Superior Imaging > Why N-13 Ammonia

Superior Imaging

While PET/MPI is widely viewed to be superior to SPECT, not all tracers are equal. Considered an optimal tracer for Myocardial Perfusion, N-13 Ammonia provides1

  • High spatial and contrast resolution images
  • High first-pass extraction and retention in the myocardium 
  • Consistently high-quality diagnostic studies regardless of patient size or gender

1. Fiechter et al., J Nucl Med 2012; 53: 1230-1234 

Diagnostic Accuracy

Using N-13 Ammonia for quantitative imaging offers significant diagnostic advantages:

  • improved risk stratification and identification of multi-vessel coronary disease1,2 
  • identification of patients who receive a survival benefit with early revascularization compared to medical therapy3 
  • ability to conduct functional assessments of intermediate stenosis
  • option to monitor coronary flow after revascularization procedures or post infarction4 
  1. Ziadi M.C. et al., J Am Coll Cardiol, 58(7), 740-748 
  2. Murthy V. L., Circulation, 124(20), 2215-2224 
  3. Patel, K.K. et al., European Heart Journal, 41(6), February 2020, (759–768) 
  4. Johnson, N.P., Gould, K.L., J Am Coll Cardiol: Cardiovascular Imaging, 4, 990-998

Annual Event Rate1

Risk Stratification using Myocardial Blood Flow (MBF)

Research shows that N-13 Ammonia with MBF is a strong predictor of patient outcomes. A study on the long-term prognostic value of N-13 Ammonia with MBF demonstrated that an abnormal MBF, regardless of normal or abnormal perfusion images, was associated with higher adverse cardiac events. Conversely, a normal perfusion along with a normal MBF suggested a 3-year "warranty" period.1

  1. Adapted from Herzog et al. “Long-Term Prognostic Value of 13N-Ammonia Myocardial Perfusion Positron Emission Tomography” JACC 2009; 150-6

Risk Reclassification

When performed with N-13 Ammonia, quantitative imaging results in more accurate patient risk reclassification. In the study shown here, 51% of the patients initially presenting in the intermediate cardiac risk category were reclassified after MBF with Ammonia N-13.

1. Murthy V.L. et. al. Circulation. 2011 Nov 15; 124(20): 2215-2224

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