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Dahdal J, Jukema RA, Harms HJ, Cramer MJ, Raijmakers PG, Knaapen P, Danad I. PET Myocardial Perfusion Imaging: Trends, Challenges, and Opportunities. J Nucl Cardiol 2024:102011. [PMID: 39067504 DOI: 10.1016/j.nuclcard.2024.102011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/25/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024]
Abstract
Various non-invasive images are used in clinical practice for the diagnosis and prognostication of chronic coronary syndromes. Notably, quantitative myocardial perfusion imaging (MPI) through positron emission tomography (PET) has seen significant technical advancements and a substantial increase in its use over the past two decades. This progress has generated an unprecedented wealth of clinical information, which, when properly applied, can diagnose and fine-tune the management of patients with different types of ischemic syndromes. This state-of-art review focuses on quantitative PET MPI, its integration into clinical practice, and how it holds up at the eyes of modern cardiac imaging and revascularization clinical trials, along with future perspectives.
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Affiliation(s)
- Jorge Dahdal
- Departments of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Cardiology, Hospital Del Salvador, Santiago, Chile
| | - Ruurt A Jukema
- Departments of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - Maarten J Cramer
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Pieter G Raijmakers
- Radiology, Nuclear Medicine & PET Research, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Paul Knaapen
- Departments of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ibrahim Danad
- Departments of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
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Maaniitty T, Knuuti J. The additional value of relative assessment of quantitative myocardial blood flow. J Nucl Cardiol 2024; 37:101886. [PMID: 38848929 DOI: 10.1016/j.nuclcard.2024.101886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024]
Affiliation(s)
- Teemu Maaniitty
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland; Department of Clinical Physiology, Nuclear Medicine and PET, Turku University Hospital, Turku, Finland.
| | - Juhani Knuuti
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland; Department of Clinical Physiology, Nuclear Medicine and PET, Turku University Hospital, Turku, Finland
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Schindler TH, Sadhu J. Moving towards PET determined coronary flow capacity in outcome prediction after coronary revascularization? Int J Cardiol 2024; 405:131921. [PMID: 38432610 DOI: 10.1016/j.ijcard.2024.131921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Thomas H Schindler
- Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Cardiovascular Medicine, Washington University School of Medicine, St. Louis, MO, USA; Cardiovascular Division, John T. Milliken Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA.
| | - Justin Sadhu
- Cardiovascular Division, John T. Milliken Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA
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Patel KK, Singh A, Qarajeh R, Shatla I, Patel FS, Lehenbauer K, Myadam R, McGhie AI, Bateman TM. Prevalence of balanced ischemia on positron emission tomography relative perfusion imaging among patients with high-risk coronary artery disease. J Nucl Cardiol 2024; 34:101836. [PMID: 38437944 PMCID: PMC11003235 DOI: 10.1016/j.nuclcard.2024.101836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/06/2024]
Affiliation(s)
- Krishna K Patel
- Icahn School of Medicine at Mount Sinai, New York, NY, USA; Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri- Kansas City, Kansas City, MO, USA.
| | - Annapoorna Singh
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri- Kansas City, Kansas City, MO, USA
| | - Raed Qarajeh
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri- Kansas City, Kansas City, MO, USA
| | - Islam Shatla
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri- Kansas City, Kansas City, MO, USA
| | - Femina S Patel
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of California Riverside, Riverside, CA, USA
| | - Kyle Lehenbauer
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri- Kansas City, Kansas City, MO, USA
| | - Rahul Myadam
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri- Kansas City, Kansas City, MO, USA
| | - A Iain McGhie
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri- Kansas City, Kansas City, MO, USA
| | - Timothy M Bateman
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri- Kansas City, Kansas City, MO, USA
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Crowley A, Gerson M. The future of PET imaging: Looking forward to more choices and increased precision with the use of oxygen-15 water. J Nucl Cardiol 2024; 31:101775. [PMID: 38342511 DOI: 10.1016/j.nuclcard.2023.101775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2024]
Affiliation(s)
- Anisiia Crowley
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati Medical Center, USA
| | - Myron Gerson
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati Medical Center, USA.
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Knuuti J, Tuisku J, Kärpijoki H, Iida H, Maaniitty T, Latva-Rasku A, Oikonen V, Nesterov SV, Teuho J, Jaakkola MK, Klén R, Louhi H, Saunavaara V, Nuutila P, Saraste A, Rinne J, Nummenmaa L. Quantitative Perfusion Imaging with Total-Body PET. J Nucl Med 2023; 64:11S-19S. [PMID: 37918848 DOI: 10.2967/jnumed.122.264870] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/04/2023] [Indexed: 11/04/2023] Open
Abstract
Recently, PET systems with a long axial field of view have become the current state of the art. Total-body PET scanners enable unique possibilities for scientific research and clinical diagnostics, but this new technology also raises numerous challenges. A key advantage of total-body imaging is that having all the organs in the field of view allows studying biologic interaction of all organs simultaneously. One of the new, promising imaging techniques is total-body quantitative perfusion imaging. Currently, 15O-labeled water provides a feasible option for quantitation of tissue perfusion at the total-body level. This review summarizes the status of the methodology and the analysis and provides examples of preliminary findings on applications of quantitative parametric perfusion images for research and clinical work. We also describe the opportunities and challenges arising from moving from single-organ studies to modeling of a multisystem approach with total-body PET, and we discuss future directions for total-body imaging.
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Affiliation(s)
- Juhani Knuuti
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland;
- Department of Clinical Physiology, Nuclear Medicine, and PET, Turku University Hospital, Turku, Finland; and
| | - Jouni Tuisku
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Henri Kärpijoki
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Hidehiro Iida
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Teemu Maaniitty
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- Department of Clinical Physiology, Nuclear Medicine, and PET, Turku University Hospital, Turku, Finland; and
| | - Aino Latva-Rasku
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Vesa Oikonen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Sergey V Nesterov
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Jarmo Teuho
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Maria K Jaakkola
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Riku Klén
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Heli Louhi
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Virva Saunavaara
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Pirjo Nuutila
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Antti Saraste
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Juha Rinne
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
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Blach A, Kwiecinski J. The Role of Positron Emission Tomography in Advancing the Understanding of the Pathogenesis of Heart and Vascular Diseases. Diagnostics (Basel) 2023; 13:1791. [PMID: 37238275 PMCID: PMC10217133 DOI: 10.3390/diagnostics13101791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Cardiovascular disease remains the leading cause of morbidity and mortality worldwide. For developing new therapies, a better understanding of the underlying pathology is required. Historically, such insights have been primarily derived from pathological studies. In the 21st century, thanks to the advent of cardiovascular positron emission tomography (PET), which depicts the presence and activity of pathophysiological processes, it is now feasible to assess disease activity in vivo. By targeting distinct biological pathways, PET elucidates the activity of the processes which drive disease progression, adverse outcomes or, on the contrary, those that can be considered as a healing response. Given the insights provided by PET, this non-invasive imaging technology lends itself to the development of new therapies, providing a hope for the emergence of strategies that could have a profound impact on patient outcomes. In this narrative review, we discuss recent advances in cardiovascular PET imaging which have greatly advanced our understanding of atherosclerosis, ischemia, infection, adverse myocardial remodeling and degenerative valvular heart disease.
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Affiliation(s)
- Anna Blach
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland
- Nuclear Medicine Department, Voxel Diagnostic Center, 40-514 Katowice, Poland
| | - Jacek Kwiecinski
- Department of Interventional Cardiology and Angiology, Institute of Cardiology, 04-628 Warsaw, Poland
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Schindler TH, Leucker TM, Bhandiwad A. Entering a new era of the identification and characterization of myocardial ischemic burden with 15O-water PET? Int J Cardiol 2021; 341:22-23. [PMID: 34329679 DOI: 10.1016/j.ijcard.2021.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Thomas H Schindler
- Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Cardiovascular Medicine, Washington University School of Medicine, St. Louis, MO, USA; Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA; Cardiovascular Division, John T. Milliken Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA.
| | - Thorsten M Leucker
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - Anita Bhandiwad
- Cardiovascular Division, John T. Milliken Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA
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