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IMAGE INTERPRETATION · CARDIAC IMAGING

PET vs SPECT MPI: Absolute Myocardial Blood Flow

Myocardial perfusion imaging — comparison of SPECT and PET
Myocardial perfusion imaging — comparison of SPECT and PET

CC BY-SA 3.0 · Wikimedia Commons · source file

Question

PET myocardial perfusion imaging (with Rb-82 or N-13 ammonia) has several advantages over SPECT MPI. Which of the following is a key advantage of PET over SPECT for myocardial perfusion imaging?

  1. APET requires no attenuation correction
  2. BPET cannot detect multivessel disease
  3. CPET MPI can measure absolute myocardial blood flow (in mL/min/g) in addition to relative perfusion
  4. DPET has lower spatial resolution than SPECT
Show the answer and explanation

C. PET MPI can measure absolute myocardial blood flow (in mL/min/g) in addition to relative perfusion

A major advantage of PET MPI over SPECT is the ability to measure ABSOLUTE myocardial blood flow (MBF) in mL/min/g and myocardial flow reserve (MFR = stress MBF / rest MBF), using dynamic PET acquisitions with kinetic modeling. This is particularly valuable for detecting balanced multivessel ischemia (where all territories are equally ischemic, making relative perfusion appear normal) and microvascular dysfunction. PET also offers: superior spatial resolution, higher count rates, routine CT attenuation correction, and shorter acquisition times. Absolute MBF measurement is not possible with conventional SPECT.

More cardiac imaging images

Tc-99m PYP scan: anterior and posterior chest views with ROI circles and heart-to-lung ratio of 1.6Tc-99m PYP Heart-to-Lung Ratio for Cardiac Amyloidosis Tc-99m PYP scan: anterior and posterior chest views with ROI measurements and H/CL ratio of 1.63Tc-99m PYP Amyloid Scan Protocol Myocardial perfusion SPECT — stress (top) and rest (bottom) imagesNormal Myocardial Perfusion SPECT, Stress and Rest Nuclear medicine myocardial perfusion scan — normal studyMyocardial Perfusion Tracers: Sestamibi and Tetrofosmin Cardiac SPECT without attenuation correction (top row) vs. with attenuation correction (bottom row)Diaphragmatic Attenuation Artifact on Cardiac SPECT Myocardial perfusion SPECT — short axis slices, stress and restFixed Perfusion Defect: Myocardial Scar on SPECT
← Dobutamine Stress for Myocardial Perfusion ImagingTc-99m PYP Heart-to-Lung Ratio for Cardiac Amyloidosis →

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