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Biodistribution and radiation dosimetry of 82Rb at rest and during peak pharmacological stress in patients referred for myocardial perfusion imaging

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Abstract

Purpose

82Rb is an ultra-short-lived positron emitter used for myocardial blood flow quantification with PET imaging. The aim of this study was to quantify the biodistribution and radiation dosimetry in patients with coronary disease and in healthy normal volunteers.

Methods

A total of 30 subjects, 26 patients with known or suspected coronary artery disease (CAD) and four healthy volunteers were injected with 82Rb chloride at 10 MBq/kg followed by a 10-min dynamic PET scan. Chest scans at rest were acquired in all subjects, as well as one additional biodistribution scan of the head, neck, abdomen, pelvis or thighs. Chest scans under stress were acquired in 25 of the CAD patients. 82Rb time-integrated activity coefficients were determined in 22 source organs using volume of interest analysis, including corrections for partial-volume losses. The mean time-integrated activity coefficients were used to calculate the whole-body effective dose using tissue weighting factors from the International Commission on Radiological Protection (ICRP) Publications 60 and 103.

Results

A total of 283 organ time-integrated activity coefficients were calculated, with a minimum of four values per source organ. The rest and stress mean effective dose was 0.8 mSv/GBq, according to the most recent ICRP definition. Using 10 MBq/kg for 3D PET imaging, the effective dose to a gender-averaged reference person (60 kg female and 73 kg male) is 1.1 mSv for a complete rest and stress perfusion study. For 2D PET using a typical injected activity of 1.1 to 2.2 GBq each for rest and stress, the effective dose for a complete study is 1.8 to 3.5 mSv.

Conclusion

The current effective dose estimate in CAD patients is four times lower than the values reported previously by the ICRP, and about 35 % lower than previous in vivo studies in young healthy subjects.

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Acknowledgments

R.S.B.B. was a Career Investigator supported by the Heart and Stroke Foundation of Ontario (HSFO). M.C.Z. was a Research Fellow supported by a University of Ottawa International Fellowship Award and a Molecular Function and Imaging Program grant (HSFO PRG6242). This project was funded in part by an Imaging in Cardiovascular Therapeutics grant (ORF RE-02-038) in partnership with support from Jubilant DraxImage, and by a Rubidium as an Alternative Radiopharmaceutical for Myocardial Imaging (Rb-ARMI) grant from the Canadian Institutes of Health Research (MIS-100901) with in-kind support from Jubilant DraxImage. The authors thank the staff in the PET unit for their assistance with acquisition and reconstruction of the PET scans.

Authors’ contributions

C.H. performed all analysis on patient data, performed dosimetry analysis including statistical analysis, and drafted the manuscript.

J.H. aided in dosimetry calculations and statistical analysis of data, and helped draft final manuscript.

C.M.Z. developed the patient imaging and ethics protocol.

R.B. helped with patient protocol development, and helped with critical analysis of the manuscript.

R.deK. oversaw all patient protocols, analysis of patient data, dosimetry calculations and final drafting of the manuscript.

Conflicts of Interest

C. Hunter, M. Cecilia Ziadi and Rob S.B. Beanlands declare that they have no conflict of interest.

R.A. deKemp receives royalties from the sale of rubidium-82 generator technologies licensed to Jubilant DraxImage (Kirkland, QC). J. Hill was a consultant for Jubilant DraxImage (Kirkland, QC), which manufactures rubidium-82 generators.

Compliance with Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This article does not contain any studies with animals performed by any of the authors.

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Authors and Affiliations

  1. Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada

    Chad R. R. N. Hunter & Robert A. deKemp

  2. University of Ottawa Heart Institute, Ottawa, ON, K1Y 4W7, Canada

    Chad R. R. N. Hunter, M. Cecilia Ziadi, Rob S. B. Beanlands & Robert A. deKemp

  3. Consultant to Jubilant DraxImage, Kirkland, QC, H9H 4J4, Canada

    Jeremy Hill

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  1. Chad R. R. N. Hunter
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Corresponding author

Correspondence to Robert A. deKemp.

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Hunter, C.R.R.N., Hill, J., Ziadi, M.C. et al. Biodistribution and radiation dosimetry of 82Rb at rest and during peak pharmacological stress in patients referred for myocardial perfusion imaging. Eur J Nucl Med Mol Imaging 42, 1032–1042 (2015). https://doi.org/10.1007/s00259-015-3028-3

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  • DOI: https://doi.org/10.1007/s00259-015-3028-3

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