Abstract

Nuclear Medicine enables functional assessment of the pediatric cardiovascular and respiratory systems. Various nuclear imaging modalities, including myocardial perfusion scintigraphy [single photon emission computerized tomography (SPECT) and positron emission tomography (PET)], fluorodeoxyglucose (FDG)-PET, radiolabeled leukocyte scintigraphy, somatostatin receptor imaging, and methaiodobenzylguanidine scintigraphy, are analyzed in the context of congenital heart disease, Kawasaki disease, heart transplantation, cardiomyopathies, and pulmonary vascular anomalies. Myocardial perfusion imaging using SPECT and PET is essential for evaluating coronary anomalies and post-surgical follow-up. FDG-PET is a valuable tool for assessing infection, inflammation, and myocardial viability. F-18 FDG PET/computed tomography demonstrates high sensitivity in diagnosing infections related to ventricular assist devices and prosthetic materials in congenital heart repair. Pulmonary perfusion scintigraphy is a reliable method for detecting pulmonary artery stenosis, venous obstruction, and embolism. Additionally, mucociliary clearance imaging contributes to understanding and monitoring diseases such as cystic fibrosis. With the advancement of new radiopharmaceuticals and high-resolution imaging systems, diagnostic accuracy increases while minimizing radiation exposure. Consequently, nuclear imaging is becoming not merely complementary but a core diagnostic tool in pediatric cardiology and pulmonology. This review aims to present the indications, radiopharmaceuticals, imaging techniques, and clinical relevance of Nuclear Medicine applications in pediatric cardiac and pulmonary conditions based on current scientific evidence.