Myocardial blood flow (MBF) quantification with PET is generally considered a gold standard for the measurement of myocardial perfusion in absolute terms. The resulting values of MBF and myocardial flow reserve (MFR) used to determine the diagnostic path of a patient have a twofold (for MFR) or threefold (for MBF) range in literature, which interferes with establishing meaningful cutoffs－numeric values to tell healthy tissues from sick.

The review discusses software-based causes of variation of the quantification values that can be introduced at various steps of an image analysis－reconstruction, segmentation, quality control, tracer kinetic modelling, and outputting the resulting values. The review discusses possible solutions as well as the future of myocardial blood flow quantification software development.