PET-Based Imaging of Ischemic Heart Disease

PET Clin. 2019 Apr;14(2):211-221. doi: 10.1016/j.cpet.2018.12.003. Epub 2019 Feb 1.

Abstract

PET-based cardiac nuclear imaging plays a large role in the management of ischemic heart disease. Compared with conventional single-photon emission CT myocardial perfusion imaging, PET provides superior accuracy in diagnosis of coronary artery disease and, with the incorporation of myocardial blood flow and coronary flow reserve, adds value in assessing prognosis for established coronary and microvascular disease. This review describes these and other uses of PET in ischemic heart disease, including assessing myocardial viability in ischemic cardiomyopathy. Developments in novel PET flow tracers and molecular imaging tools to assess atherosclerotic plaque vulnerability, vascular calcification, and vascular remodeling also are described.

Keywords: Coronary artery disease; Coronary flow reserve; Molecular imaging; Myocardial perfusion imaging; Myocardial viability; PET/CTA hybrid imaging.

Publication types

  • Review

MeSH terms

  • Computed Tomography Angiography / economics
  • Computed Tomography Angiography / methods
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / economics
  • Coronary Circulation / physiology
  • Cost-Benefit Analysis
  • Fractional Flow Reserve, Myocardial / physiology
  • Humans
  • Multimodal Imaging / economics
  • Multimodal Imaging / methods
  • Myocardial Ischemia / diagnostic imaging*
  • Myocardial Ischemia / economics
  • Myocardial Ischemia / physiopathology
  • Myocardial Perfusion Imaging / economics
  • Myocardial Perfusion Imaging / methods
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Radiopharmaceuticals
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / economics
  • Tomography, Emission-Computed, Single-Photon / methods

Substances

  • Radiopharmaceuticals