Available online 26 August 2023

Imaging water pathways in the human body provides an excellent way of measuring accurately the blood flow directed to different organs. This makes it a powerful diagnostic tool for a wide range of diseases that are related to perfusion and oxygenation. Although water PET has a long history, its true potential has not made it into regular clinical practice. The article highlights the potential of water PET in molecular imaging and suggests its prospective role in becoming an essential tool for the 21st century precision medicine in different domains ranging from preclinical to clinical research and practice. The recent technical advances in high-sensitivity PET imaging can play a key accelerating role in empowering this technique, though there are still several challenges to overcome.

arterial spin labelling

blood-oxygen-level-dependent

cerebral metabolic rate of O2 consumption

coronary artery disease

cerebrovascular disorders

deep brain stimulation

image derived input function

long axial field of view

Late Gadolinium Enhancement

mild cognitive impairment

Major Depressive Disorder

Medical Device Regulations

oxygen extraction fraction

peripheral arterial disease

positron emission tomography

positron emission tomography-magnetic resonance image

perfusable tissue fraction

perfusable tissue index

post-traumatic stress disorder

peripheral vascular disease

single photon emission computed tomography

© 2023 The Author(s). Published by Elsevier Inc.