How to perform quantification of myocardial blood flow using single-photon emission computed tomography myocardial perfusion imaging.

Quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) using SPECT myocardial perfusion imaging (MPI) represents a significant advancement in the field of nuclear cardiology. The introduction of cadmium-zinc-telluride (CZT) solid-state detectors and innovative reconstruction algorithms has enabled dynamic SPECT imaging for MBF quantification. This review provides a guide to performing and interpreting quantitative SPECT MBF measurements in clinical practice. We discuss appropriate patient selection, protocol optimization, technical requirements, and acquisition parameters. Step-by-step approaches to image reconstruction, processing methods, and quantitative analysis are outlined, with emphasis on real-world clinical cases discussion. The review also addresses common technical challenges, potential pitfalls, and practical solutions for implementing this technology in routine clinical care. This article aims to facilitate wider adoption of SPECT MBF quantification as a valuable tool for diagnosing coronary artery disease and assessing coronary microvascular function.