Excerpt

Cardiac positron emission tomography (PET) imaging steadily continues to evolve into a pivotal imaging modality for the management of patients with cardiovascular diseases. While there is accumulating evidence that PET myocardial perfusion imaging may be the first choice in the evaluation of ischemic heart disease,1,2 other indications such as prosthetic heart valve endocarditis,3 atherosclerotic plaque imaging,4 cardiac amyloidosis, 5 or cardiac sarcoidosis 6 are either already established or about to be implemented into clinical routine in the near future. There are, however, several important limitations still to be addressed. Despite the substantial refinements in various aspects of hardware and software technology, exploiting the potential spatial resolution of PET systems remains challenging in the field of cardiac imaging as image quality is inherently and simultaneously affected by cardiac contractions, respiratory motion, and patient movements. As a consequence, the high theoretical spatial resolution of state-of-the-art PET scanners does not translate into the effective global spatial resolution of PET images obtained in the clinical setting. Naturally, several techniques have been developed over the years to compensate for this loss in spatial resolution. However, while the road towards correction of cardiac contractions basically starts and ends with ECG gating, the road towards getting respiratory motion under control has proved to be much less straightforward. …