Current and future applications of cardiac nuclear medicine

Cardiac nuclear medicine refers to three techniques: 1. Radionuclide ventriculography (RNV, also known as MUGA) 2. Myocardial perfusion scintigraphy (MPS) 3. Positron emission tomography (PET) Radionuclide ventriculography has been largely superseded by echocardiography. Occasionally it is helpful in determining ventricular function when echocardiographic views are limited and there is a contraindication to magnetic resonance imaging (MRI). MPS is by far the most commonly used imaging modality to assess myocardial ischaemia. It provides robust data on perfusion, viability and function. It is being challenged by techniques such as stress echocardiography, cardiac MRI (CMR) and cardiac computed tomography (CT). Cardiac PET remains highly specialised and is primarily used as the gold standard for assessment of myocardial viability. The last few years have seen an exciting, expanding role for the detection and management of endocardial infection, cardiac sarcoidosis, and in complex heart failure.