Cardiac PET Perfusion Tracers: Current Status and Future Directions

PET myocardial perfusion imaging (MPI) is increasingly being used for noninvasive detection and evaluation of coronary artery disease. However, the widespread use of PET MPI has been limited by the shortcomings of the current PET perfusion tracers. The availability of these tracers is limited by the need for an onsite (15O water and 13N ammonia) or nearby (13N ammonia) cyclotron or commitment to costly generators (82Rb). Owing to the short half-lives, such as 76 seconds for 82Rb, 2.06 minutes for 15O water, and 9.96 minutes for 13N ammonia, their use in conjunction with treadmill exercise stress testing is either not possible (82Rb and 15O water) or not practical (13N ammonia). Furthermore, the long positron range of 82Rb makes image resolution suboptimal and its low myocardial extraction limits its defect resolution. In recent years, development of an 18F-labeled PET perfusion tracer has gathered considerable interest. The longer half-life of 18F (109 minutes) would make the tracer available as a unit dose from regional cyclotrons and allow use in conjunction with treadmill exercise testing. Furthermore, the short positron range of 18F would result in better image resolution. Flurpiridaz F 18 is by far the most thoroughly studied in animal models and is the only 18F-based PET MPI radiotracer currently undergoing clinical evaluation. Preclinical and clinical experience with Flurpiridaz F 18 demonstrated a high myocardial extraction fraction, high image and defect resolution, ...
Source: Seminars in Nuclear Medicine - Category: Radiology Authors: Source Type: research