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Updated: Oct 12, 2025
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Combining flow and reserve measurement during myocardial perfusion imaging: A new era for myocardial perfusion
Matthieu Bailly1, Maria Joao Ribeiro2, Denis Angoulvant3
1Nuclear Medicine Department, CHR Orleans, 14, Avenue de l'Hôpital, 45100 Orleans, France; UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France.
Abstract:
Myocardial flow reserve represents the ratio of myocardial blood flow between stress and rest, giving functional information about both macrocirculation and microcirculation; it has been reported extensively in positron emission tomography, with an increase in diagnostic performance, providing important prognostic information and being a powerful tool to guide therapy. Advances in single photon emission computed tomography, with the widespread availability of "cadmium zinc telluride" single photon emission computed tomography cameras, raise the question of myocardial flow reserve use in daily clinical practice. In this article, we review the pathophysiology of myocardial blood flow and myocardial flow reserve, and the initial data available from single photon emission computed tomography myocardial blood flow and myocardial flow reserve evaluation; we also discuss potential limitations to the wider implementation of flow evaluation in single photon emission computed tomography.
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