.27.20130136. Epub 2013 Sep 25.

PET tracers and techniques for measuring myocardial blood flow in patients with coronary artery disease

Bailing Hsu  1
Affiliations
Review

PET tracers and techniques for measuring myocardial blood flow in patients with coronary artery disease

Bailing Hsu. J Biomed Res. 2013 Nov.

Abstract

Assessment of the relative distribution of myocardial flow with myocardial perfusion imaging (MPI) is methodologically limited to predict the presence or absence of flow-limited coronary artery disease (CAD). This limitation may often occur, when obstructive lesions involve multiple epicardial coronary arteries or disease-related disturbances of the coronary circulation coexist at the microvascular level. Non-invasive assessment of myocardial blood flow in absolute units with position emission tomography (PET) has been positioned as the solution to improve CAD diagnosis and prediction of patient outcomes associated with risks for cardiac events. This article reviews technical and clinical aspects of myocardial blood flow quantitation with PET and discusses the practical consideration of this approach toward worldwide clinical utilization.

Keywords: PET; coronary artery disease; myocardial blood flow.

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Conflict of interest statement

The author reported no conflict of interests.

Figures

Fig. 1
Fig. 1. Schematic illustration of radiotracer uptake in relation to regional myocardial blood flow.
Fig. 2
Fig. 2. Representative flow models.
A: one-tissue compartment and two kinetic parameters as a two compartment model. B: two-tissue compartments and three kinetic parameters as a three compartment model.
Fig. 3
Fig. 3. An example of SPECT myocardial blood flow quantitation to detect three-vessel CAD with luminal narrowing in LAD.
D1=90%; LCX: M=90%, D=90%, OM1=50%; RCA: PD=80%, confirmed by invasive coronary angiogram (upper panel). Attenuation-corrected perfusion images are interpreted to report a normal perfusion study without evidence of transient ischemia dilatation (middle panel). SPECT flow quantitation uncovers severe CAD with flow steal (CFR< 1.0) for all three territories associated with a total of 91% CAD burden throughout the whole myocardium (lower panel). LAD=left anterior descending, D1=diagonal 1, LCX=left circumflex, M=middle, D=distal, OM1=obtuse margina 1, RCA=right coronary artery, PD=posterior descending.
See this image and copyright information in PMC

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