Dynamic positron computed tomography of the heart with a high sensitivity positron camera and nitrogen-13 ammonia

Dynamic positron computed tomography (PCT) of the heart was performed with a high-sensitivity, whole-body multislice PCT device and [13N]ammonia. Serial 15-sec dynamic study immediately after i.v. [13N]ammonia injection showed blood pool of the ventricular cavities in the first scan and myocardial images from the third scan in normal cases (n = 4). In patients with myocardial infarction (n = 8) and mitral valve disease (n = 2), tracer washout from the lung and myocardial peak time tended to be longer, suggesting presence of pulmonary congestion. PCT delineated tracer retention in the dorsal part of the lung. Serial 5-min late dynamic study in nine cases showed gradual increase in myocardial activity for 30 min in all normal segments and 42% of infarct segments, while less than 13% activity increase was observed in 50% of infarct segments. Thus, serial dynamic PCT with [13N]ammonia assessing tracer kinetics in the heart and lung is a valuable adjunct to the static myocardial perfusion imaging for evaluation of various cardiac disorders.