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Title: N-13 ammonia for the noninvasive evaluation of myocardial blood flow by positron emission computed tomography

Abstract

The kinetics and characteristics of nitrogen-13 labelled ammonia as an indicator of blood flow in the myocardium were evaluated in open-chest dogs. Its utility as an imaging agent was tested in animals and man. (PSB)

Authors:
;
Publication Date:
Research Org.:
California Univ., Los Angeles (USA). Lab. of Nuclear Medicine and Radiation Biology
OSTI Identifier:
6598430
Alternate Identifier(s):
OSTI ID: 6598430
Report Number(s):
UCLA-12-1240
TRN: 81-006343
DOE Contract Number:
AC03-76SF00012
Resource Type:
Technical Report
Country of Publication:
United States
Language:
English
Subject:
59 BASIC BIOLOGICAL SCIENCES; 62 RADIOLOGY AND NUCLEAR MEDICINE; BLOOD FLOW; MYOCARDIUM; NITROGEN 13; TRACER TECHNIQUES; POSITRON COMPUTED TOMOGRAPHY; OPTIMIZATION; AMMONIA; LABELLED COMPOUNDS; POSITRON CAMERAS; BETA DECAY RADIOISOTOPES; BETA-PLUS DECAY RADIOISOTOPES; BODY; CAMERAS; CARDIOVASCULAR SYSTEM; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; ELECTRON CAPTURE RADIOISOTOPES; EMISSION COMPUTED TOMOGRAPHY; GAMMA CAMERAS; HEART; HYDRIDES; HYDROGEN COMPOUNDS; ISOTOPE APPLICATIONS; ISOTOPES; LIGHT NUCLEI; MINUTES LIVING RADIOISOTOPES; MUSCLES; NITROGEN COMPOUNDS; NITROGEN HYDRIDES; NITROGEN ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPES; TOMOGRAPHY 550201* -- Biochemistry-- Tracer Techniques; 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics

Citation Formats

Schelbert, H.R., and Phelps, M.E. N-13 ammonia for the noninvasive evaluation of myocardial blood flow by positron emission computed tomography. United States: N. p., 1979. Web. doi:10.2172/6598430.
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Schelbert, H.R., & Phelps, M.E. N-13 ammonia for the noninvasive evaluation of myocardial blood flow by positron emission computed tomography. United States. doi:10.2172/6598430.
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Schelbert, H.R., and Phelps, M.E. Mon . "N-13 ammonia for the noninvasive evaluation of myocardial blood flow by positron emission computed tomography". United States. doi:10.2172/6598430. https://www.osti.gov/servlets/purl/6598430.
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@article{osti_6598430,
title = {N-13 ammonia for the noninvasive evaluation of myocardial blood flow by positron emission computed tomography},
author = {Schelbert, H.R. and Phelps, M.E.},
abstractNote = {The kinetics and characteristics of nitrogen-13 labelled ammonia as an indicator of blood flow in the myocardium were evaluated in open-chest dogs. Its utility as an imaging agent was tested in animals and man. (PSB)},
doi = {10.2172/6598430},
journal = {},
number = ,
volume = ,
place = {United States},
year = {Mon Jan 01 00:00:00 EST 1979},
month = {Mon Jan 01 00:00:00 EST 1979}
}
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Technical Report:
View Technical Report (0.28 MB)
DOI:  10.2172/6598430
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  • ; ; ; ... - Am. J. Cardiol.; (United States)
    The possibility of detecting mild coronary stenoses with positron computed tomography and nitrogen (N-13) ammonia administered during pharmacologic coronary vasodilation was previously demonstrated in chronically instrumented dogs. The feasibility of using this technique in human beings and its sensitivity in determining the degree and extent of coronary artery disease were examined in 13 young normal healthy volunteers and 32 patients with angiographically documented coronary artery disease. N-13 ammonia was administered intravenously and its distribution in the left ventricular myocardium recorded at rest and during dipyridamole-induced coronary hyperemia. In the 13 volunteers, N-13 activity was homogeneous at rest and during hyperemia,more » whereas 31 of the 32 patients had regional defects on the hyperemic images not present during rest. All six patients with double, all 10 with triple and 15 of 16 patients with single vessel disease (97 percent) were correctly identified with the technique. Two vessel involvement was correctly identified in five of the six patients with double vessel disease and three vessel disease in six of 10 patients. Of all 58 coronary stenoses, 52 (90 percent) were correctly identified. In a subgroup of 11 patients, the technique was compared with exercise thallium-201 planar images, which were abnormal in 10 (91 percent) whereas N-13 images were abnormal in all 11. Of the 19 stenosed coronary arteries in this subgroup, 11 (58 percent) were correctly identified with thallium-201 and 17 (89 percent) with tomography (p less than 0.01). It is concluded that cross-sectional imaging of the myocardial distribution of N-13 ammonia administered during pharmacologic coronary vasodilation is a highly sensitive and accurate means for noninvasive detection of coronary stenoses in human beings and for estimating the extent of coronary artery disease.« less

  • ; ; ; ...
    The usefulness of /sup 13/NH/sub 3/ as an indicator of regional myocardial perfusion suitable for positron emission computerized axial tomography (PCT) has been suggested. However, the relationship between myocardial blood flow and uptake of /sup 13/NH/sub 3/ has not been examined quantitatively. It was therefore the purpose of the current investigation to quantitate the relationship of myocardial /sup 13/NH/sub 3/ tissue concentration to myocardial blood flow and to examine its suitability for PCT imaging. Twelve open chest dogs were studied. In 8 of the dogs 25 imaging procedures with /sup 13/NH/sub 3/ and PCT were performed. In the remaining fourmore » dogs the relationship between flow and myocardial /sup 13/NH/sub 3/ tissue concentration was assessed by in vitro techniques. The PCT technique provided high quality cross-sectional images of the distribution of /sup 13/NH/sub 3/ in left ventricular myocardium. No significant redistribution of /sup 13/NH/sub 3/ in myocardium occurred with time. Alterations in regional myocardial blood flow resulted in changes of the regional distribution of /sup 13/NH/sub 3/ that were readily appreciated on the PCT images.« less

  • ;
    While the results of regional myocardial glucose metabolism measurements using positron emission computed tomography (/sup 13/N-ammonia) are promising, their utility and value remains to be determined in man. If this technique can be applied to patients with acute myocardial ischemia or infarction it may permit delineation of regional myocardial segments with altered, yet still active metabolism. Further, it may become possible to evaluate the effects of interventions designed to salvage reversibly injured myocardium by this technique.

  • ; ; ; ... - Journal of the American College of Cardiology; (USA)
    Evaluation of regional myocardial blood flow by conventional scintigraphic techniques is limited to the qualitative assessment of regional tracer distribution. Dynamic imaging with positron emission tomography allows the quantitative delineation of myocardial tracer kinetics and, hence, the measurement of physiologic processes such as myocardial blood flow. To test this hypothesis, positron emission tomographic imaging in combination with N-13 ammonia was performed at rest and after pharmacologically induced vasodilation in seven healthy volunteers. Myocardial and blood time-activity curves derived from regions of interest over the heart and ventricular chamber were fitted using a three compartment model for N-13 ammonia, yielding ratemore » constants for tracer uptake and retention. Myocardial blood flow (K1) averaged 88 +/- 17 ml/min per 100 g at rest and increased to 417 +/- 112 ml/min per 100 g after dipyridamole infusion (0.56 mg/kg) and handgrip exercise. The coronary reserve averaged 4.8 +/- 1.3 and was not significantly different in the septal, anterior and lateral walls of the left ventricle. Blood flow values showed only a minor dependence on the correction for blood metabolites of N-13 ammonia. These data demonstrate that quantification of regional myocardial blood flow is feasible by dynamic positron emission tomographic imaging. The observed coronary flow reserve after dipyridamole is in close agreement with the results obtained by invasive techniques, indicating accurate flow estimates over a wide range. Thus, positron emission tomography may provide accurate and noninvasive definition of the functional significance of coronary artery disease and may allow the improved selection of patients for revascularization.« less

  • ; ; ; ...
    Positron emission computed tomography is a new technique for the noninvasive measure of myocardial blood flow, mechanical function and, in particular, metabolism. The capability of this new study means is due to the technological innovations of the imaging device and the availability of radioactive tracers that are specific for blood flow and metabolism. The device permits recording of cross-sectional images of the left ventricular myocardium that reflect quantitatively regional tracer tissue concentrations. By employing tracer kinetic models this new technique permits the measurement of regional glucose and fatty acid metabolism of the heart. While already an important new tool formore » investigative studies into cardiac physiology and pathophysiology, the clinical utility of positron emission tomography remains to be defined.« less