Integrated PET/CT

Townsend, David W.; Besozzi, Myrwood C.; Carney, Jonathan

doi:10.1007/978-0-387-38295-1_3

Cited by 1 publication

(8 citation statements)

References 14 publications

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“…The maximum kinetic energy of positrons emitted during 82 Rb decay is significantly higher than that of 18 F or 13 N. Consequently, the spatial uncertainty in the location of the decaying nucleus-which depends on the distance traveled by the positrons before their annihilation (positron range)-is greater for 82 Rb (2.6-mm full width at half maximum [FWHM]) than for 18 F (0.2-mm FWHM) or 13 N (0.7-mm FWHM). Although 82 Rb imaging yields excellent image quality with current PET technology, its longer positron range and its short half-life, which requires significant image smoothing to suppress noise, both mitigate somewhat the improved spatial resolution of PET.…”

Section: Radiopharmaceuticalsmentioning

confidence: 85%

“…After injection, 13 N-ammonia rapidly disappears from the circulation, permitting the acquisition of images of excellent quality. Although the sequestration of 13 N-ammonia in the lungs is usually minimal, it may be increased in patients with depressed left ventricular (LV) systolic function or chronic pulmonary disease and, occasionally, in smokers. This may, in turn, adversely affect the quality of the images.…”

Section: N-ammoniamentioning

confidence: 99%

“…In arterial blood, 13 N-ammonia consists of neutral ammonia (NH 3 ) in equilibrium with its charged ammonium (NH 4 ) ion. The neutral NH 3 molecule readily diffuses across plasma and cell membranes, leading to virtually complete extraction from the vascular pool.…”

Section: N-ammoniamentioning

confidence: 99%

“…Inside the myocyte, it reequilibrates with its ammonium form, which is trapped in glutamine via the enzyme glutamine synthase (5,6). Once inside the myocyte, 13 N-ammonia is incorporated into the glutamine pool and becomes metabolically trapped (6). Only a small fraction diffuses back into the intravascular space (6).…”

Section: N-ammoniamentioning

confidence: 99%

“…13 N-Ammonia images may also be degraded by occasional intense liver activity, which can interfere with the evaluation of the inferior wall. Although the sequestration of 13 N-ammonia in the lungs is usually minimal, it may be increased in patients with depressed LV systolic function or chronic pulmonary disease and, occasionally, in smokers (8).…”

Section: N-ammoniamentioning

confidence: 99%

See 4 more Smart Citations

Clinical Myocardial Perfusion PET/CT

Carli¹,

Dorbala²,

Meserve³

et al. 2007

Journal of Nuclear Medicine

254

182

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The field of nuclear cardiology is witnessing growing interest in the use of cardiac PET for the evaluation of patients with coronary artery disease (CAD). The available evidence suggests that myocardial perfusion PET provides an accurate means for diagnosing obstructive CAD, which appears superior to SPECT especially in the obese and in those undergoing pharmacologic stress. The ability to record changes in left ventricular function from rest to peak stress and to quantify myocardial perfusion (in mL/min/g of tissue) provides an added advantage over SPECT for evaluating multivessel CAD. There is growing and consistent evidence that gated myocardial perfusion PET also provides clinically useful risk stratification. Although the introduction of hybrid PET/CT technology offers the exciting possibility of assessing the extent of anatomic CAD (CT coronary angiography) and its functional consequences (ischemic burden) in the same setting, there are technical challenges in the implementation of CT-based transmission imaging for attenuation correction. Nonetheless, this integrated platform for assessing anatomy and biology offers a great potential for translating advances in molecularly targeted imaging into humans. PET has contributed significantly to advance our understanding of heart physiology and pathophysiology for .25 y. Initially, it emerged as a powerful investigative tool that allowed in vivo quantification of physiologic processes, including myocardial perfusion and metabolism, neuronal and receptor function, and, more recently, molecularly targeted oncologic imaging. Despite its success in research applications, the limited availability of this technology, its increased cost, and the limited data supporting its use and reimbursement have all contributed to the relatively limited clinical acceptance of this imaging technology. Fortunately, there are now clear signs that change is under way. Indeed, the exponential growth in the number of PET/CT systemsattributable primarily to the technology's widely accepted role in clinical oncology-along with the Food and Drug Administration's approval of PET radiopharmaceuticals for cardiac imaging, changes in reimbursement, and the increasing documentation of PET's clinical efficacy have all contributed to help advance its clinical role in cardiovascular medicine.The emergence of integrated PET/CT technology as the dominant configuration of clinical scanners also holds great promise for cardiac imaging as it provides a potential opportunity to delineate the anatomic extent and physiologic severity of coronary atherosclerosis in a single setting. However, the recent rapid growth of PET/CT is now opening a considerable gap between the most sophisticated users of the technology and those with a more limited knowledge base and fewer training opportunities; this includes cardiologists, as well as nuclear medicine specialists, and radiologists, who frequently lack clinical experience in performing and interpreting these cardiovascular procedures. The objective of this review ...

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Section: Radiopharmaceuticalsmentioning

confidence: 85%

Section: N-ammoniamentioning

confidence: 99%

Section: N-ammoniamentioning

confidence: 99%