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

J Nucl Cardiol. 2021 Feb;28(1):295-299. doi: 10.1007/s12350-019-01886-7. Epub 2019 Sep 12.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: Clinical N13-ammonia production by the Ionetix ION-12SC delivers high quality myocardial PET perfusion images in a rapid protocol.

Keywords: PET; instrumentation; perfusion imaging agents; tracer development.

MeSH terms

  • Aged
  • Ammonia*
  • Coronary Artery Disease / diagnostic imaging*
  • Cyclotrons
  • Drug Compounding / instrumentation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging*
  • Nitrogen Radioisotopes*
  • Positron Emission Tomography Computed Tomography*
  • Superconductivity

Substances

  • Nitrogen Radioisotopes
  • Nitrogen-13
  • Ammonia