Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands.
Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands.
Br J Radiol. 2023 Dec;96(1152):20230704. doi: 10.1259/bjr.20230704. Epub 2023 Oct 24.
Cardiovascular diseases (CVD) are the leading cause of death worldwide and have an increasing impact on society. Precision medicine, in which optimal care is identified for an individual or a group of individuals rather than for the average population, might provide significant health benefits for this patient group and decrease CVD morbidity and mortality. Molecular imaging provides the opportunity to assess biological processes in individuals in addition to anatomical context provided by other imaging modalities and could prove to be essential in the implementation of precision medicine in CVD. New developments in single-photon emission computed tomography (SPECT) and positron emission tomography (PET) systems, combined with rapid innovations in promising and specific radiopharmaceuticals, provide an impressive improvement of diagnostic accuracy and therapy evaluation. This may result in improved health outcomes in CVD patients, thereby reducing societal impact. Furthermore, recent technical advances have led to new possibilities for accurate image quantification, dynamic imaging, and quantification of radiotracer kinetics. This potentially allows for better evaluation of disease activity over time and treatment response monitoring. However, the clinical implementation of these new methods has been slow. This review describes the recent advances in molecular imaging and the clinical value of quantitative PET and SPECT in various fields in cardiovascular molecular imaging, such as atherosclerosis, myocardial perfusion and ischemia, infiltrative cardiomyopathies, systemic vascular diseases, and infectious cardiovascular diseases. Moreover, the challenges that need to be overcome to achieve clinical translation are addressed, and future directions are provided.
心血管疾病（CVD）是全球范围内的主要死亡原因，对社会的影响日益增加。精准医学旨在为个体或群体提供最佳的医疗服务，而不是针对普通人群，这可能为这一患者群体带来显著的健康益处，并降低 CVD 的发病率和死亡率。分子影像学除了提供其他影像学方式提供的解剖学背景外，还有机会评估个体的生物学过程，并可能在 CVD 精准医学的实施中发挥重要作用。单光子发射计算机断层扫描（SPECT）和正电子发射断层扫描（PET）系统的新发展，结合有前途和特异性放射性药物的快速创新，为诊断准确性和治疗评估提供了令人印象深刻的改进。这可能会改善 CVD 患者的健康结果，从而减轻社会影响。此外，最近的技术进步为准确的图像定量、动态成像和放射性示踪剂动力学的定量提供了新的可能性。这可能允许更好地评估疾病活动随时间的变化和治疗反应的监测。然而，这些新方法的临床应用进展缓慢。本文综述了分子影像学的最新进展，以及定量 PET 和 SPECT 在心血管分子影像学各个领域（如动脉粥样硬化、心肌灌注和缺血、浸润性心肌病、系统性血管疾病和感染性心血管疾病）的临床价值。此外，还讨论了实现临床转化所需克服的挑战，并提供了未来的发展方向。
