Now one of the mainstays of cardiac imaging, PET offers undeniably better imaging and diagnostic potential. When paired with N-13 Ammonia, the value of PET grows even clearer.
With a low positron range and excellent extraction and retention, N-13 Ammonia paves the way to better diagnostics with high sensitivity and overall accuracy for detecting CAD.* The result is better risk classification and overall patient management.
Providing high diagnostic accuracy in both male and female patients as well as overweight and obese patients, N-13 Ammonia is used in a growing number of major academic institutions and is rapidly changing the standard of excellence for PET imaging.
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
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High spatial and contrast resolution images
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High first-pass extraction and retention in the myocardium
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Consistently high-quality diagnostic studies regardless of patient size or gender
1. Fiechter et al., J Nucl Med 2012; 53: 1230-1234
READ MORE > Diagnostic Accuracy > Risk Stratification > Risk Reclassification > Case Studies
Expanded Testing Options
Difficult cases call for different thinking and solutions. In many instances, N-13 Ammonia PET-MPI is the answer.
Thanks to a longer half-life, N-13 Ammonia allows for testing options not possible with other FDA-approved tracers.
For example, N-13 Ammonia allows for patients to be treadmill exercised as an alternative to pharmacologic stress.
Recent studies utilizing treadmill N-13 Ammonia stress testing have demonstrated:
- Reliable diagnostic accuracy and image quality in obese and non-obese patients.1
- Annual event rate consistent with previously published SPECT and PET data.2
- Produces larger, more severe defects compared to dipyridamole stress.3
- Aggarwal NR, Drozdova A, Askew JW, Kemp BJ, Chareonthaitawee P. Feasibility and diagnostic accuracy of exercise treadmill nitrogen-N-13 Ammonia PET myocardial perfusion imaging of obese patients. Journal of Nuclear Cardiology. 2015 Dec 1;22(6):1273-80.
- Chow BJ, Al Shammeri OM, Beanlands RS, Chen L, DaSilva J, Ruddy TD. Prognostic value of treadmill exercise and dobutamine stress positron emission tomography. Canadian Journal of Cardiology. 2009 Jul 1;25(7):e220-4.
- Chow BJ, Beanlands RS, Lee A, DaSilva JN, Alkahtani A, Ruddy TD. Treadmill exercise produces larger perfusion defects than dipyridamole stress N-13 ammonia positron emission tomography. Journal of the American College of Cardiology. 2006 Jan 17;47(2):411-6.
N-13 Ammonia v. Rb-82 Cl
N-13 Ammonia v. Rb-82 Cl Comparison
| Physical properties 2 | N-13 Ammonia | Rb-82 Cl |
|---|---|---|
| Half life (min) | 9.97 | 1.27 |
| Positron decay | 100% | 95.5% |
| Positron range (mm) | 0.57 | 2.60 |
| Image Resolution (mm) FWHM | 5 | 8 |
| Effective radiation (mSv/MBq) | 0.002 | 0.0034 |
| Raw material | High Purity O-16 water and methane gas | Sr-82/Sr-85 |
| Supplied | Unit Dose | Generator |
| Physiological properties 1 | Ammonia N-13 | Rb-82 Cl |
|---|---|---|
| Physiology | Diffusible/retained | Extracted/retained |
| Rest | Stress | Rest | Stress | |
|---|---|---|---|---|
| Extraction fraction | 0.98 | 0.93 | 0.70 | 0.40 |
| Retention fraction | 0.87-0.97 | 0.56-0.65 | 0.47-0.55 | 0.27-0.28 |
- deKemp et. al. “Will 3-dimensional PET-CT enable the routine quantification of myocardial blood flow?” J. Nucl Cardiol 2007; 14:380-97
- Sabin, MG, Radiopharmaceuticals for Nuclear Cardiology: Radiation Dosimetry, Uncertainties, and Risk, J Nucl Med 2008; 49:1555-1563
Reimbursement
Reimbursement is critical to the financial viability of any cardiac PET program. N-13 Ammonia is FDA-approved, fully reimbursed by Medicare and private payers. Plus, IONETIX stands ready to help you navigate the reimbursement process so you can focus on what you do best: delivering the best care possible.
Prescribing Information
INDICATIONS AND USAGE
N-13 Ammonia Injection is a radioactive diagnostic agent for Positron Emission Tomography (PET) indicated for diagnostic PET imaging of the myocardium under rest or pharmacologic stress conditions to evaluate myocardial perfusion in patients with suspected or existing coronary artery disease.
CONTRAINDICATIONS
None known.
ADVERSE REACTIONS
No adverse reactions have been reported for N-13 Ammonia Injection based on a review of the published literature, publicly available reference sources, and adverse drug reaction reporting system.
WARNINGS AND PRECAUTIONS
N-13 Ammonia Injection may increase the risk of cancer. Use the smallest dose necessary for imaging and ensure safe handling to protect the patient and health care worker.