Current status and future directions in artificial intelligence for nuclear cardiology

INTRODUCTION: Myocardial perfusion imaging (MPI) is one of the most commonly ordered cardiac imaging tests. Accurate motion correction, image registration, and reconstruction are critical for high-quality imaging, but this can be technically challenging and has traditionally relied on expert manual processing. With accurate processing, there is a rich variety of clinical, stress, functional, and anatomic data that can be integrated to guide patient management. AREAS COVERED: PubMed and Google Scholar were reviewed for articles related to artificial intelligence in nuclear cardiology published between 2020 and 2024. We will outline the prominent roles for artificial intelligence (AI) solutions to provide motion correction, image registration, and reconstruction. We will review the role for AI in extracting anatomic data for hybrid MPI which is otherwise neglected. Lastly, we will discuss AI methods to integrate the wealth of data to improve disease diagnosis or risk stratification. EXPERT OPINION: There is growing evidence that AI will transform the performance of MPI by automating and improving on aspects of image acquisition and reconstruction. Physicians and researchers will need to understand the potential strengths of AI in order to benefit from the full clinical utility of MPI.