INDICATIONS FOR CLINICAL-APPLICATION OF P OSITRON EMISSION TOMOGRAPHYIN CARDIOLOGY

Positron emission tomography (PET) respresents the most advanced scint igraphic technique which allows accurate qualitative and quantitative assessment of regional myocardial tracer distribution. Besides its wel l documented potential as a research tool, PET has gained increasing c linical acceptance in cardiology. At the current time, the two most im portant clinical indications are the detection of coronary artery dise ase using perfusion traces and the evaluation of patients with advance d coronary artery disease and impaired left ventricular function for i dentification of tissue viability using metabolic tracers. Direct comp arison of PET and SPECT imaging has shown improved diagnostic accuracy of PET imaging for detection of CAD. However, the high cost and limit ed availability of this technique limit its widespread application as routine method for detection of CAD. Nevertheless, for determination o f the functional significance of regional stenoses, PET is the most ac curate non-invasive method available. Numerous studies using PET FDG-i maging have demonstrated the high diagnostic accuracy of metabolic ima ging for the detection of tissue viability. Recovery of function follo wing revascularization can be predicted with high positive and negativ e predictive value. Based on its documented diagnostic performance, PE T is recommended for assessment of tissue viability especially in pati ents with severely impaired left ventricular function who are candidat es for revascularization or cardiac transplantation. Promising new adv ances in imaging technology may reduce the costs of PET instrumentatio n and, therefore, widen the clinical application of this technique.