Cardiac PET Intensive Virtual Workshop (May 3-4, 2025)-PET MBF Practice Points

PET MBF Practice Points

Pdf Summary

The American Society of Nuclear Cardiology's 2025 document offers guidance for medical professionals on performing, interpreting, and reporting myocardial blood flow (MBF) measurements using cardiac positron emission tomography (PET) myocardial perfusion imaging (MPI). The document focuses on the importance of quantifying MBF at rest and during peak stress, primarily evaluated using the myocardial blood flow reserve (MBFR) or myocardial flow reserve (MFR).<br /><br />MBFR is a critical metric, representing the stress-to-rest MBF ratio, and is essential for numerous clinical scenarios, enhancing traditional PET MPI data's diagnostic and prognostic utility. These include scenarios with suspected unsuccessful vasodilation, low cardiovascular event risk assessments, and coronary artery disease (CAD) evaluations. The document also outlines the assessment of coronary microvascular dysfunction (CMD) in various patient conditions.<br /><br />The document emphasizes the utilization of rubidium-82 tracer in PET MPI and provides practical advice for consistent MBF measurement, such as ensuring proper patient preparation and equipment calibration. The acquisition of MBF data should include simultaneous rest and stress measurements, with a focus on accurate input data capture by starting the PET camera before tracer injection.<br /><br />Quality control is crucial for obtaining precise MBF data. It includes detecting and correcting common errors such as misregistration or patient motion that could affect results. Interpretation of MBFR involves considering patient-specific factors and comparing MBF values against established benchmarks to stratify risk levels for future cardiovascular events.<br /><br />The document also provides guidelines for reporting MBF and MBFR, emphasizing caution in cases where MBFR may not add diagnostic or prognostic value. Sample reporting statements are provided to guide clinicians in articulating results clearly and effectively.<br /><br />Ultimately, this comprehensive guide aims to help clinicians employ MBF measurements to improve patient care outcomes by more accurately diagnosing and prognosticating cardiovascular conditions.

Keywords

myocardial blood flow

cardiac PET

myocardial perfusion imaging

myocardial flow reserve

coronary artery disease

rubidium-82 tracer

coronary microvascular dysfunction

patient preparation

quality control

risk stratification