The Role of Cardiac PET in Diagnosis and Prognosis of Ischemic Heart Disease: Optimal Modality Across Different Patient Populations

This review revisits a now-familiar contest — cardiac PET versus the older SPECT — through the lens of which patients benefit most.

The authors restate PET’s structural advantages: better resolution, higher diagnostic accuracy, lower radiation, and the ability to quantify myocardial blood flow. Their added angle is population-specific value — PET’s edge is largest in complex or hard-to-image patients and where SPECT returns equivocal results, situations in which flow quantification resolves the ambiguity.

The practical takeaway is to reach for PET more readily in complicated cases and after inconclusive SPECT, rather than treating the two as interchangeable. The resistance is the familiar inertia of centers invested in legacy nuclear imaging.

We rate the evidence low: a 46-reference narrative review without original data, and one author discloses imaging-vendor funding. Its clinical significance is moderate — the case for PET in complex patients is sound — but real-world adoption stays limited by scanner availability and cost. (Several reviews in this library make overlapping PET-over-SPECT arguments; this one’s contribution is the patient-population framing.)