Non-invasive and quantitative evaluation of myocardial PET imaging: Next step for advanced therapy

Myocardial positron emission tomography (PET) is superior in detecting ischemia in patients with left main or multivessel disease, conditions that are challenging to assess using single-photon emission computed tomography (SPECT). Additionally, quantitative measurements of myocardial blood flow and myocardial flow reserve (MFR) have been established as significant prognostic indicators for patients with ischemic heart disease. Moreover, ¹³N-ammonia PET offers high temporal and spatial resolution, enabling the assessment of both left and right ventricular strain, a quantitative marker of regional myocardial wall motion. Ongoing research aims to translate these advanced PET-based methodologies into SPECT imaging. Furthermore, MFR has proven valuable for diagnosing and predicting cardiac allograft vasculopathy in heart transplant recipients. More recently, it has also been utilized to evaluate the efficacy of cardiac regeneration therapy in individuals with severe heart failure and reduced cardiac function. This review presents existing evidence and highlights recent advancements in myocardial PET.