Clinical relevance of PET myocardial blood flow quantification

Until a few years ago, myocardial perfusion imaging (MPI) using positron-emission tomography (PET) and the absolute quantification of myocardial blood flow (MBF) was limited to research institutions. Following an increase in the number of PET scanner installations and in the availability of perfusion tracers that do not have to be produced by an on-site cyclotron and commercial software for MBF quantification, a more widespread clinical use of MBF quantification with PET can be expected. This article aims to provide a comprehensive overview of the advantages of MBF quantification with PET highlighting the potential applications in several clinical settings, from patients with cardiovascular risk factors and early coronary artery disease (CAD) to patients with multi-vessel or myocardial disease. Finally, using current evidence, the independent and incremental prognostic information of MBF quantification with PET in addition to the visual interpretation of MPI will also be described.