Dataset Information

Saline-push improves rubidium-82 PET image quality.

ABSTRACT:

Introduction

Rubidium-82 (⁸²Rb) PET is used widely for myocardial perfusion imaging. The purpose of this study was to investigate if an additional saline-push following the ⁸²Rb elution improves PET image quality.

Methods

⁸²Rb PET scans were acquired with and without 26 mL saline-push in six patients as part of a clinical quality improvement program. Dynamic images were analyzed to measure the total activity delivered to the superior vena cava (SVC) and retained in the left ventricle (LV) myocardium. Tracer uptake images were used to measure blood background coefficient-of-variation (COV), myocardium-to-blood signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) to assess image quality.

Results

Similar eluted activity was measured with/without the saline-push (830 vs 795 MBq; P = 0.24). The activity delivered to the heart and retained in the myocardium was consistently increased more than twofold (SVC: + 114% and LV: + 104%; P < 0.001) with the saline-push. Image quality was improved in all patients, with lower background noise (COV: - 19%), higher SNR (+ 24%) and CNR (+ 27%) (all P ≤ 0.01).

Conclusions

The saline-push used to flush ⁸²Rb activity out of the infuser tubing, patient injection and intravenous access lines consistently increased the activity delivered to the heart by twofold. This technique is recommended to maximize image quality with ⁸²Rb PET.

SUBMITTER: Renaud JM

PROVIDER: S-EPMC6908549 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Publications

Saline-push improves rubidium-82 PET image quality.

Renaud Jennifer M JM Wu Kai Yi KY Gardner Kimberly K Aung May M Beanlands Rob S B RSB deKemp Robert A RA

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 20180327 6

<h4>Introduction</h4>Rubidium-82 (<sup>82</sup>Rb) PET is used widely for myocardial perfusion imaging. The purpose of this study was to investigate if an additional saline-push following the <sup>82</sup>Rb elution improves PET image quality.<h4>Methods</h4><sup>82</sup>Rb PET scans were acquired with and without 26 mL saline-push in six patients as part of a clinical quality improvement program. Dynamic images were analyzed to measure the total activity delivered to the superior vena cava (SVC ...[more]

PMID: 29589206

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Project description:BackgroundChanges in renal perfusion may play a pathophysiological role in hypertension and kidney disease, however to date, no method for renal blood flow (RBF) determination in humans has been implemented in clinical practice. In a previous study, we demonstrated that estimation of renal perfusion based on a single positron emission tomography/computed tomography (PET/CT) scan with Rubidium-82 (82Rb) is feasible and found an approximate 5% intra-assay coefficient of variation for both kidneys, indicative of a precise method.This study's aim was to determine the day-to day variation of 82Rb PET/CT and to test the method's ability to detect increased RBF induced by infusion of amino acids.MethodsSeventeen healthy subjects underwent three dynamic 82Rb PET/CT scans over two examination days comprising: Day A, a single 8-minute dynamic scan and Day B, two scans performed before (baseline) and after RBF stimulation by a 2-hour amino acid-infusion. The order of examination days was determined by randomization. Time activity curves for arterial and renal activity with a 1-tissue compartment model were used for flow estimation; the K1 kinetic parameter representing renal 82Rb clearance. Day-to-day variation was calculated based on the difference between the unstimulated K1 values on Day A and Day B and paired t-testing was performed to compare K1 values at baseline and after RBF stimulation on Day B.ResultsDay-to-day variation was observed to be 5.5% for the right kidney and 6.0% for the left kidney (n = 15 quality accepted scans). K1 values determined after amino acid-infusion were significantly higher than pre-infusion values (n = 17, p = 0.001). The mean percentage change in K1 from baseline was 13.2 ± 12.9% (range - 10.4 to 35.5) for the right kidney; 12.9 ± 13.2% (range - 15.7 to 35.3) for the left kidney.ConclusionDay-to-day variation is acceptably low. A significant K1 increase from baseline is detected after application of a known RBF stimulus, indicating that 82Rb PET/CT scanning can provide a precise method for evaluation of RBF and it is able to determine changes herein.Clinical trial registrationEU Clinical Trials Register, 2017-005008-88. Registered 18/01/2018.

Project description:IntroductionStrontium-82/Rubidium-82 (82Sr/82Rb) generators are used widely for positron emission tomography (PET) imaging of myocardial perfusion. In this study, the 82Rb isotope yield and production efficiency of two FDA-approved 82Sr/82Rb generators were compared.MethodsN = 515 sequential daily quality assurance (QA) reports from 9 CardioGen-82® and 9 RUBY-FILL® generators were reviewed over a period of 2 years. A series of test elutions was performed at different flow-rates on the RUBY-FILL® system to determine an empirical correction-factor used to convert CardioGen-82® daily QA values of 82Rb activity (dose-calibrator 'maximum' of 50 mL elution at 50 mL·min-1) to RUBY-FILL® equivalent values (integrated 'total' of 35 mL elution at 20 mL·min-1). The generator yield (82Rb) and production efficiency (82Rb yield/82Sr parent activity) were measured and compared after this conversion to a common scale.ResultsAt the start of clinical use, the system reported 82Rb activity from daily QA was lower for CardioGen-82® vs RUBY-FILL® (2.3 ± 0.2 vs 3.0 ± 0.2 GBq, P < 0.001) despite having similar 82Sr activity. Dose-calibrator 'maximum' (CardioGen-82®) values were found to under-estimate the integrated 'total' (RUBY-FILL®) activity by ~ 24% at 50 mL·min-1. When these data were used to convert the CardioGen-82 values to a common measurement scale (integrated total activity) the CardioGen-82® efficiency remained slightly lower than the RUBY-FILL® system on average (88 ± 4% vs 95 ± 4%, P < 0.001). The efficiency of 82Rb production improved for both systems over the respective periods of clinical use.Conclusions82Rb generator yield was significantly under-estimated using the CardioGen-82® vs RUBY-FILL® daily QA procedure. When generator yield was expressed as the integrated total activity for both systems, the estimated 82Rb production efficiency of the CardioGen-82® system was ~ 7% lower than RUBY-FILL® over the full period of clinical use.

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Dataset Information

Saline-push improves rubidium-82 PET image quality.

Introduction

Methods

Results

Conclusions

Publications

Saline-push improves rubidium-82 PET image quality.

Similar Datasets

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