Quantitative approaches to 18F-flurpiridaz positron emission tomography image analysis

Abstract

<p><strong>Key points</strong></p><p>¹⁸F-flurpiridaz is a positron emission tomography (PET) radiotracer for myocardial perfusion imaging (MPI) approved by the United States Food and Drug Administration in September 2024.</p><p>This radiotracer's properties, including a very high 94% myocardial first-pass extraction fraction and positron range of 1 mm, render this probe suitable for high-resolution MPI and quantitative myocardial blood flow (MBF) determination.<br></p><p>We present ¹⁸F-flurpiridaz in the context of other PET MPI radiopharmaceuticals, discuss pivotal experimental studies that provided the foundation for subsequent software-based quantitative strategies in humans, and detail the published methods of relative MPI as well as MBF quantitation.</p><p>The reviewed methods provide a standardization of ¹⁸F-flurpiridaz PET and MBF interpretation that are poised to facilitate this radiotracer's adoption and implementation in cardiac imaging centers.</p>