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

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Journal of Nuclear Cardiology Aims and scope

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.

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Disclosures

Justin Pieper, Vaiibhav N. Patel, Sylvia Escolero, Jacob R. Nelson, David Hubers, Jill Rothley, and Richard L. Weinberg have no disclosures or conflicts of interest related to this publication. Edward P. Ficaro and James R. Corbett have financial interest in INVIA Medical Imaging Solutions, which licenses the commercial software used for imaging processing. Alexis Poitrasson-Rivière is employed by INVIA. INVIA Medical Imaging Solutions did not provide direct support to this study. Joseph Oliverio, Christopher K. Shreves, and Nick Freiburger own stock options and are employed by Ionetix Corporation. Venkatesh L. Murthy has received consulting fees and stock options from Ionetix, Inc., owns stock in General Electric and Cardinal Health, has a research Grant from Siemens Medical Imaging, and has provided expert witness testimony on behalf of Jubilant Draximage. Venkatesh L. Murthy is supported by 1R01HL136685 from the National, Heart, Lung, Blood Institute and 1R01AG059729 from the National Institute on Aging.

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Author notes

  1. Justin Pieper and Vaiibhav N. Patel contributed equally to this work and are co-first authors.

  2. Richard L. Weinberg and Venkatesh L. Murthy contributed equally to this work and are co-senior authors.

Authors and Affiliations

  1. Department of Internal Medicine, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA

    Justin Pieper MD

  2. Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, Ann Arbor, USA

    Vaiibhav N. Patel MD, James R. Corbett MD, Richard L. Weinberg MD, PhD & Venkatesh L. Murthy MD, PhD

  3. University of Michigan Medical School, Ann Arbor, MI, USA

    Sylvia Escolero BS & Jacob R. Nelson BS

  4. Ionetix Corporation, San Francisco, CA, USA

    Christopher K. Shreves BS, Nick Freiburger BS, MPH & Joseph Oliverio BS, MBA

  5. Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA

    David Hubers RPh, BCNP, Jill Rothley BS, CNMT, James R. Corbett MD & Venkatesh L. Murthy MD, PhD

  6. INVIA, Ann Arbor, MI, USA

    Alexis Poitrasson-Rivière PhD & Edward P. Ficaro PhD

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  1. Justin Pieper MD
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  2. Vaiibhav N. Patel MD
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  3. Sylvia Escolero BS
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  8. David Hubers RPh, BCNP
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  9. Jill Rothley BS, CNMT
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  11. Joseph Oliverio BS, MBA
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  13. Richard L. Weinberg MD, PhD
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  14. Venkatesh L. Murthy MD, PhD
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Corresponding author

Correspondence to Justin Pieper MD.

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Pieper, J., Patel, V.N., Escolero, S. et al. Initial clinical experience of N13-ammonia myocardial perfusion PET/CT using a compact superconducting production system. J. Nucl. Cardiol. 28, 295–299 (2021). https://doi.org/10.1007/s12350-019-01886-7

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  • DOI: https://doi.org/10.1007/s12350-019-01886-7

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