Advances in myocardial perfusion imaging

Excerpt

The ability to image myocardial perfusion at rest and following stress using noninvasive imaging techniques began in the early 1970s. Initially performed using radioactive potassium as a tracer and planar imaging,1 substantial advances in perfusion tracers and imaging techniques have culminated in today’s noninvasive approaches. A literal explosion of information followed the introduction of thallium-201 as a perfusion tracer later in the 1970s. Examinations of its property of redistribution led to adoption of protocols that discriminated stress-induced ischemia from infarct following a single injection and following a second injection.2 In the early to mid-1990s, the approval of the Tc99m-based agents sestamibi3 and later tetrofosmin4 allowed improved image quality in more challenging patients, and enabled the widespread use of gated techniques to capture functional information simultaneously with perfusion. The early approval of rubidium-82 for imaging myocardial infarction5 and later stress perfusion6 led to its use in a relatively small number of centers that had access to the tracer. …