Rapid dual-injection single-scan 13N-ammonia PET for quantification of rest and stress myocardial blood flows

Phys Med Biol. 2006 Oct 21;51(20):5347-62. doi: 10.1088/0031-9155/51/20/018. Epub 2006 Oct 3.

Abstract

Quantification of myocardial blood flows at rest and stress using 13N-ammonia PET is an established method; however, current techniques require a waiting period of about 1 h between scans. The objective of this study was to test a rapid dual-injection single-scan approach, where 13N-ammonia injections are administered 10 min apart during rest and adenosine stress. Dynamic PET data were acquired in six human subjects using imaging protocols that provided separate single-injection scans as gold standards. Rest and stress data were combined to emulate rapid dual-injection data so that the underlying activity from each injection was known exactly. Regional blood flow estimates were computed from the dual-injection data using two methods: background subtraction and combined modelling. The rapid dual-injection approach provided blood flow estimates very similar to the conventional single-injection standards. Rest blood flow estimates were affected very little by the dual-injection approach, and stress estimates correlated strongly with separate single-injection values (r=0.998, mean absolute difference=0.06 ml min-1 g-1). An actual rapid dual-injection scan was successfully acquired in one subject and further demonstrates feasibility of the method. This study with a limited dataset demonstrates that blood flow quantification can be obtained in only 20 min by the rapid dual-injection approach with accuracy similar to that of conventional separate rest and stress scans. The rapid dual-injection approach merits further development and additional evaluation for potential clinical use.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ammonia* / administration & dosage
  • Ammonia* / pharmacokinetics
  • Blood Flow Velocity / physiology*
  • Carbon Isotopes / administration & dosage
  • Carbon Isotopes / pharmacokinetics
  • Coronary Circulation / physiology*
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / physiology*
  • Exercise Test
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Injections, Intra-Arterial
  • Male
  • Middle Aged
  • Positron-Emission Tomography / methods*
  • Radioisotope Dilution Technique
  • Radiopharmaceuticals / administration & dosage
  • Reproducibility of Results
  • Rest
  • Sensitivity and Specificity

Substances

  • Carbon Isotopes
  • Radiopharmaceuticals
  • Ammonia