Recent advances in cardiac PET and PET/CT myocardial perfusion imaging

Abstract

Cardiovascular imaging has gained an important role in the evaluation of patients with either known or suspected coronary artery disease. The choices have expanded, imaging procedures have improved. Currently, testing procedures include echocardiography, magnetic resonance imaging, cardiac CTA, cardiac catheterization, and nuclear myocardial perfusion imaging with either single photon emission computed tomography (SPECT) or positron emission tomography (PET). Each of these imaging modalities has its strengths and weaknesses. However, SPECT myocardial perfusion imaging has emerged as a reliable and widely available tool for physicians to use in the assessment of their patient for the exclusion or presence and severity of CAD. Recently, cardiac PET has emerged as an alternative to SPECT imaging. Cardiac positron emission tomography (PET) imaging has gained considerable support and use in the field of cardiovascular imaging over the past several years. For example, delivery of the most accessible PET tracer, Rubidium-82 (RB-82) has quadrupled; the use of myocardial viability studies has increased, and the value of cardiac PET perfusion imaging is now being recognized. This recent increase in activity and interest has been spearheaded by several factors, such as availability of the camera technology, advances in cardiac PET acquisition and perfusion procedures, improved display procedures and software, as well as literature supporting the diagnostic and prognostic accuracy of PET perfusion imaging. This review will highlight cardiac PET as presented in a recent symposium with regards to differences between SPECT imaging and PET, literature supporting cardiac PET for both diagnostic accuracy and risk stratification, and features of cardiac PET/CT that differentiate it from SPECT. The review includes recent literature advances.