[Evaluation of patients with coronary insufficiency using single-photon gamma tomography and positron-emission tomography].

In summary, PET and SPECT myocardial imaging both have important roles to play in evaluation of patients with suspected coronary artery and myocardial disease. Tl-201 remains the predominant tracer in clinical use, and even when technetium-labeled myocardial perfusion agents are widely available, Tl-201 will undoubtedly continue to be used for the next few years. PET imaging remains the mode of choice for research evaluation of coronary artery and cardiovascular disease, as well as the preferred method for investigating difficult cases which are equivocal on SPECT perfusion imaging. Wider availability of both PET cameras and central radiopharmacies providing cyclotron produced PET radiopharmaceuticals should provide the impetus for expansion of PET myocardial imaging applications. Even at the price of $1,000-1,500 per scan, study results which permit better informed decisions regarding performance of $5,000-50,000 interventional procedures such as PTCA and CABG make the economics of PET justified. Even with the progress of competing modalities such as echocardiography, MR flow imaging, and MR spectroscopy with tissue characterization, nuclear medicine methods for myocardial evaluation should remain of major importance for the foreseeable future.