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Cardiac PET Perfusion Tracers: Current Status and Future Directions

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1053/j.semnuclmed.2014.06.011 Byline: Jamshid Maddahi, Rene R.S. Packard Abstract: PET myocardial perfusion imaging (MPI) is increasingly being used for noninvasive detection and evaluation of coronary artery disease... Full description

Journal Title: Seminars in Nuclear Medicine Sept, 2014, Vol.44(5), p.333(11)
Main Author: Maddahi, Jamshid
Other Authors: Packard, Rene R. S.
Format: Electronic Article Electronic Article
Language: English
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Quelle: Cengage Learning, Inc.
ID: ISSN: 0001-2998
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title: Cardiac PET Perfusion Tracers: Current Status and Future Directions
format: Article
creator:
  • Maddahi, Jamshid
  • Packard, Rene R. S.
subjects:
  • Medical Imaging Equipment
  • Pets
  • Tracers (Biology)
  • Ammonia
  • Medical Schools
  • Coronary Heart Disease
ispartof: Seminars in Nuclear Medicine, Sept, 2014, Vol.44(5), p.333(11)
description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1053/j.semnuclmed.2014.06.011 Byline: Jamshid Maddahi, Rene R.S. Packard Abstract: PET myocardial perfusion imaging (MPI) is increasingly being used for noninvasive detection and evaluation of coronary artery disease. However, the widespread use of PET MPI has been limited by the shortcomings of the current PET perfusion tracers. The availability of these tracers is limited by the need for an onsite (.sup.15O water and.sup.13N ammonia) or nearby (.sup.13N ammonia) cyclotron or commitment to costly generators (.sup.82Rb). Owing to the short half-lives, such as 76 seconds for.sup.82Rb, 2.06 minutes for.sup.15O water, and 9.96 minutes for.sup.13N ammonia, their use in conjunction with treadmill exercise stress testing is either not possible (.sup.82Rb and.sup.15O water) or not practical (.sup.13N ammonia). Furthermore, the long positron range of.sup.82Rb makes image resolution suboptimal and its low myocardial extraction limits its defect resolution. In recent years, development of an.sup.18F-labeled PET perfusion tracer has gathered considerable interest. The longer half-life of.sup.18F (109 minutes) would make the tracer available as a unit dose from regional cyclotrons and allow use in conjunction with treadmill exercise testing. Furthermore, the short positron range of.sup.18F would result in better image resolution. Flurpiridaz F 18 is by far the most thoroughly studied in animal models and is the only.sup.18F-based PET MPI radiotracer currently undergoing clinical evaluation. Preclinical and clinical experience with Flurpiridaz F 18 demonstrated a high myocardial extraction fraction, high image and defect resolution, high myocardial uptake, slow myocardial clearance, and high myocardial-to-background contrast that was stable over time -- important properties of an ideal PET MPI radiotracer. Preclinical data from other.sup.18F-labeled myocardial perfusion tracers are encouraging. Author Affiliation: (*) Division of Cardiology, Department of Medicine, University of California at Los Angeles (UCLA) School of Medicine, Los Angeles, CA (a ) Division of Nuclear Medicine, Department of Molecular and Medical Pharmacology, UCLA School of Medicine, Los Angeles, CA Article Note: (footnote) [star] Funding: Flurpiridaz F 18 clinical trials have been sponsored by Lantheus Medical Imaging. Lantheus Medical Imaging had no role in writing of this article. Dr Packard is supported by NIH,
language: English
source: Cengage Learning, Inc.
identifier: ISSN: 0001-2998
fulltext: fulltext
issn:
  • 0001-2998
  • 00012998
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descriptionTo link to full-text access for this article, visit this link: http://dx.doi.org/10.1053/j.semnuclmed.2014.06.011 Byline: Jamshid Maddahi, Rene R.S. Packard Abstract: PET myocardial perfusion imaging (MPI) is increasingly being used for noninvasive detection and evaluation of coronary artery disease. However, the widespread use of PET MPI has been limited by the shortcomings of the current PET perfusion tracers. The availability of these tracers is limited by the need for an onsite (.sup.15O water and.sup.13N ammonia) or nearby (.sup.13N ammonia) cyclotron or commitment to costly generators (.sup.82Rb). Owing to the short half-lives, such as 76 seconds for.sup.82Rb, 2.06 minutes for.sup.15O water, and 9.96 minutes for.sup.13N ammonia, their use in conjunction with treadmill exercise stress testing is either not possible (.sup.82Rb and.sup.15O water) or not practical (.sup.13N ammonia). Furthermore, the long positron range of.sup.82Rb makes image resolution suboptimal and its low myocardial extraction limits its defect resolution. In recent years, development of an.sup.18F-labeled PET perfusion tracer has gathered considerable interest. The longer half-life of.sup.18F (109 minutes) would make the tracer available as a unit dose from regional cyclotrons and allow use in conjunction with treadmill exercise testing. Furthermore, the short positron range of.sup.18F would result in better image resolution. Flurpiridaz F 18 is by far the most thoroughly studied in animal models and is the only.sup.18F-based PET MPI radiotracer currently undergoing clinical evaluation. Preclinical and clinical experience with Flurpiridaz F 18 demonstrated a high myocardial extraction fraction, high image and defect resolution, high myocardial uptake, slow myocardial clearance, and high myocardial-to-background contrast that was stable over time -- important properties of an ideal PET MPI radiotracer. Preclinical data from other.sup.18F-labeled myocardial perfusion tracers are encouraging. Author Affiliation: (*) Division of Cardiology, Department of Medicine, University of California at Los Angeles (UCLA) School of Medicine, Los Angeles, CA (a ) Division of Nuclear Medicine, Department of Molecular and Medical Pharmacology, UCLA School of Medicine, Los Angeles, CA Article Note: (footnote) [star] Funding: Flurpiridaz F 18 clinical trials have been sponsored by Lantheus Medical Imaging. Lantheus Medical Imaging had no role in writing of this article. Dr Packard is supported by NIH, USA (Grant no. T32 HL007895). Dr Maddahi is supported by a research grant from Lantheus Medical Imaging., [star][star] Disclosure: Dr Maddahi is the lead principal investigator for Flurpiridaz F 18 phase I, II, and III clinical trials, the chair of the steering committee, and a scientific advisor to Lantheus Medical Imaging.
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abstractTo link to full-text access for this article, visit this link: http://dx.doi.org/10.1053/j.semnuclmed.2014.06.011 Byline: Jamshid Maddahi, Rene R.S. Packard Abstract: PET myocardial perfusion imaging (MPI) is increasingly being used for noninvasive detection and evaluation of coronary artery disease. However, the widespread use of PET MPI has been limited by the shortcomings of the current PET perfusion tracers. The availability of these tracers is limited by the need for an onsite (.sup.15O water and.sup.13N ammonia) or nearby (.sup.13N ammonia) cyclotron or commitment to costly generators (.sup.82Rb). Owing to the short half-lives, such as 76 seconds for.sup.82Rb, 2.06 minutes for.sup.15O water, and 9.96 minutes for.sup.13N ammonia, their use in conjunction with treadmill exercise stress testing is either not possible (.sup.82Rb and.sup.15O water) or not practical (.sup.13N ammonia). Furthermore, the long positron range of.sup.82Rb makes image resolution suboptimal and its low myocardial extraction limits its defect resolution. In recent years, development of an.sup.18F-labeled PET perfusion tracer has gathered considerable interest. The longer half-life of.sup.18F (109 minutes) would make the tracer available as a unit dose from regional cyclotrons and allow use in conjunction with treadmill exercise testing. Furthermore, the short positron range of.sup.18F would result in better image resolution. Flurpiridaz F 18 is by far the most thoroughly studied in animal models and is the only.sup.18F-based PET MPI radiotracer currently undergoing clinical evaluation. Preclinical and clinical experience with Flurpiridaz F 18 demonstrated a high myocardial extraction fraction, high image and defect resolution, high myocardial uptake, slow myocardial clearance, and high myocardial-to-background contrast that was stable over time -- important properties of an ideal PET MPI radiotracer. Preclinical data from other.sup.18F-labeled myocardial perfusion tracers are encouraging. Author Affiliation: (*) Division of Cardiology, Department of Medicine, University of California at Los Angeles (UCLA) School of Medicine, Los Angeles, CA (a ) Division of Nuclear Medicine, Department of Molecular and Medical Pharmacology, UCLA School of Medicine, Los Angeles, CA Article Note: (footnote) [star] Funding: Flurpiridaz F 18 clinical trials have been sponsored by Lantheus Medical Imaging. Lantheus Medical Imaging had no role in writing of this article. Dr Packard is supported by NIH, USA (Grant no. T32 HL007895). Dr Maddahi is supported by a research grant from Lantheus Medical Imaging., [star][star] Disclosure: Dr Maddahi is the lead principal investigator for Flurpiridaz F 18 phase I, II, and III clinical trials, the chair of the steering committee, and a scientific advisor to Lantheus Medical Imaging.
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