• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.31-40
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• 1995

We compared stress/rest myocardial Tc-99m-MIBl tomographic image findings with rest/stress rubidium-82 tomographic images. In 23 patients with coronary artery disease (12 of them received bypass grafts before) and 6 normal subjects, rest rubidium PET study was performed : rubidium-82 and Tc-99m-MIBI were injected simultaneously to each patient after dipyridamole stress for rubidium PET and MIBI SPECT; and rest MIBI SPECT was performed 4 hours thereafter. We scored segmental decrease of rubidium or MIBI uptakes into 5 grades for 29 segments from 3 short-axis, vertical and horizontal slices. Scores were summed for each major arterial territory. When more score than two grade-2's or one grade-3 was considered as the cue for significant stenosis for major arterial territories, 67% of 46 stenosed arteries were found with MIBI studies and 78% of them by rubidium studies. Fourteen among 28 grafted arterial territories of 12 post-CABG patients were found normal with both rubidium and MIBI. Segmental scores were concordant between rubidium and MIBI in 72% of 709 stress segments and in 80% of 825 rest segments. Stress rubidium segmental scores were less than stress MIBI scores in 9%, so were rest rubidium scores. Stress rubidium scores were more than stress MIBI scores in 20% of segments, and rest rubidium segmental scores were more than rest MIBl scores in 11%. Rank correlations (Spearman's rho's more than 0.7(stress) and 0.5(rest), slopes (MIBI/rubidium) around 0.7(stress) and 0.9 (rest)) suggested deeper and wider defects in stress with rubidium. Slope over 1 (MIBI/rubidium) with LAD segemental scores at rest and 7 territories which had much larger score with MIBI revealed exaggeration of rest defects with rest MIBI in same-day stress/rest study. Difference scores (stress-rest for each territory) suggesting Ischemia were larger with rubidium (slope of MIBI/rubidium around 0.45). As has been implied by animal or separate-day-human studies, these segmental analyses with simultaneous examination in patients told that rubidium PET flow studies disclose ischemia more often than MIBI studies and that rest MIBI studies in same-day stress/rest-sequence gave a little larger rest defect than they would have shown.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.5 no.2
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• pp.71-78
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• 2019

Nuclear imaging is one of the most powerful measures for non-invasive diagnosis of myocardial vascular disease. Radionuclide such as ¹³N, ¹⁵O, ²⁰¹Tl and ⁸²Rb is used for the measurement of cardiac blood flow. ¹³N, ¹⁵O and ²⁰¹Tl are produced in cyclotrons while ⁸²Rb is obtained from generator. Rubidium (Rb), an alkali ion, behaves biologically like potassium, and accumulates in myocardial tissue. Rb has rapid blood clearance profile which allows the use of ⁸²Rb with a short physical half-life of 75 s for non-invasive evaluation of regional myocardial perfusion. There are several advantages of ⁸²Rb over other radioisotopes. An ultra-short half-life significantly reduces the exposure of patients to radiation and allows to repeat injections for studying the effects of medical intervention. As a positron emitter, ⁸²Rb allows positron emission tomography (PET) imaging which have shown superior diagnostic performances. ⁸²Rb can be produced from generator by decay of its parent ⁸²Sr. However, the preparation of ⁸²Sr is difficult, because appropriate purity is required to meet the specification of the product. Recently reported procedure from ARRONAX research institute showed that a Chelex-100 resin is sufficient for this purpose and additional column is not necessary. Whereas Brookhaven National Laboratory (BNL) procedure contains three ion exchange resin separation, including Chelex-100 resin. Currently, since ⁸²Sr production site is non-existent in Korea, Korea Atomic Energy Research Institute (KAERI) has plan to produce ⁸²Sr within specifications. We compared ⁸²Sr purification procedures reported from ARRONAX and BNL to investigate the most suitable procedure for our conditions.

• Journal of Biomedical Engineering Research
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• v.16 no.2
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• pp.223-230
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• 1995

This study investigates a combined mathematical model for the quantitative estimation of regional myocardial blood flow in experimental canine coronary artery occlusion and in patients with ischemic myocardial diseases using Rb-82 dynamic myocardial positron emission tomography. The coronary thrombosis was induced using the new catheter technique by narrowing the lumen of coronary vessel gradually, which finally led to partial obstruction of coronary artery. Thirty four Rb-82 dynamic myocardial PET scans were performed sequentially for each experiment using our 5, 10 and 20 second acquisition protocol, respectively, and six to seven regions of interest were drawn on each transaxial slices, one on left ventricular chamber for input function and the others on normal and decreased perfusion myocardial segments for the flow estimation in those regions. Two compartment model and graphical analysis method have been applied to the measured sets of regional PET data, and the rate constants of influx to myocardial tissue were calculated for regional myocardial flow estimates with the two parameter fits of raw data by the Levenberg-Marquardt method. The results showed that, (I) two compartment model suggested by Kety-Schmidt, with proper modification of the measured data and volume of distribution, could be used for the simple estimation of regional myocardial blood flow, (2) the calculated regional myocardial blood flow estimates were dependent on the selection of input function, which reflected partial volume effect and left ventricular wall motion in previously used graphical analysis, and (3) mathematically fitted input and tissue time activity curves were more suitable than the direct application of the measured data in terms of convergence.

• Proceedings of the KOSOMBE Conference
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• v.1995 no.11
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• pp.157-158
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• 1995

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.326-330
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• 1994

A $^{82}Sr/^{82}Rb$ generator was prepared by loading $^{82}Sr$ to preconditioned tin dioxide column. The generator was eluted by normal saline with flow rate up to 8m1/min, and the eluted radioactivity was monitored by dose calibrator. Radioactivity began to come out at 5ml and reached to peak around 9ml. The total eluted radioactivity increased linearly with flow rate, and the maximum obtained radioactivity was 35mCi at 8m1/min. The $^{82}Rb$ preparation was proven to be free from both strontium radioactivity and pyrogen. The $^{82}Rb$ was injected to normal female volunteer and positron emission tomographic Image of heart was obtained successfully.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.3
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• pp.174-178
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• 2009

Many radiopharmaceuticals have been developed and wildy used in the imaging cardiac function. Myocardial perfusion imaging (MPI) is a well established noninvasive method of assessing coronary blood flow and has been widely used in patients diagnosed or suspected with coronary artery diseases. The innovation of radiopharmaceuticals used in the cardiac imaging is one of the most important contributors to the development of nuclear cardiology. Thallium-201 and various technetium-99m agents have been globally used for myocardial perfusion SPEG, and N-13 ammonia (13NH3), rubidium-82 (82Rb), 0-15 water (H2150) for myocardial perfusion PET. As well as the cardiac perfusion studies, new radiopharmaceuticals that visualize fat metabolism or receptors of the sympathetic nervous system have successfully been applied to clinical practice. Useful information can be obtained for diagnosing coronary artery disease, evaluating patients' condition, or assessing therapeutic effects. In this review, we describe the characteristics and clinical usefulness of radiopharmaceuticals used for cardiac SPEG and PET.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.7 no.2
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• pp.119-125
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• 2021

⁸²Sr for ⁸²Rb generator was produced through the irradiation of the proton beam on the ^nat.RbCI target at the target irradiation facility installed at the end of the Rl-dedicated beamline of the 100 MeV proton linear accelerator of KOMAC (Korea Multi-purpose Accelerator Complex). The average current of the proton beam was 1.2 µA for irradiation time of 150 min. For the separation and purification of the ⁸²Sr from ^nat.RbCI irradiated, Chelex-100 resin was used. The activities of ⁸²Sr in the irradiated ^nat.RbCI target solution and after purification were 45.29 µCi and 43.4 µCi, respectively. The separation and purification yield was 95.8%. As an adsorbent to be filled in the generator for ⁸²Sr adsorption hydrous tin oxide was selected. The adsorption yield of ⁸²Sr into the generator adsorbent was > 99 %, and the total amount of ⁸²Sr adsorbed to the generator was 21.6 µCi as of the day of the ⁸²Rb elution experiment. When the elution amount was 22 mL, the maximum⁸²Rb elution yield was 93.3%, and the elution yield increased as the flow rate increased. After the eluted ⁸²Rb was filled in the correction phantom of the small PET for animals, a PET image was taken. The image scan time was set to 5 min, and the phantom PET image was successfully obtained. As results of impurity analysis on eluted ⁸²Rb using ICP-MS, ^nat.Rb stable isotopes that compete in vivo of ⁸²Rb were identified as undetected levels and were determined to be No-Carrier-Added (NCA).

• The Korean Journal of Nuclear Medicine
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• v.36 no.1
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• pp.1-7
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• 2002

Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.