SNMMI abstract of the year: New pet imaging method simplifies coronary artery disease detection

NEW ORLEANS (June 22, 2025)—A newly developed cardiac PET imaging technique offers a simpler way to detect significant coronary artery disease—eliminating the need for complex scanning protocols. This innovative approach, which maintains high diagnostic accuracy, has the potential to make advanced heart imaging more accessible and feasible, particularly during exercise stress testing. The study was presented at the Society of Nuclear Medicine and Molecular Imaging (SNMMI) 2025 Annual Meeting, where it received top recognition as the Abstract of the Year.

Each year, SNMMI chooses an abstract that best exemplifies the most promising advances in the field of nuclear medicine and molecular imaging. This year, the SNMMI Henry N. Wagner, Jr., Abstract of the Year was chosen from more than 1,300 abstracts submitted to the meeting and voted on by reviewers and the society leadership.

¹⁸F-flurpiridaz is a new imaging agent recently approved by the U.S. Food and Drug Administration that helps doctors evaluate blood flow to the heart in people with known or suspected heart disease. Because it stays active in the body longer than older agents, it makes it easier to perform heart scans after exercise—providing not only clear diagnostic images but also valuable information about how the heart performs under stress.

“One limitation of ¹⁸F-flurpiridaz PET is that post-exercise imaging does not allow for first-pass imaging with kinetic modeling to quantify myocardial flow reserve (MFR),” said Robert de Kemp, PhD, head imaging physicist in Cardiac Imaging at the University of Ottawa Heart Institute, in Ottawa, Ontario, Canada. “To address this, our study evaluated whether a simplified post-stress imaging protocol could accurately estimate MFR during both exercise and pharmacologic stress.”

In the study, 220 patients with coronary artery disease underwent ¹⁸F-flurpiridaz PET scans at rest and after either medication-induced or treadmill exercise stress. Static images were taken post-exercise, while dynamic images were acquired at rest and during pharmacologic stress. Researchers measured myocardial blood flow and standardized uptake values (SUV) to develop a mathematical model linking SUV ratios to blood flow ratios. This model was used to estimate MFR from the static imaging data. The accuracy of these estimates in detecting multivessel coronary artery disease was assessed by comparing them to invasive coronary angiography results obtained as part of the ¹⁸F-flurpiridaz phase 3A trial.

The simplified PET approach accurately estimated MFR during pharmacologic stress, showing strong diagnostic ability to detect impaired blood flow. Similarly, in patients who exercised, the estimated MFR reliably identified significant multivessel coronary artery disease with comparable accuracy.

“This is the first evidence showing it may be possible to estimate MFR with treadmill exercise PET imaging,” said de Kemp. “If the proposed method is confirmed, then exercise stress testing with ¹⁸F-flurpiridaz PET should become a first-line test for diagnosis and risk-stratification in patients with coronary artery disease.”

He continued, “These exercise flow reserve estimates can be easily implemented by PET/CT vendors and third-party providers of cardiac image analysis software, allowing the new approach to be implemented quickly upon validation in future studies.”

Abstract 251377. “Quantification of Myocardial Flow Reserve using Exercise Stress F-18-Flurpiridaz PET Imaging,” Kai-yi Wu, Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada; Justen Choueiry, Rob Beanlands, and Robert de Kemp, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Joel Lazewatsky, formerly at Lantheus Medical Imaging, North Billerica, Massachusetts; Cesare Orlandi, Medtrace Pharma A/S, Hørsholm, Denmark; and Rene Packard and Jamshid Maddahi, University of California, Los Angeles, Los Angeles, California.

Link to Abstract

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All 2025 SNMMI Annual Meeting abstracts can be found online.

About the Society of Nuclear Medicine and Molecular Imaging
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to advancing nuclear medicine and molecular imaging—vital elements of precision medicine that allow diagnosis and treatment to be tailored to individual patients in order to achieve the best possible outcomes.

SNMMI’s members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit www.snmmi.org.

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