Quantitative Assessment of Myocardial Blood Flow with SPECT

Abstract

The quantitative assessment of myocardial blood flow (MBF) and coronary flow reserve (CFR) may be useful for the functional evaluation of coronary artery disease, allowing judgment of its severity, tracking of disease progression, and evaluation of the anti-ischemic efficacy of therapeutic strategies. Quantitative estimates of myocardial perfusion and CFR can be derived from single-photon emission computed tomography (SPECT) myocardial perfusion images by use of equipment, tracers, and techniques that are available in most nuclear cardiology laboratories. However, this method underestimates CFR, particularly at high flow rates. The recent introduction of cardiac-dedicated gamma cameras with solid-state detectors provides very fast perfusion imaging with improved resolution, allowing fast acquisition of serial dynamic images during the first pass of a flow agent. This new technology holds great promise for MBF and CFR quantification with dynamic SPECT. Future studies will clarify the effectiveness of dynamic SPECT flow imaging.

Keywords: ACU; CAD; CCT; CFR; CMR; Coronary flow reserve; FFR; LV; MBF; Myocardial blood flow; PCI; PET; SPECT; SPECT imaging; aortic time–activity curve; cardiac computed tomography; cardiac magnetic resonance; coronary artery disease; coronary flow reserve; fractional flow reserve; left ventricular; myocardial blood flow; percutaneous coronary intervention; positron emission tomography; single-photon emission computed tomography.