Quantitative myocardial perfusion imaging across PET, SPECT, CMR, and CT

Area of Science:

• Cardiology
• Medical Imaging
• Diagnostic Techniques

Background:

• Coronary computed tomography angiography (CCTA) trials have shifted focus from functional testing.
• Myocardial perfusion imaging (MPI) remains vital for specific patient groups, including those with suspected coronary artery disease (CAD), microvascular dysfunction, and cardiomyopathies.

Purpose of the Study:

• To review the physiological principles, acquisition, and post-processing strategies for MPI.
• To discuss the clinical relevance and future perspectives of quantitative MPI across various imaging modalities.

Main Methods:

• Review of current literature on positron emission tomography (PET), cardiovascular magnetic resonance (CMR), computed tomography (CT), and Single Photon Emission Computed Tomography (SPECT) for MPI.
• Focus on absolute quantification of myocardial blood flow (MBF).

Main Results:

• Advances in PET, CMR, and CT allow for absolute quantification of myocardial blood flow (MBF).
• Quantitative MPI offers improved diagnostic and prognostic performance compared to traditional methods.

Conclusions:

• Quantitative MPI is essential for a comprehensive assessment of myocardial perfusion in diverse cardiovascular conditions.
• There is a need to reappraise the role of MPI in light of technological advancements and new clinical trial data.