Benefits of Time-of-flight Positron Emission Tomography Computed Tomography with ¹³N-ammonia

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Noninvasive quantification of regional myocardial blood flow (MBF) and coronary flow reserve (CFR) by myocardial perfusion positron emission tomography/computed tomography (PET/CT) imaging is well-established and has additional diagnostic value over traditional visual analysis. A growing need for high sensitivity and high spatial resolution capable of assessing smaller targets with shorter acquisition time has led to technical advancements. These include whole-body imaging, 3-dimensional (3D) mode acquisition, application of new scintillator materials, and iterative reconstruction algorithms. Among these advancements, the combination of 3D mode acquisition and time-of-flight (TOF) technology has played an important role in clinical oncology PET/CT studies. In this review, I summarized studies that have focused on the use of TOF PET/CT with ¹³N-ammonia (¹³N-NH₃). Compared with conventional PET acquisition, the combination of 3D mode acquisition and the TOF imaging can improve noise and image quality in ¹³N-NH₃ perfusion imaging. As a result, it yields high reproducibility and accurate measurement of CFR.