STATE-OF-THE-ART PAPER
Cardiac Positron Emission Tomography
Frank M. Bengel, MD*,
Takahiro Higuchi, MD,
Mehrbod S. Javadi, MD and
Riikka Lautamäki, MD, PhD
Division of Nuclear Medicine/PET, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
Manuscript received November 13, 2008;
revised manuscript received January 27, 2009,
accepted February 23, 2009.
* Reprint requests and correspondence: Dr. Frank M. Bengel, Director of Cardiovascular Nuclear Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, 601 North Caroline Street/JHOC 3225, Baltimore, Maryland 21287 (Email: fbengel1{at}jhmi.edu).
Positron emission tomography (PET) is a powerful, quantitative imaging modality that has been used for decades to noninvasively investigate cardiovascular biology and physiology. Due to limited availability, methodologic complexity, and high costs, it has long been seen as a research tool and as a reference method for validation of other diagnostic approaches. This perception, fortunately, has changed significantly within recent years. Increasing diversity of therapeutic options for coronary artery disease, and increasing specificity of novel therapies for certain biologic pathways, has resulted in a clinical need for more accurate and specific diagnostic techniques. At the same time, the number of PET centers continues to grow, stimulated by PET's success in oncology. Methodologic advances as well as improved radiotracer availability have further contributed to more widespread use. Evidence for diagnostic and prognostic usefulness of myocardial perfusion and viability assessment by PET is increasing. Some studies suggest overall cost-effectiveness of the technique despite higher costs of a single study, because unnecessary follow-up procedures can be avoided. The advent of hybrid PET-computed tomography (CT), which enables integration of PET-derived biologic information with multislice CT-derived morphologic information, and the key role of PET in the development and translation of novel molecular-targeted imaging compounds, have further contributed to more widespread acceptance. Today, PET promises to play a leading diagnostic role on the pathway toward a future of high-powered, comprehensive, personalized, cardiovascular medicine. This review summarizes the state-of-the-art in current imaging methodology and clinical application, and outlines novel developments and future directions.
Key Words: positron emission tomography • myocardial perfusion • myocardial viability • hybrid imaging • molecular imaging
|
Abbreviations and Acronyms
| | CAD = coronary artery disease | | CFR = coronary flow reserve | | CMS = Centers for Medicare and Medicaid Services | | CT = computed tomography | | FDA = Food and Drug Administration | | FDG = fluorodeoxyglucose | | MBF = myocardial blood flow | | PET = positron emission tomography | | SPECT = single-photon emission computed tomography |
|
Related Article
-
Inside This Issue
J. Am. Coll. Cardiol. 2009 54: A22.
[Full Text]
[PDF]
|
