Guidelines for quantification of myocardial blood flow using PET issued

Two well-known institutions have released a joint position paper putting forward guidelines for quantification of myocardial blood flow using PET.

The “Clinical Quantification of Myocardial Blood Flow Using PET” has been issued by the Society of Nuclear Medicine and Molecular Imaging’s (SNMMI) Cardiovascular Council and the American Society of Nuclear Cardiology (ASNC). The guidelines have been published in the Journal of Nuclear Cardiology and The Journal of Nuclear Medicine.

Radionuclide myocardial perfusion imaging (MPI) is among the most commonly performed diagnostic tests in cardiology. Positron emission tomography (PET) can quantify global and regional myocardial blood flow, assess regional perfusion abnormalities with relative MPI, and assess function abnormalities and chamber dimensions. Quantification of myocardial blood flow requires accurate measurement of the total tracer activity transported by the arterial blood and delivered to the myocardium over time.

This position statement consolidates and updates technical considerations for clinical quantification of myocardial blood flow and myocardial flow reserve, and it summarizes and updates the scientific basis for their clinical application.

“Quantification of myocardial blood flow is the next great leap in nuclear cardiology, and this document summarizes the data supporting its use and offers guidance to those who are planning to make these measurements in practice,” explains Venkatesh L. Murthy, MD, PhD, vice president-elect of SNMMI’s Cardiovascular Council and a lead author of the position statement.

Prem Soman, MD, PhD, FACC, FASNC, president of ASNC and co-author of the document, points out, “This is a comprehensive document which offers many useful insights into the theory and practice of PET myocardial perfusion imaging.”

The position paper states, “Quantification of myocardial blood flow and myocardial flow reserve represents a substantial advance for diagnostic and prognostic evaluation of suspected or established coronary artery disease.

These methods are at the cusp of translation to clinical practice.” It notes, however, that further efforts are necessary to standardize measures across laboratories, radiotracers, equipment, and software–pointing out, “Most critically, data are needed supporting improved clinical outcomes when treatment selection is based on these measures.”

Sindy Thompson

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