Generator-produced rubidium-82 positron emission tomography myocardial perfusion imaging-From basic aspects to clinical applications.

Cardiovascular disease is the leading cause of death in modern industrialized countries with an aging population. This fact has fueled the need for innovative diagnostic testing intended to improve coronary artery disease (CAD) patient care. Detection of myocardial ischemia using myocardial perfusion imaging (MPI) plays an important role for CAD diagnosis and the prediction of future risk of cardiovascular events. Positron emission tomography (PET) MPI has high diagnostic accuracy and can estimate regional myocardial blood flow (MBF) in patients with CAD. Rubidium-82 ((82)Rb) is a generator-produced PET myocardial perfusion tracer and has been widely used in North America in clinical practice. (82)Rb PET has recently become available in some cardiovascular centers in Europe and Japan. Clinical trials are expected in both regions. (82)Rb PET has high diagnostic accuracy and recent data have shown its prognostic value. Thus, (82)Rb PET would greatly contribute to CAD patients' care. (82)Rb PET can also be used to quantify MBF. This review describes the current status of (82)Rb MPI from basic principles to clinical implications. This paper also highlights the recent development of MBF quantification using (82)Rb PET.