Current status and prospects of cardiac PET

With positron emission tomography (PET), noninvasive measurements of myocardial blood flow and metabolism have now become possible. 1) Myocardial blood flow: We developed a high-resolution PET system for rabbits and showed that myocardial N-13 ammonnia uptake correlated well with flow measure with microspheres. We also demonstrated that a simplified PET protocol using N-13 ammonia or Rb-82 provide noninvasive measurement of coronary flow reserve in dog experiments. This protocol enables to produce estimates of myocardial blood flow in man and that are well correlated with the complex compartment model. 2) Myocardial glucose metabolism: We validated experimentally a simple method to quantify tissue glucose utilization with the brain reference index (BRI) using C-14 deoxyglucose and assessed its clinical feasibility for myocardial PET. 3) Membrane integrity: Loss of cell membrane integrity for trapping the potassium or it's analog is a market of myocardial necrosis/viability. We recently synthetized potassium-38 as a PET tracer and started an experimental study. (author)