TABLE 2.
Key Radiopharmaceuticals and Target Mechanisms in Clinical Nuclear Cardiology
| Tracer | Target mechanism |
| SPECT | |
| 99mTc-sestamibi, 99mTc-tetrofosmin, 201Tl | Myocardial perfusion |
| 99mTc-PYP, 99mTc-DPD, 99mTc-HMDP | Cardiac amyloidosis |
| 99mTc-HMPAO- or 111In-labeled WBC | Inflammation |
| 123I-metaiodobenzylguanidine | Myocardial sympathetic innervation |
| 123I-BMIPP | Fatty acid uptake |
| 99mTc-annexin V | Apoptotic cell death |
| 99mTc-RGD imaging peptide | αvβ3 integrin expression |
| PET | |
| 15O-water, 13N-ammonia, 82Rb, 18F-flurpiridaz* | Myocardial perfusion, absolute myocardial blood flow |
| 11C-deoxyglucose | Glucose utilization (viability), inflammation |
| 18F-sodium fluoride | Microcalcification (atherosclerotic plaque) |
| 11C-PiB, 18F-florbetaben, 18F-florbetapir | Cardiac and extracardiac amyloidosis |
| 11C-acetate | Oxidative metabolism, cardiac efficiency |
| 11C-palmitate, 11C-lactate, 11C-glucose, 18F-FTHA | Various aspects of myocardial substrate metabolism |
| 11C-mHED, 11C-epinephrine, 18F-LMI1195* | Myocardial sympathetic innervation |
| 11C-CGP12177, 11C-MQNB, 11C-KR31173 | Receptors of neurohumoral system (β-adrenergic, muscarinic, angiotensin) |
| 68Ga-pentixafor, 68Ga-dotatate, 11C-PK11195 | Receptors involved in inflammatory pathways (CXCR4, somatostatin type 2, TSPO) |
| 18F-fluciclatide, 68Ga-FAPI | Targets involved in extracellular matrix reorganization (αvβ3 integrin, myofibroblast) |
18F-flurpiridaz and 18F-LMI1195: preapproval evaluation in clinical trials.
PYP = pyrophosphate; DPD = diphosphonopropane dicarboxylic acid; HMDP = hydroxymethylene diphosphonate; HMPAO = hexamethyl-propylene-amine-oxime; WBC = white blood cells; BMIPP = β-methyl-iodophenyl-pentadecanoic acid; RGD = arginyl-glycyl-aspartic acid; PiB = Pittsburgh compound B; FTHA = fluorothioheptadecanoic acid; mHED = meta-hydroxyephedrine; 18F-LMI1195 = N-[3-bromo-4-(3-18F-fluoro-propoxy)-benzyl]-guanidine; MQNB = methyl-quinuclidinyl benzilate; CXCR4 = CXC-motif chemokine receptor type 4; TSPO = translocator protein; FAPI = fibroblast activation protein inhibitor. 11C-CGP12177 = 11C-(4-(3-t-butylamino-2-hydroxypropoxy)-benzimidazol-1); 11C-MQNB = 11C-labeled methiodide quinuclidinyl benzilate; 11C-KR31173 = 11C-labeled2-Butyl-5-methoxymethyl-6-(1-oxopyridin-2-yl)-3-[[2-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]-3H-imidazo[4,5-b]pyridine;11C-PK11195 = [11C]-(R)-(2-chlorophenyl)-N-methyl-N-(1-methylpropyl)-3-isoquinoline-carboxamide PK11195.