Initial clinical experience of N13-ammonia myocardial perfusion PET/CT using a compact superconducting production system

• Published in: Journal of nuclear cardiology Vol. 28; no. 1; pp. 295 - 299
• Main Authors: Pieper, Justin, Patel, Vaiibhav N., Escolero, Sylvia, Nelson, Jacob R., Poitrasson-Rivière, Alexis, Shreves, Christopher K., Freiburger, Nick, Hubers, David, Rothley, Jill, Corbett, James R., Oliverio, Joseph, Ficaro, Edward P., Weinberg, Richard L., Murthy, Venkatesh L.
• Format: Journal Article
• Language: English
• Published: Cham Elsevier Inc 01.02.2021; Springer International Publishing; Springer Nature B.V
• Subjects: Aged; Ammonia; Brief Report; Cardiology; Coronary Artery Disease - diagnostic imaging; Cyclotrons; Drug Compounding - instrumentation; Female; Humans; Imaging; instrumentation; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial Perfusion Imaging; Nitrogen Radioisotopes; Nuclear Medicine; perfusion imaging agents; PET; Positron Emission Tomography Computed Tomography; Radiology; Superconductivity; tracer development; perfusion imaging agents; instrumentation; PET; tracer development
• ISSN: 1071-3581; 1532-6551
• DOI: 10.1007/s12350-019-01886-7

Although N13-ammonia has favorable properties among FDA approved radiotracers, complexity of implementation has limited its use. We describe the initial patient experience of N13-ammonia PET imaging using a compact N13-ammonia production system. N13 was produced using the ION-12SC, a 12MeV, 10uA superconducting minimally shielded cyclotron, and reduced to N13-ammonia in an automated multi-use purification unit. Patients were power injected with 9.3 ± 1.1 mCi (344.1 ± 40.7 MBq) of N13-ammonia for rest imaging, and 18.8 ± 0.9 mCi (695.6 ± 33.3 MBq) of N13-ammonia was injected at peak hyperemia for stress testing. Images were interpreted for relative perfusion, left ventricular volumes/function, blood flow quantification, and scored for image quality. In total 97 patients underwent 98 N13-ammonia PET scans (32 rest only/65 rest-stress/1 stress only). Image quality was 91.8% good or excellent. None were poor/non-diagnostic. Study durations were acceptable. Tracer related radiation dosimetry to patients was 0.7 ± 0.1 mSv (rest only), and 2.1 ± 0.1 mSv (rest-stress). Clinical N13-ammonia production by the Ionetix ION-12SC delivers high quality myocardial PET perfusion images in a rapid protocol.