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Advances in Digital PET Technology and Its Potential Impact on Myocardial Perfusion and Blood Flow Quantification

  • Nuclear Cardiology (V Dilsizian, Section Editor)
  • Published:
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Abstract

Purpose of Review

In this review, we explore the development of digital PET scanners and describe the mechanism by which they work. We dive into some technical details on what differentiates a digital PET from a conventional PET scanner and how such differences lead to better imaging characteristics. Additionally, we summarize the available evidence on the improvements in the images acquired by digital PET as well as the remaining pitfalls. Finally, we report the comparative studies available on how digital PET compares to conventional PET, particularly in the quantification of coronary blood flow.

Recent Findings

The advent of digital PET offers high sensitivity and time-of-flight (TOF), which allow lower activity and scan times, with much less risk of detector saturation. This allows faster patient throughput, scanning more patients per generator, and acquiring more consistent image quality across patients. The higher sensitivity captures more of the potential artifacts, particularly motion-related ones, which presents a current challenge that still needs to be tackled.

Summary

The digital silicon photomultiplier (SiPM) positron emission tomography (PET) machine has been an important development in the technological advancements of non-invasive nuclear cardiovascular imaging. It has enhanced the utility for PET myocardial perfusion imaging (MPI) and myocardial blood flow (MBF) quantification.

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Abbreviations

PET:

Positron emission tomography

MPI:

Myocardial perfusion imaging

MBF:

Myocardial blood flow

SiPM:

Silicon photomultiplier

TOF:

Time of flight

CAD:

Coronary artery disease

CMD:

Coronary microvascular dysfunction

PMT:

Photomultiplier tube

SPAD:

Single-photon avalanche diode

DPC:

Digital photon counter

FOV:

Field of view

MFR:

Myocardial blood flow reserve

MACE:

Major adverse cardiovascular event

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Authors and Affiliations

  1. Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, Smith Tower - Suite 1801, 77030, Houston, TX, USA

    Fares Alahdab, Mahmoud Al Rifai, Ahmed Ibrahim Ahmed & Mouaz H. Al-Mallah

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  1. Fares Alahdab
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  2. Mahmoud Al Rifai
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  3. Ahmed Ibrahim Ahmed
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  4. Mouaz H. Al-Mallah
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Correspondence to Mouaz H. Al-Mallah.

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Dr. Al-Mallah discloses research funding from Siemens and acts as a consultant to Jubilant. The rest of the authors have nothing to disclose.

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Alahdab, F., Al Rifai, M., Ahmed, A.I. et al. Advances in Digital PET Technology and Its Potential Impact on Myocardial Perfusion and Blood Flow Quantification. Curr Cardiol Rep 25, 261–268 (2023). https://doi.org/10.1007/s11886-023-01850-5

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