1. Introduction

Nuclear cardiology is a non-anatomical, physiological imaging method. The use of radioactive or radiopharmaceutical substances makes it possible to study several physiopathological mechanisms of cardiovascular disease in vivo. Via this imaging technique, it is also possible to visualize and accompany an instituted therapy’s physiological effects on cardiac function, on the cellular and biochemical level. Of all the applications of nuclear medicine in cardiology, scintigraphy or myocardial perfusion imaging with technetium-99m-labeled radiopharmaceuticals synchronized with electrocardiogram (Gated-SPECT), is the most common exam in clinical practice. For this reason, this technique will be the most discussed in these Guidelines.

Recent years have, however, seen a growing concern among the scientific community regarding rational and optimized use of ionizing radiation in medicine. Cardiovascular imaging, moreover, encompasses all functional and anatomical imaging techniques and should, in this context, be used rationally and cost-effectively. Other applications of nuclear medicine in cardiology have also emerged and gained prominence during the past decades, especially positron emission tomography (PET) for the study of coronary flow reserve, cardiac sympathetic activity, and inflammatory/infectious processes, and cardiac amyloidosis (CA). All of these aspects have been taken into consideration and will be covered in detail in the chapters developed herein.

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