New frontiers for cardiac PET: looking beyond mean transmural myocardial quantification

Excerpt

In this issue of the journal, Sciagrà et al. report on the use of ¹³N-ammonia (¹³NH₃) to recognize transmural perfusion abnormalities in patients with hypertrophic cardiomyopathy (HCM) [1]. The authors developed a method to quantify absolute blood flow in the subendocardial and subepicardial layers. This paper comes after a series of studies using ¹⁵O-water (H₂ ¹⁵O) with cardiac positron emission tomography (PET) to split mean transmural myocardial perfusion into two layers (subendocardial and subepicardial) and conducted in patients having normal or increased left ventricular (LV) myocardial wall thickness: HCM, coronary artery disease (CAD), aortic stenosis and healthy controls [2‐6]. The study by Sciagrà et al. is of particular interest because it broadens the scope of application of cardiac PET to the use of a more widely available myocardial perfusion PET radiotracer ¹³NH₃ for splitting mean transmural absolute myocardial wall perfusion into subendocardial and subepicardial components. …