Nuclear Perfusion Imaging for Functional Evaluation of Patients With Known Or Suspected Coronary Artery Disease: the Future is Now

Abstract

Nuclear imaging, with both single-photon emission computed tomography and PET, has a well-established role in the assessment of patients with known or suspected coronary artery disease. There is a large body of evidence regarding the diagnostic accuracy and prognostic value of these modalities, however, they continue to evolve rapidly with advances in camera and tracer technology, as well as changes in imaging protocols to increase lab efficiency, improve image quality and to decrease radiation exposure to patients. Nuclear imaging also provides insights into atherogenesis at a molecular level and can be combined with other imaging modalities, providing both functional and structural data and complimentary information on the presence of coronary disease and its functional implications.

Current and Future Clinical Applications of Cardiac Positron Emission Tomography

“…The use of 82 Rb is most cost-effective and justified in high volume centers where 30-40 patients can be imaged on a weekly basis. 28 82 Rb has a half-life of 76 s, resulting in very low radiation dosimetry (effective dose of approximately 2 mSv for a rest/ stress protocol with CT attenuation correction 29, 30 ), but also has the disadvantage of rendering exercise stress testing impractical. 13,31,32 Furthermore, in comparison with other PET radiotracers, 82 Rb has the lowest first-pass extraction (Table).…”