Nuclear cardiology (PET and SPECT)—basic principles

Historically, radionuclide imaging has been the key to the success and widespread clinical application of non-invasive techniques for detection of myocardial ischaemia. Today, the use of myocardial perfusion single photon emission computed tomography (SPECT) for the diagnostic and prognostic workup of coronary artery disease is supported by a very large body of evidence. Positron emission tomography (PET) as an advanced, quantitative technique is increasingly penetrating the clinical arena. The field is responding to recent trends by adopting new technology and algorithms for reduction of radiation exposure and by developing a toolbox for targeted molecular imaging of key biologic mechanisms involved in heart disease and therapy response. By this, nuclear cardiology will continue to serve as a role model for the success of functional imaging in heart disease. This chapter gives an overview over the basic technology, including novel methodologic developments.