A Novel 18 F-Labeled Tracer for the Quantification of Myocardial Blood Flow and Infarct Size With Positron-Emission Tomography

Abstract

Currently, nuclear imaging techniques can be used to diagnose coronary macrovascular and microvascular disease and to measure infarct size and left ventricular ejection fraction. Semiquantitative assessment of regional myocardial perfusion with single-photon emission computed tomography is a noninvasive, robust, and widely available method of assessing myocardial ischemia and has an established role in the clinical setting.1 A great number of studies have assessed the sensitivity and specificity of this technique for the detection of coronary artery disease (CAD), with coronary arteriography usually being used as the standard by which the accuracy of scintigraphy is judged.1 The main limitation of single-photon emission computed tomography perfusion imaging is that it provides only semiquantitative information on the regional distribution of myocardial blood flow (MBF). This is particularly relevant in conditions in which MBF and coronary flow reserve (CFR) are diffusely abnormal, (eg, in patients with hypertrophic and dilated cardiomyopathies).2 Article p 77 The ability to make quantitative measurements of MBF with positron-emission tomography (PET) allows determination of the functional significance of epicardial coronary lesions. In patients with single-vessel CAD, chronic stable angina, and no previous history of myocardial infarction (MI), CFR in response to a standard dose of dipyridamole was found to be markedly reduced in the myocardial regions subtended by the stenosed coronary artery compared with regions subtended by angiographically normal vessels.3 Using H215O or 13NH3 with PET, the relationship between stenosis severity, measured by quantitative coronary angiography, and its consequences on regional MBF and CFR has been …