{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:55:36Z","timestamp":1773251736676,"version":"3.50.1"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":223,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008487","name":"Finnish Ministry of Social Affairs and Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008487","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005744","name":"Foundation for Pediatric Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005744","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005633","name":"Finnish Foundation for Cardiovascular Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Positron emission tomography (PET) perfusion with 15O-water is the reference standard for myocardial blood flow (MBF) quantification. Its strengths are low radiation dose, optimal tracer kinetics, and a short imaging protocol. However, the use of 15O-water or PET perfusion in patients with various complex congenital heart diseases has been rarely studied. We report the initial experiences of 15O-water PET perfusion in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>All 15O-water scans from patients with complex congenital heart disease at Helsinki University Hospital were retrospectively assessed (11\/2021\u201311\/2025). Thirteen congenital heart disease patients who underwent adenosine-stress 15O-water PET were identified. Most common diagnoses were transposition of the great arteries (5\/13, 38%), Tetralogy of Fallot (3\/13, 23%), and univentricular heart (3\/13, 23%). PET perfusion was diagnostic in all cases with no adverse effects reported. The radiation dose for stress protocol was 0.3 mSv for paediatric and 0.6 mSv for adult patients, and double when rest perfusion was also obtained to calculate myocardial flow reserve. The global stress MBF was normal (&amp;gt;2.3\u2005mL\/g\/min) in 12\/13 patients. Eleven patients (85%) had anatomical coronary imaging available, all without significant stenoses. One patient had an apical transmural scar on cardiac magnetic resonance imaging, and both stress and rest 15O-water PET perfusion was decreased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>15O-water PET offers a feasible and safe ultra-low-dose approach to quantify myocardial perfusion in complex congenital heart disease and may help identify flow-limiting disease when CT anatomy alone is inconclusive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjimp\/qyag033","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:43:24Z","timestamp":1772109804000},"source":"Crossref","is-referenced-by-count":0,"title":["15O-water PET perfusion in complex congenital heart disease"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8425-9702","authenticated-orcid":false,"given":"Sanna","family":"Kettunen","sequence":"first","affiliation":[{"name":"New Children\u2019s Hospital Pediatric Research Center, Helsinki University Hospital and University of Helsinki , PL 347, 00029 HUS, Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riitta","family":"Paakkanen","sequence":"additional","affiliation":[{"name":"New Children\u2019s Hospital Pediatric Research Center, Helsinki University Hospital and University of Helsinki , PL 347, 00029 HUS, Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9092-7763","authenticated-orcid":false,"given":"Tiina","family":"Ojala","sequence":"additional","affiliation":[{"name":"New Children\u2019s Hospital Pediatric Research Center, Helsinki University Hospital and University of Helsinki , PL 347, 00029 HUS, Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teemu","family":"Maaniitty","sequence":"additional","affiliation":[{"name":"Turku PET Centre, Turku University Hospital and University of Turku , Turku ,","place":["Finland"]},{"name":"Department of Clinical Physiology, Nuclear Medicine, and PET, Turku University Hospital , Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valtteri","family":"Uusitalo","sequence":"additional","affiliation":[{"name":"Clinical Physiology and Nuclear Medicine, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2026031018373634300_qyag033-B1","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1016\/j.jacc.2014.05.069","article-title":"Quantitative assessment of myocardial perfusion in the detection of significant coronary artery disease: cutoff values and diagnostic accuracy of quantitative [(15)O]H2O PET imaging","volume":"64","author":"Danad","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2026031018373634300_qyag033-B2","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/joim.13080","article-title":"Coronary artery disease in patients with congenital heart defects","volume":"288","author":"Jokinen","year":"2020","journal-title":"J Intern Med"},{"key":"2026031018373634300_qyag033-B3","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s13550-023-01045-7","article-title":"Adenosine-induced splenic switch-off on [15O]H2O PET perfusion for the assessment of vascular vasodilatation","volume":"13","author":"Inkinen","year":"2023","journal-title":"EJNMMI Res"},{"key":"2026031018373634300_qyag033-B4","doi-asserted-by":"crossref","first-page":"H1798","DOI":"10.1152\/ajpheart.01309.2004","article-title":"Myocardial perfusion reserve in adults with cyanotic congenital heart disease","volume":"289","author":"Brunken","year":"2005","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2026031018373634300_qyag033-B5","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.ijcard.2019.07.041","article-title":"Myocardial blood flow and cardiac sympathetic innervation in young adults late after arterial switch operation for transposition of the great arteries","volume":"299","author":"Ossner","year":"2020","journal-title":"Int J Cardiol"},{"key":"2026031018373634300_qyag033-B6","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1016\/S0735-1097(98)00479-3","article-title":"Myocardial blood flow and coronary flow reserve late after anatomical correction of transposition of the great arteries","volume":"32","author":"Bengel","year":"1998","journal-title":"J Am Coll Cardiol"},{"key":"2026031018373634300_qyag033-B7","doi-asserted-by":"crossref","first-page":"102175","DOI":"10.1016\/j.nuclcard.2025.102175","article-title":"18F flurpiridaz PET MPI: imaging characteristics and clinical trials","volume":"45S","author":"Maddahi","year":"2025","journal-title":"J Nucl Cardiol"}],"container-title":["European Heart Journal - Imaging Methods and 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