Molecular cardiac PET besides FDG viability imaging

Molecular cardiac non F-18-FDG PET is currently based on perfusion imaging. It is of excellent diagnostic accuracy to detect coronary artery disease (CAD) and superior to perfusion SPECT. There is also evidence for its incremental prognostic value. The unique feature of PET to measure myocardial perfusion in absolute terms and in short time periods define its impact on cardiac imaging enabling both the evaluation of early changes in CAD and the accurate characterization of multivessel disease. Currently, all available PET perfusion tracers in Europe are cyclotron products. Rb-82, a generator product, is the most frequently employed perfusion tracer in the United States and cyclotron independent. This tracer has the potential to become an alternative in Europe soon. Nowadays, PET systems are manufactured as hybrid PET-CT scanners. In oncology, hybrid imaging revealed, that the combination of functional and morphological imaging is superior to the single components. In cardiology, the integration of perfusion PET imaging with CT calcium scoring and CT anatomy of the coronary arteries represents a similar constellation. Atherosclerotic plaque evaluation by combined PET-CT technique will be one of the most promising future applications with a potential immense impact on prophylaxis, diagnosis and therapy of CAD in the future. (orig.)