Evaluation of Myocardial Blood Flow Using ¹⁸F-flurpiridaz PET: Established Applications with Pharmacologic Stress and Roadmap for Exercise Stress Implementation.
- 1Ahmanson Translational Theranostics Division, Department of Nuclear Medicine and Theranostics, University of California Los Angeles (UCLA), Los Angeles, CA, USA.
- 2Departments of Medicine (Division of Artificial Intelligence in Medicine), Biomedical Sciences and Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- 3Division of Cardiology, Department of Medicine, Department of Physiology, California NanoSystems Institute, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA. [email protected].
Abstract
Purpose of review
Recently approved by the United States Food and Drug Administration, ¹⁸F-flurpiridaz for positron emission tomography (PET) myocardial perfusion imaging (MPI) enables high-quality assessment of myocardial blood flow (MBF). Its half-life of approximately 110 min supports regional distribution and allows unit-dose delivery. These features make this probe well suited for MBF quantitation and expand access to quantitative cardiac PET at smaller centers.Recent findings
During pharmacologic stress, absolute MBF and myocardial flow reserve provide incremental diagnostic information beyond relative perfusion imaging. These measures have been validated across multiple methods and software platforms. Further study of this tracer under peak exercise may provide clinically relevant assessment of myocardial demand-induced changes in flow. Potential investigational approaches include artificial intelligence (AI)-derived virtual MBF, exercise-adjusted standardized uptake value (SUV) ratio-derived myocardial flow reserve (MFR) surrogate, and direct kinetic modeling during in-scanner ergometry. While conceptually promising, limitations inherent to exercise-based approaches in stress MBF and/or MFR estimation highlight the need for pragmatic research strategies before potential clinical applicability.
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BibTeX
@article{ali2026evaluation,
title = {{Evaluation of Myocardial Blood Flow Using ¹⁸F-flurpiridaz PET: Established Applications with Pharmacologic Stress and Roadmap for Exercise Stress Implementation.}},
author = {Farzana Z Ali and Piotr J Slomka and René R Sevag Packard},
journal = {Current cardiology reports},
year = {2026},
month = oct,
doi = {10.1007/s11886-026-02439-4},
url = {https://europepmc.org/article/MED/42909758},
note = {CC BY},
}
RIS
TY - JOUR
TI - Evaluation of Myocardial Blood Flow Using ¹⁸F-flurpiridaz PET: Established Applications with Pharmacologic Stress and Roadmap for Exercise Stress Implementation.
AU - Farzana Z Ali
AU - Piotr J Slomka
AU - René R Sevag Packard
PY - 2026
DA - 2026/10/23
JO - Current cardiology reports
DO - 10.1007/s11886-026-02439-4
UR - https://europepmc.org/article/MED/42909758
AB - Purpose of review Recently approved by the United States Food and Drug Administration, ¹⁸F-flurpiridaz for positron emission tomography (PET) myocardial perfusion imaging (MPI) enables high-quality assessment of myocardial blood flow (MBF). Its half-life of approximately 110 min supports regional distribution and allows unit-dose delivery. These features make this probe well suited for MBF quantitation and expand access to quantitative cardiac PET at smaller centers.Recent findings During pharmacologic stress, absolute MBF and myocardial flow reserve provide incremental diagnostic information beyond relative perfusion imaging. These measures have been validated across multiple methods and software platforms. Further study of this tracer under peak exercise may provide clinically relevant assessment of myocardial demand-induced changes in flow. Potential investigational approaches include artificial intelligence (AI)-derived virtual MBF, exercise-adjusted standardized uptake value (SUV) ratio-derived myocardial flow reserve (MFR) surrogate, and direct kinetic modeling during in-scanner ergometry. While conceptually promising, limitations inherent to exercise-based approaches in stress MBF and/or MFR estimation highlight the need for pragmatic research strategies before potential clinical applicability.
SN - 1523-3782
SN - 1534-3170
ER -