Table 2.

Advantages and disadvantages of PET, MRS, and SPECT in evaluation of myocardial metabolism

	Advantages	Disadvantages
PET	Quantitative metabolic and blood flow measurements; high sensitivity; radiotracers as natural substrates and chemical analogs; many metabolic radiotracers available	Cyclotron needed on site due to short half lives; only one process can be evaluated at a time; difficulty with separating reaction steps in a pathway
MRS	Simultaneous measurements of multiple metabolic pathways and function; ease in performing serial measurements, no ionizing radiation; higher field strength in small animal imaging	Poor sensitivity (millimolar); low signal to noise ratio; intravoxel signal contamination; long acquisition times; measurement limited to anterior wall in humans
SPECT	High sensitivity; widely available; long half lives facilitate radiopharmaceutical delivery; simultaneous imaging of two radiopharmaceuticals with different energies; ECG gating for myocardial function	Inability to quantify processes with lack of attenuation correction; poor temporal and spatial resolution; few radiopharmaceuticals available for evaluation of metabolism