Nuclear Medicine PET Scan Cardiovascular Assessment, Protocols, And Interpretation

Noninvasive imaging plays a pivotal role in assessing epicardial coronary artery anatomy, myocardial perfusion, and ventricular function in patients with known or suspected cardiovascular diseases. The increasing global burden of cardiovascular diseases has led to the introduction of highly sensitive and specific imaging modalities. Over the last two decades, the development of new software has contributed tremendously and broadened non-invasive imaging dimensions. Molecular imaging has revolutionized diagnostic imaging by utilizing high spatial and temporal resolution, significantly improving sensitivity and specificity. Because of increasing knowledge of cardiovascular biology and advances in imaging technologies, molecular imaging has become an essential tool in the fields of cardiovascular medicine.Positron emission tomography (PET) is a prime example of molecular imaging, which has contributed immensely to understanding cardiac anatomy and pathophysiology over the last two decades. Similar to other molecular imaging, PET utilizes intrinsic tissue characteristics as the source of image contrast, which leads to a better understanding of integrative biology and provides earlier detection and accurate diagnosis of disease. Stress myocardial positron emission tomography with Rubidium (Rb) provides a powerful estimate of cardiovascular mortality and accurately predicts prognosis in patients with coronary artery disease. Whereas PET with 2-deoxy-2-(F) fluoro-D-glucose (F-FDG) has been utilized as the gold standard for assessing myocardial viability with the help of glucose metabolism.The introduction of hybrid positron emission tomography with computed tomography (PET/CT) imaging by utilizing 3-dimensional acquisitions has been demonstrated as an important milestone in the field of myocardial perfusion imaging. It has significantly shortened the imaging protocol and reduced radiation exposure. Cardiac PET has also been proven as an effective non-invasive imaging modality for diagnosing myocardial infiltrative diseases, cardiac ischemia, and cardiac infections.