Recent advances in cardiac positron emission tomography for quantitative perfusion analyses and molecular imaging
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REVIEW ARTICLE
Recent advances in cardiac positron emission tomography for quantitative perfusion analyses and molecular imaging Osamu Manabe1,2 · Masanao Naya3 · Tadao Aikawa2,4 · Nagara Tamaki5 Received: 9 June 2020 / Accepted: 31 August 2020 © The Japanese Society of Nuclear Medicine 2020
Abstract Positron emission tomography (PET) has been used to noninvasively evaluate myocardial perfusion and metabolism. For clinical assessments of myocardial perfusion, the quantitative capability of PET permits precise assessments of ischemia and microcirculatory dysfunction, playing an important role in patient management and outcome analyses. 18F-fluorodeoxyglucose (FDG) PET has recently been used to identify active cardiovascular lesions such as cardiac sarcoidosis, endocarditis, and aortitis. This may hold promise for the early and accurate diagnosis of such fatal diseases, as well as for patient management. This review covers new and clinical roles of cardiac PET in treatment strategies and patient outcomes. Keywords Cardiac PET · Myocardial blood flow · Active myocardial lesions · Quantitative analysis
Introduction With the rapid development of imaging modalities, a variety of new applications for the noninvasive imaging of cardiac diseases have appeared [1, 2]. Positron emission tomography (PET) has long been used as a functional imaging modality that uses several PET tracers to target perfusion, metabolism, innervation, and inflammatory conditions [3–8]. More recently, this imaging technique has played important roles in many clinical conditions such as early clinical diagnosis, patient management, and monitoring treatment response [9]. Here we review the recent clinical applications of cardiac PET for cardiovascular diseases, with a focus on quantitative
* Masanao Naya [email protected] 1
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
2
Department of Radiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
3
Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita‑15, Nishi‑7, Kita‑ku, Sapporo 060‑8638, Japan
4
Cardiovascular Research Center, Icahn School of Medicine At Mount Sinai, New York, NY, USA
5
Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
myocardial perfusion imaging and inflammatory imaging using PET.
Advantages of PET perfusion assessments PET has a number of advantages. It provides higher quality myocardial perfusion images than conventional singlephoton emission computed tomography (SPECT) imaging. PET myocardial perfusion imaging (MPI) thus provides more accurate diagnostic values and a higher incremental prognostic value than SPECT–MPI in patients with coronary artery disease (CAD) [10–13]. Another major advantage of PET over SPECT is the ability to quantify tracer concentrations. PET, therefore, permits the quantitative analysis of myocardial blood flow (MBF; in mL per g per min) and the myocardial flo
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