PET tracers and techniques for measuring myocardial blood flow in patients with coronary artery disease

Assessment of the relative distribution of myocardial flow with myocardial perfusion imaging (MPI) is meth?odologically limited to predict the presence or absence of flow-limited coronary artery disease (CAD). This limi?tation may often occur, when obstructive lesions involve multiple epicardial coronary arteries or disease-related disturbances of the coronary circulation coexist at the microvascular level. Non-invasive assessment of myocar?dial blood flow in absolute units with position emission tomography (PET) has been positioned as the solution to improve CAD diagnosis and prediction of patient outcomes associated with risks for cardiac events. This article reviews technical and clinical aspects of myocardial blood flow quantitation with PET and discusses the practical consideration of this approach toward worldwide clinical utilization.