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Updated: Jul 14, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Will 3-dimensional PET-CT enable the routine quantification of myocardial blood flow?
Robert A deKemp1, Keiichiro Yoshinaga, Rob S B Beanlands
1National Cardiac PET Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. RAdeKemp@ottawaheart.ca <RAdeKemp@ottawaheart.ca>
Insights
Positron emission tomography (PET) accurately quantifies myocardial blood flow (MBF) and flow reserve. This technique is vital for assessing coronary artery disease and microvascular dysfunction, with 3D PET-CT offering enhanced diagnostic capabilities.
Area of Science:
- Cardiovascular Imaging
- Nuclear Cardiology
- Medical Physics
Background:
- Myocardial blood flow (MBF) quantification using positron emission tomography (PET) is crucial for evaluating coronary artery disease (CAD).
- Emerging applications include assessing microvascular dysfunction in early atherosclerosis and cardiomyopathies.
- Fully three-dimensional (3D) PET acquisition presents opportunities and challenges for cardiac imaging.
Purpose of the Study:
- To highlight the utility of 3D PET for MBF quantification.
- To explore the integration of 3D PET with CT for combined anatomical and functional assessment.
- To emphasize the need for high-throughput protocols for clinical adoption.
Main Methods:
- Utilizing fully 3D PET acquisition for simultaneous MBF measurement with ECG-gated perfusion imaging.
- Translating 3D PET protocols to PET-CT systems for improved attenuation correction.
- Leveraging cardiac CT for anatomical evaluation and cardiac PET for hemodynamic quantification.
Main Results:
- Existing studies support the use of 3D cardiac PET for accurate flow quantification.
- PET-CT offers virtually noise-free attenuation correction, enhancing image quality.
- The combined PET-CT approach integrates anatomical and hemodynamic assessments.
Conclusions:
- 3D cardiac PET is a valuable tool for MBF and flow reserve quantification.
- PET-CT provides a powerful platform for comprehensive cardiac assessment.
- Development of high-throughput protocols is essential for evaluating the clinical impact of this technology.
Abstract:
Quantification of myocardial blood flow (MBF) and flow reserve has been used extensively with positron emission tomography (PET) to investigate the functional significance of coronary artery disease. Increasingly, flow quantification is being applied to investigations of microvascular dysfunction in early atherosclerosis and in nonatherosclerotic microvascular disease associated with primary and secondary cardiomyopathies. Fully three-dimensional (3D) acquisition is becoming the standard imaging mode on new equipment, bringing with it certain challenges for cardiac PET, but also the potential for MBF to be measured simultaneously with routine electrocardiography (ECG)-gated perfusion imaging. Existing 3D versus 2D comparative studies support the use of 3D cardiac PET for flow quantification, and these protocols can be translated to PET-CT, which offers a virtually noise-free attenuation correction. This technology combines the strengths of cardiac CT for evaluation of anatomy with cardiac PET for quantification of the hemodynamic impact on the myocardium. High throughput clinical imaging protocols are needed to evaluate the incremental diagnostic and prognostic value of this technology.
