Nuclear cardiology has become a well established subspecialty in the field of cardiovascular diseases. It employs radioisotopes and pharmaceutical agents labeled with isotopes for imaging of the cardiovascular system. Unlike other imaging modalities which essentially display anatomical details, nuclear studies or scintigraphy procedures demonstrate functional abnormalities. During the last three decades, myocardial perfusion imaging (MPI) using Thallium (201Tl) for non-invasive detection of coronary artery lesions, has this field has advanced to SPECT (single photon emission computerized tomography), an excellent imaging technique, with newer Technetium (99mTc) labeled tracers. The value of MPI in improved detection of coronary artery disease (CAD), and assessment of ischaemic severity is well documented. Its role is valuable in risk stratification, prognostication, viability assessment, and follow-up after revascularization in patients with known or suspected CAD. Non-invasive assessment of global and regional left ventricular function using gated first pass and equilibrium radionuclide angiography (RNA) is now well established. It also allows for the quantitative assessment of the LV function simultaneously with the evaluation of the LV perfusion. With the advent of positron emission tomography (PET), the scope of functional imaging is now widened. Imaging of myocardial glucose utilization in the setting of ischaemia helps in studying the pathophysiology of various diseases. Metabolism in myocardium can be studied using 18 Fluorodeoxy glucose and 11C-fatty acids.
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