Cardiac nuclear medicine, part I: the methods

With the rapid improvement in instrumentation and radiopharmaceuticals, cardiovascular nuclear medicine has undergone dramatic growth. Radiotracer techniques for the estimation of myocardial blood flow, metabolism and cardiac hemodynamics have been accepted into routine clinical practice. These techniques are also providing sensitive tools to help us elucidate cardiac physiology and pathophysiology. Three commonly used examinations are: technetium-99m pyrophosphate imaging for the detection of irreversibly damaged myocardium; thallium-201 imaging for the evaluation of myocardial perfusion and integrity; and cardiac wall motion studies with technetium-99m labeled red blood cells for the assessment of ventricular contraction. This is the first part of a three-part series on cardiac nuclear medicine. Part II will focus on diagnosis of coronary artery disease, and part III will focus on myocardial infarction and other cardiac diseases.