TY - JOUR
T1 - Myocardial blood flow
T2 - Putting it into clinical perspective
AU - Schindler, Thomas Hellmut
N1 - Funding Information:
This article was supported by a departmental fund from Johns Hopkins University, Baltimore, Maryland (No. 175470), and a research grant from the Swiss National Science Foundation (No. 3200N0-122237).
Publisher Copyright:
© 2015, American Society of Nuclear Cardiology.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - In recent years, positron emission tomography/computed tomography (PET/CT)-determined myocardial perfusion in conjunction with myocardial blood flow (MBF) quantification in mL·g−1·min−1 has emerged from mere research application to initial clinical use in the detection and characterization of the coronary artery disease (CAD) process. The concurrent evaluation of MBF during vasomotor stress and at rest with the resulting myocardial flow reserve (MFR = MBF during stress/MBF at rest) expands the scope of conventional myocardial perfusion imaging not only to the detection of the most advanced and culprit CAD, as evidenced by the stress-related regional myocardial perfusion defect, but also to the less severe or intermediate stenosis in patients with multivessel CAD. Due to the non-specific nature of the hyperemic MBF and MFR, the interpretation of hyperemic flow increases with PET/CT necessitates an appropriate placement in the context with microvascular function, wall motion analysis, and eventually underlying coronary morphology in CAD patients. This review aims to provide a comprehensive overview of various diagnostic scenarios of PET/CT-determined myocardial perfusion and flow quantification in the detection and characterization of clinically manifest CAD.
AB - In recent years, positron emission tomography/computed tomography (PET/CT)-determined myocardial perfusion in conjunction with myocardial blood flow (MBF) quantification in mL·g−1·min−1 has emerged from mere research application to initial clinical use in the detection and characterization of the coronary artery disease (CAD) process. The concurrent evaluation of MBF during vasomotor stress and at rest with the resulting myocardial flow reserve (MFR = MBF during stress/MBF at rest) expands the scope of conventional myocardial perfusion imaging not only to the detection of the most advanced and culprit CAD, as evidenced by the stress-related regional myocardial perfusion defect, but also to the less severe or intermediate stenosis in patients with multivessel CAD. Due to the non-specific nature of the hyperemic MBF and MFR, the interpretation of hyperemic flow increases with PET/CT necessitates an appropriate placement in the context with microvascular function, wall motion analysis, and eventually underlying coronary morphology in CAD patients. This review aims to provide a comprehensive overview of various diagnostic scenarios of PET/CT-determined myocardial perfusion and flow quantification in the detection and characterization of clinically manifest CAD.
KW - CAD
KW - left ventricular wall motion
KW - multivessel disease
KW - myocardial blood flow
KW - myocardial flow reserve
KW - myocardial ischemia
KW - positron emission tomography
UR - http://www.scopus.com/inward/record.url?scp=84951942816&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84951942816&partnerID=8YFLogxK
U2 - 10.1007/s12350-015-0372-4
DO - 10.1007/s12350-015-0372-4
M3 - Article
C2 - 26711100
AN - SCOPUS:84951942816
SN - 1071-3581
VL - 23
SP - 1056
EP - 1071
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
IS - 5
ER -