Selection of PET Camera and Implications on the Reliability and Accuracy of Absolute Myocardial Blood Flow Quantification

Purpose of ReviewPET scanner design and performance evaluation has been driven historically by the imaging requirements for whole-body imaging in oncology. Cardiac PET imaging for accurate quantification of myocardial blood flow (MBF) using short-lived tracers such as rubidium-82 imposes additional requirements for wide dynamic range and high count-rate accuracy. This paper examines the technical challenges encountered in cardiac imaging of myocardial perfusion and blood flow quantification.Recent FindingsThe newest PET-CT scanners using digital silicon photomultiplier technology have high absolute sensitivity (4-20%) and time-of-flight resolution (3-7 cm) which further improves image quality. The concept of "integral" noise equivalent counts (iNEC) is introduced to compare scanner count-rate performance over the wide dynamic range encountered in MBF imaging with rubidium-82.SummaryThe latest-generation digital PET scanners with wide axial field-of-view and enhanced time-of-flight resolution should enable accurate quantification of MBF, without any compromise in the quality of conventional ECG-gated myocardial perfusion images.