First Post-Approval Clinical Use of F-18 Flurpiridaz With Exercise Cardiac PET in the United States.

BACKGROUND

F-18 flurpiridaz is a novel radiotracer approved for positron emission tmography (PET) myocardial perfusion imaging. Its long half-life supports exercise stress testing, and its short positron range and high myocardial extraction fraction provide superior image resolution.

EARLY REPORTS SUMMARY: A 70-year-old man with known coronary artery disease and prior coronary revascularization underwent exercise cardiac PET with F-18 flurpiridaz for chest discomfort. PET showed ischemia in the left anterior descending and right coronary artery territories. Coronary angiography revealed a severe mid-left anterior descending lesion and a severe proximal lesion in a small-caliber right posterior descending artery.

DISCUSSION: Ischemia on PET correlated with coronary angiography and optical coherence tomography, guiding revascularization and altering clinical management.

NOVELTY: This case represents the first post-approval clinical experience of F-18 flurpiridaz with exercise cardiac PET imaging in the United States.

TAKE-HOME MESSAGE: F-18 flurpiridaz has made exercise cardiac PET feasible in the clinical setting.