Practical aspects of setting up

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• Practical aspects of setting up
• a Cardiac PET service

Caroline Hurley
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Rubidium-82?

• Rubidium-82 is a generator produced isotope from
  the decay of strontium-82
• Rb-82 has T ½ of 75 seconds
• Potassium analogue, good uptake in Cardiac
  muscle, with images possible from 2 minutes.
• Short half life means the patient can be repeated
  with a stress scan after 10 minutes.

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Scanning sequence
Topogram
AC CT
Ca Score
AC CT
Stress 7min
Rest 7min
Adenosine
Rb-82 infusion
Rb -82 infusion
10 minute interval
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Scheduling
Mon Tues Wed Thur Thur Fri
700-830 Rubidium Cart QC and PETCT QC Rubidium Cart QC and PETCT QC Rubidium Cart QC and PETCT QC Rubidium Cart QC and PETCT QC Rubidium Cart QC and PETCT QC Rubidium Cart QC and PETCT QC
830 - 1200 6 Rb 7 Rb 7 Rb 7 Rb 7Rb
830 - 1200 4 Rb 6 Rb 7 Rb 7 Rb 7 Rb 7Rb
1230 - 1630 3 Rb 3 Rb 3 Rb 3 Rb 3 Rb 4 FDG
1230 - 1630 3 FDG 3 FDG 3 FDG 3 FDG 3 FDG 4 FDG
1630 - 2030 4 FDG 4 FDG 4 FDG 4 FDG 4 FDG

• 39-43 cardiac scans per week
• 32 FDG
• -28 Oncology
• - 4 other
• (cardiac viability, infection imaging, Brain
  imaging)
• Paediatric Imaging

F-Dopa with GA
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Staffing

• 2 Stressors - either Nurse, Technician or Doctor
• alternate patients
• 2/3 Technicians
• Computer
• Camera set up
• Patient prep
• 1 Technician QC

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QC tests
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CardioGen-82 generator and cart

• Generator sits inside a shielded container in the
  cart
• Automatic infusion system
• Positron detector
• Control Panel

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Position of the cart

• Space at the PET side of the camera for the cart.
• Socket
• Space for gloves, admin sets, wipes, saline
• Stress infusion pump
• Clear exit route

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Remote Monitoring

• 12 lead ECG with remote monitoring
• Integrated BP monitoring
• CCTV
• Timers
• Intercom
• Emergency equipment
• Oxygen

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Preparation room

• Explain procedure
• Check preparation instructions have been followed
• Identify any concerns
• Attach ECG
• Cannula (18G)

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Recovery room

• Remove the cannula
• Space for the patient to get dressed
• Final check that the Patient feeling well.

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Image Registration

• Images are acquired in list mode
• A static reconstruction is made during imaging
  from 3-4min.
• Adjust the registration between the PET data and
  the CT data
• Reconstruction of Static, Gated and dynamic data
  sets

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Expiry of generator

• 42 days post calibration date or
• A total volume of 17Litres has passed through the
  generator column
• An elute Sr-82 level of 0.01µCi /mCi of Rb-82 or
• An elute Sr-85 level of 0.1µCi /mCi of Rb-82.
• Alert Limit
• 14 litres of elution volume has passed over the
  column or
• Sr-82 level reaches 0.002µCi per mCi of Rb-82 or
• Sr-85 level reaches 0.02µCi per mCi of Rb-82

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And Finally..

• Generator change Day
• Waste
• Return of the Generators CAA approved training

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Thank you

• Thank you

Film editor Matthew Memmott
Louise Crook as The Patient