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

• 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

• THANKS FOR YOUR ATTENTION

• Merci de votre attention

• Grazie mille per la vostra attenzione

• Vielen Dank für Ihre Aufmerksamkeit