Myocardial perfusion can be studied using spect or pet tracers pet imaging is limited by the access to tracer production unit (cyclotron)



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  • Myocardial perfusion can be studied using SPECT or PET tracers

  • PET imaging is limited by the access to tracer production unit (cyclotron)

  • Rubidium-82 can easily be produced by a Strontium-82 generator, without the need of cyclotron

  • Rubidium-82 is extensively used in USA for myocardial perfusion imaging by PET-CT





Rb-82 is an analog of K+ (potassium).

  • Rb-82 is an analog of K+ (potassium).

  • Strontium-82 ( half-life 25.5 days) decays to Rubidium-82 (half-life 75 sec, positron emission, annihilation photons 511kev).

  • As Thallium (Tl-201) Rb-82 is extracted by myocardial tissue via the Na⁺K+-ATPase active transport.

  • The short half-life of Rubidium-82 allows to perform rest/stress imaging within 20 minutes.

  • We use an adenosine stress (140 µg/kg/min over 6 min) to perform real time stress imaging owing to the short half-life of Rb-82 .





New generator every month.

  • New generator every month.

  • Possible elution every 10min.

  • The radionucleidic purity of Rb-82 eluate is determined by measuring the residual activity of Sr-82 and Sr-85 using a ionization chamber.

  • Any other radionucleidic in the elution is considered a radionucleidic impurity .

  • The final eluate should not contain more than 0.02 kBq of Sr-82 and not more than 0.2 kBq of Sr-85 per MBq of Rb-82 injection.





Shorter acquisition time

  • Shorter acquisition time

  • Lower radiation exposure

  • Attenuation correction

  • Myocardial blood flow quantification

  • Ejection Fraction at peak stress







To assess the evolution of Sr-82 and Sr-85 breakthrough during the clinical use of Rb-82 generator .

  • To assess the evolution of Sr-82 and Sr-85 breakthrough during the clinical use of Rb-82 generator .



10 generators Cardiogen-82 ® Bracco Diagnostics of Rb-82 were used for 481 rest/stress studies.

  • 10 generators Cardiogen-82 ® Bracco Diagnostics of Rb-82 were used for 481 rest/stress studies.

  • 162 radionucleidic purity controls were performed before any injection to the first patient.

  • Sr-82/Rb-82<0.02 kBq/MBq

  • Sr-85/Rb-82<0.2 kBq/MBq



BEFORE ANY INJECTION TO THE FIRST PATIENT

  • BEFORE ANY INJECTION TO THE FIRST PATIENT







The high peaks may be explained by :

  • The high peaks may be explained by :

    • Intrinsic variations of the activimeter
    • Breakthrough variations in the laboratory
    • Number of days since last use (accumulation of Sr-82 during the week-end)


Sr-82 and Sr-85 breakthroughs were small for a total eluted volume <8L

  • Sr-82 and Sr-85 breakthroughs were small for a total eluted volume <8L

  • Every controls remained under the authorized limits and allowed the clinical use of Rb-82



THANKS FOR YOUR ATTENTION




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