PET and SPECT Tracers for Myocardial Perfusion Imaging

Area of Science:

• Nuclear cardiology and cardiovascular imaging.
• Development of radiopharmaceuticals for medical diagnostics.

Background:

• Coronary artery disease remains a leading cause of death, necessitating advanced diagnostic tools.
• Myocardial perfusion imaging (MPI) is vital for early diagnosis and treatment guidance.
• Positron emission tomography (PET) MPI offers superior image quality and diagnostic accuracy compared to SPECT MPI.

Purpose of the Study:

• To review current and emerging myocardial perfusion imaging (MPI) tracers.
• To evaluate tracer suitability for clinical application, including quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR).
• To discuss the development rationale, physiological mechanisms, and evaluation results of various tracers.

Main Methods:

• Review of clinically available and investigational MPI tracers.
• Analysis of tracer development, physiological uptake mechanisms, and published evaluation data.
• Assessment of tracer suitability based on clinical needs, technological capabilities, and market factors.

Main Results:

• PET MPI enables routine quantification of MBF and MFR, improving diagnostic and prognostic accuracy.
• Simultaneous acquisition of MPI, MBF, and MFR is feasible with certain PET tracers (e.g., rubidium).
• New tracers must align with evolving clinical needs and technological advancements for successful integration.

Conclusions:

• The development of perfusion radiotracers is accelerating due to improved understanding of physiology and advanced imaging tools.
• Effective tracers are translating more efficiently from research to clinical practice.
• Careful evaluation is needed to ensure tracers meet the demands for accurate MBF and MFR quantification in nuclear cardiology.