RECENT ADVANCES IN NUCLEAR CARDIOLOGY

Abstract

Cardiovascular disease continues to rank among the most significant drivers of preventable global mortality, creating sustained demand for imaging modalities capable of detecting pathophysiology at its earliest and most amenable stages. Nuclear cardiology has progressed substantially from its origins in qualitative myocardial perfusion scintigraphy to encompass a range of functional, quantitative, and hybrid techniques. Pivotal developments—among them positron emission tomography (PET), cadmium–zinc–telluride (CZT) detector technology, and artificial intelligence (AI)—have shifted the discipline from observer-dependent interpretation to objectively measurable, reproducible physiological assessment. Non-invasive quantification of myocardial blood flow (MBF) and coronary flow reserve (CFR) has materially altered the evaluation of coronary artery disease (CAD), including its microvascular and multivessel manifestations. Growing applications in cardiac inflammation, infectious disease, and cardio-oncology broaden the specialty's clinical footprint further still. This review surveys the historical development, technological innovations, principal clinical applications, and emerging directions of nuclear cardiology, highlighting its contribution to precision cardiovascular medicine.