Evaluation of Ischemic Heart Disease

The use of PET/CT hybrid imaging in ischemic heart disease, integrating information from PET and CT, has grown in the last decade, particularly because of its capacity of quantifying myocardial perfusion, allowing the assessment of myocardial blood flow (MBF) and myocardial flow reserve (MFR). This feature makes PET/CT the technique best suited to detect multivessel coronary artery disease which might not be identified with SPECT due to its inherent limitation in cases of balanced ischemia. Additionally, the CT component of these hybrid imaging systems allows calculation of coronary artery calcium score (ChACS) and the visualization of the epicardial coronary arteries with coronary CT angiography (CCTA). PET/CT has therefore a great potential in the diagnosis and management of CAD. This chapter will cover several clinical cases, illustrating many different clinical applications in ischemic heart disease.