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15O-Water PET MPI: Current Status and Future Perspectives

Teemu Maaniitty1, Juhani Knuuti1, Antti Saraste2

  • 1Turku PET Centre, University of Turku, Turku, Finland; Department of Clinical Physiology, Nuclear Medicine and PET, Turku University Hospital, Turku, Finland.

Seminars in Nuclear Medicine
|April 15, 2020
PubMed

Insights

15O-water Positron Emission Tomography (PET) accurately quantifies myocardial blood flow (MBF) and myocardial flow reserve (MFR). This imaging technique effectively detects coronary artery stenosis and provides prognostic information for patients with coronary artery disease (CAD).

Area of Science:

  • Nuclear Medicine
  • Cardiology
  • Radiochemistry

Background:

  • Myocardial perfusion imaging using 15O-water Positron Emission Tomography (PET) is established for quantitative myocardial blood flow (MBF) and myocardial flow reserve (MFR) assessment.
  • Advancements in PET scanner and software technology allow for precise global and regional MBF quantification in clinical settings.

Purpose of the Study:

  • To review the fundamental principles of MBF measurement utilizing 15O-water PET.
  • To synthesize findings from clinical studies evaluating 15O-water PET in the diagnosis of obstructive coronary artery disease (CAD).

Main Methods:

  • Quantitative analysis of myocardial blood flow (MBF) and myocardial flow reserve (MFR) using 15O-water Positron Emission Tomography (PET).
  • Comparison of PET-derived MBF/MFR with invasive fractional flow reserve (FFR) measurements for detecting significant coronary artery stenosis.

Main Results:

  • Reduced stress MBF or MFR measured by 15O-water PET demonstrates high accuracy in identifying hemodynamically significant coronary artery stenosis.
  • MBF and MFR values derived from 15O-water PET offer significant prognostic value regarding mortality and myocardial infarction risk.
  • Clinical implementation of 15O-water PET for CAD evaluation is feasible and aids in guiding revascularization decisions.

Conclusions:

  • 15O-water PET is a validated, quantitative tool for assessing myocardial blood flow and flow reserve.
  • This technique accurately detects obstructive coronary artery disease and provides crucial prognostic information.
  • Clinical application of 15O-water PET facilitates management strategies for patients with suspected or known CAD.

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