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

SummaryCardiovascular 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 (82Rb) is a generator-produced PET myocardial perfusion tracer and has been widely used in North America in clinical practice. 82Rb PET has recently become available in some cardiovascular centers in Europe and Japan. Clinical trials are expected in both regions. 82Rb PET has high diagnostic accuracy and recent data have shown its prognostic value. Thus, 82Rb PET would greatly contribute to CAD patients’ care. 82Rb PET can also be used to quantify MBF.This review describes the current status of 82Rb MPI from basic principles to clinical implications. This paper also highlights the recent development of MBF quantification using 82Rb PET.