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SPECT and PET in the Evaluation of Coronary Artery Disease¹

¹ From the Division of Nuclear Medicine, Department of Radiology, Stanford University School of Medicine, Stanford, Calif (H.J., H.W.S., G.M.S.), and the Nuclear Medicine Service, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94305 (G.M.S.). Presented as a scientific exhibit at the 1997 RSNA scientific assembly. Received April 13, 1998; revision requested May 21 and received June 30; accepted July 1. Address reprint requests to G.M.S.

Cardiac positron emission tomography (PET) is an accurate method for assessing myocardial perfusion and metabolism in the evaluation of coronary heart disease. PET allows more accurate detection of myocardial ischemia than single photon emission tomography (SPECT). In addition, PET has higher spatial resolution and allows attenuation correction and the quantification of various physiologic parameters. PET with 2-(fluorine-18) fluoro-2-deoxy-d-glucose is considered the standard of reference for predicting improvement in regional or global left ventricular function after revascularization by identifying hibernating viable myocardium that shows diminished perfusion and preserved metabolism. Other less commonly used clinical applications of cardiac PET include assessment of myocardial oxygen consumption and fatty acid metabolism. The use of PET in myocardial imaging is expected to increase in the near future with the regional distribution of positron-emitting radiotracers and the emergence of relatively low-cost PET systems.

Index Terms: Coronary vessels, diseases • Coronary vessels, emission CT (ECT), 54.12162, 54.12163 • Coronary vessels, radionuclide studies, 54.1217 • Myocardium, diseases • Myocardium, emission CT (ECT), 511.12162, 511.12163 • Myocardium, radionuclide studies, 54.1217

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