How viable is SPECT for viability assessment in the PET era?

Excerpt

The article published by Zhang et al has entertained a novel assessment of myocardial viability with the integration of myocardial perfusion, wall motion and thickening with SPECT as a valid alternative to conventional PET imaging. In patients with ischemic heart failure, the ability to assess viable myocardium has been a cornerstone to assess cardiac status and potentially alter outcomes in patients with reduced left ventricular function. Patients with dysfunctional but viable myocardium have historically benefited from revascularization.1 Hibernation is a phase best described as viable myocardium existing in a transitional state with recurrent ischemic triggers rendering the myocardium dysfunctional, but still in possession of the metabolic capacity to contribute to contractile reserve following revascularization.2 …