The Role of Cardiac PET in Diagnosis and Prognosis of Ischemic Heart Disease: Optimal Modality Across Different Patient Populations

Abstract

Purpose of Review Despite single-photon emission computerized tomography (SPECT) being the most used nuclear imaging technique for diagnosis of coronary artery disease (CAD), many now consider positron emission tomography (PET) as a superior modality. This review will focus on the advances of cardiac PET in recent years and its advantages compared to SPECT in diagnosis and prognosis of CAD. Recent Findings PET’s higher resolution and enhanced diagnostic accuracy, as well as lower radiation exposure, all help explain the rationale for its wider spread and use. PET also allows for measurement of myocardial blood flow (MBF) and myocardial flow reserve (MFR), which aids in several different clinical scenarios, such as diagnosing multivessel disease or identifying non-responders. PET has also been shown to be useful in diagnosing CAD in various specific populations, such as patients with prior COVID-19 infection, cardiac transplant, and other comorbidities.

Myocardial Blood Flow Reserve, Microvascular Coronary Health, and Myocardial Remodeling in Patients With Aortic Stenosis

“… 11 The myocardial blood flow (MBF) and myocardial flow reserve (MFR) quantified in PET myocardial perfusion imaging (MPI) have shown a distinct and incremental prognostic value in patients with potential or confirmed coronary artery disease. 12 , 13 Limited understanding of the AS disease process, including coronary artery disease and ventricular dysfunction in the context of AS, hinders the development of effective medical therapies to slow or halt disease progression. 14 , 15 , 16 Valve replacement has to date been the only approach that offers therapeutic relief.…”