Optimization of Intraventricular Radioactive Concentration for 13N ammonia PET with Time-of-Flight Scanner: Simplified Phantom Study with Noise Equivalent Count Rate Analysis

Yoko Kaimoto; Kenji Fukushima; Kazuko Kanaya; Masayasu Asanuma; Kaoru Aoba; Atsushi Yamamoto; Risako Nakao; Koichiro Kaneko; Michinobu Nagao; Koichi Chida

doi:10.17996/anc.23-00178

Optimization of Intraventricular Radioactive Concentration for ¹³N ammonia PET with Time-of-Flight Scanner: Simplified Phantom Study with Noise Equivalent Count Rate Analysis

Ann Nucl Cardiol. 2023;9(1):33-39. doi: 10.17996/anc.23-00178. Epub 2023 Oct 31.

Authors

Yoko Kaimoto^{1

2}, Kenji Fukushima³, Kazuko Kanaya¹, Masayasu Asanuma¹, Kaoru Aoba¹, Atsushi Yamamoto^{4

5}, Risako Nakao⁵, Koichiro Kaneko⁴, Michinobu Nagao⁴, Koichi Chida²

Affiliations

¹ Department of Radiological service, Tokyo Woman's Medical University, Tokyo, Japan.
² Department of Health Sciences, Graduate School of Medicine, Tohoku University, Miyagi, Japan.
³ Department of Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan.
⁴ Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan.
⁵ Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.

Abstract

Background: Myocardial blood flow quantification (MBF) is one of the distinctive features for cardiac positron emission tomography. The MBF calculation is mostly obtained by estimating the input function from the time activity curve in dynamic scan. However, there is a substantial risk of count-loss because the high radioactivity pass through the left ventricular (LV) cavity within a short period. We aimed to determine the optimal intraventricular activity using the noise equivalent count rate (NECR) analysis with simplified phantom model. Methods: Positron emission tomography computed tomography scanner with LYSO crystal and time of flight was used for phantom study. 150 MBq/mL of ¹³N was filled in 10 mL of syringe, placed in neck phantom to imitate end-systolic small LV. 3D list-mode acquisition was repeatedly performed along radioactive decay. Net true and random count rate were calculated and compared to the theoretical activity in the syringe. NECR curve analysis was used to determine the optimal radioactive concentration. Result: The attenuation curves showed good correlation to the theoretical activity between 20 to 370, and 370 to 740 MBq (r²=1.0 ± 0.0001, p<0.0001; r²=0.99 ± 0.0001, p<0.0001 for 20 to 370, and 370 to 740, respectively), while did not over 740 MBq (p=0.62). NECR analysis revealed that the peak rate was at 2.9 Mcps, there at the true counts were significantly suppressed. The optimal radioactive concentration was determined as 36 MBq/mL. Conclusion: Simulative analysis for high-dose of ¹³N using the phantom imitating small LV confirmed that the risk of count-loss was increased. The result can be useful information in assessing the feasibility of MBF quantification in clinical routine.

Keywords: Cardiac PET; Input function; Myocardial flow; Myocardial perfusion; Noise equivalent counts ratio.