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Fused cardiac PET/CT

We provide a range of cardiac scans:

Myocardial Perfusion Scintigraphy: We offer state-of-the-art myocardial perfusion SPECT imaging using a novel, dedicated cardiac system with solid-state detectors which enables faster imaging at lower radiation doses.

Sharir, T. et al. Multicenter trial of high-speed versus conventional single-photon emission computed tomography imaging: quantitative results of myocardial perfusion and left ventricular function. J Am Coll Cardiol 55, 1965–1974 (2010).
S Ben-Haim, et al. Simultaneous dual-radionuclide myocardial perfusion imaging with a solid-state dedicated cardiac camera. Eur J Nucl Med Mol Imaging 37, 1710–1721 (2010).

Myocardial Perfusion PET using Rubidium-82, enables faster imaging at lower radiation doses even in patients with high BMIs. It is often combined with CT coronary angiography to provide both perfusion and anatomy in a hybrid imaging test.

Groves A.M. et al. Cardiac 82Rubidium PET/CT: initial European experience. Eur J Nucl Med Mol Imaging 2007 Dec;34(12):1965-72.
Groves, A. M. et al. First experience of combined cardiac PET/64-detector CT angiography with invasive angiographic validation. Eur J Nucl Med Mol Imaging 36, 2027–2033 (2009).
Menezes, L. J. et al. Assessment of left ventricular function at rest using rubidium-82 myocardial perfusion PET: comparison of four software algorithms with simultaneous 64-slice coronary CT angiography. Nucl Med Commun 30, 918–925 (2009).

Myocardial Viability PET imaging with FDG helps predict functional improvement before revascularization.

CT Calcium scoring: Calcification of the coronary arteries is a sign of atherosclerotic disease and can be quantified using multi-slice computed tomography (CT). We provide same day calcium scoring as the Rapid Access Chest Pain Clinic to rule out coronary artery disease in low risk patients.

CT coronary angiography is provided for patients with suspected CAD, to evaluate disease progression, and to establish the need for revascularization. CT can also be used to assess the function of the heart, the anatomy of the heart, and the degree of coronary calcification in the heart.

Groves, A. M. et al. CT coronary angiography: quantitative assessment of myocardial perfusion using test bolus data-initial experience. Eur Radiol 18, 2155–2163 (2008).

Whole-body FDG

The Institute of Nuclear Medicine at UCLH provides a high quality and comprehensive cancer imaging service utilising the latest imaging technologies. We are able to detect and localise lesions using combined anatomical and functional imaging with SPECT-CT and PET-CT. As well as tumour imaging with 18-FDG we routinely utilise other PET tracers including 68 Ga-DOTATATE ,18F-Choline and 18-Fluoride . We provide a unique PET somatostatin receptor imaging service using an onsite 68Ga generator for labelling of octreotide ligands. We have also performed the largest number of 18F-Choline PET-CT scans in the UK for patients with prostate carcinoma. In April 2012 the UK’s first PET-MRI scanner in the country was installed at the Cancer Imaging Centre, UCLH. This is intended for use in clinical imaging in Cancer patients as well as research. We accept referrals and working closely with clinical partners in nearby NHS trusts and also over a wider geographical area.


PETMRstrip.JPG
Fused PET and MRI images from the UKs first combined PET/MRI scanner.

Housed in the new University College Hospital on Euston Road, the Institute of Nuclear Medicine is the largest single site Nuclear Medicine department in the UK. Having state of the art equipment such as SPECT/CT, PET/CT and the first PET/MRI installation in the UK, the department is at the leading edge of neuroimaging applications.

Current investigations performed at the centre include:

DaTScan imaging for Parkinsonian syndromes and to differentiate between Alzheimer’s Disease and Lewy Body Dementia.

  • The Institute has been active in this area since the onset of this technology, and has been involved in many key publications and research collaborations since.

Imaging of Age related disorders such as Alzheimer’s disease and Fronto-Temporal Dementia using FDG PET and new Beta-Amyloid Plaque imaging agents.

  • The introduction of PET/MRI for this application has provided a powerful combination of fused anatomical and functional data from MRI, with the early signs of disease that are only available with PET imaging.

Primary and metastatic Brain cancers

  • The use of different tracers within the department such as Fluoro-deoxyglucose (FDG), Fluorothymidine (FLT), Fluorocholine and Gallium-68 Neuropeptides offer a wide and varied range of probes to detect and characterize brain tumours.

Epilepsy Imaging

  • The Institute has extensive experience in FDG brain PET imaging to lateralize and/or find the focus of epileptic fits. This has been recently enhanced by the introduction of simultaneous PET and MRI on our new PET/MRI scanner. To supplement this service, the department are also currently in the process in setting up an ictal/inter-ictal SPECT service for epileptic focus localization.

In Professor Peter Ell, and Dr John Dickson, the department has substantial experience in both the interpretation and also the development of neuroimaging. The department also maintains good and strong relationships with neurologists based at Queen Square (London), and beyond.

Radionuclide therapy is an established practice within University College London Hospital. Currently we receive referrals both nationally and internationally for the treatment of a range of conditions including neuroendocrine tumours (NETs), thyroid carcinoma, meningioma and pituitary tumours. We also provide conventional radioiodine therapy on an out-patient basis for the treatment of thyrotoxicosis. We are one of only two centres in the UK to offer paediactric radionuclide therapy.

Within UCLH, we have 10 dedicated rooms for Radionuclide therapy. These are state-of-art, en-suite and lead-lined with a separate room situated adjacent that is designated for comforters and carers.

We offer state-of-art diagnostic imaging assessment to monitor eligibility for radionuclide therapy, incorporating 123I-mIBG (Metaiodobenzylguanidine) scintigraphy, 18F-FDG and 68Ga-DOTATATE PETCT. Additionally, assessments can be performed on the PET/MR machine located in the UCLH cancer centre. This is the first machine of its kind in the UK.

Referrals for therapy are discussed in multi-disciplinary meetings comprising a range of medical, scientific and technical staff, where case histories are reviewed together with imaging studies.

A recent addition to the service is the use of 177Lu-DOTATATE therapy to treat patients with Neuroblastomas. 68Ga-DOTATATE PET/CT is used to scan children with neuroblastoma and identify those suitable for radionuclide therapy with 177Lu-DOTATATE. We have shown, for what is to our knowledge the first time, that treatment with 177Lu-DOTATATE is safe and feasible in children with relapsed or primary refractory high-risk neuroblastomas.

GE Discovery NM/CT 670 SPECT/CT camera

The Institute of Nuclear Medicine has extensive experience in SPECT and SPECT/CT imaging, with the department housing a number of state of the art hybrid SPECT/CT scanners. Combined SPECT/CT is an integrated imaging system which offers a combination of functional data from a multi-head SPECT gamma camera and high- resolution anatomical details from a multi-slice diagnostic CT scanner. The SPECT functional data when fused with CT anatomical data provides the clinicians with better visualisation of the images and enables them to accurately define the exact location and extent of the disease. The addition of anatomic information increases the sensitivity as well as the specificity of imaging findings. The CT data is also used for attenuation correction of the SPECT data, giving improved image quality.

The Institute of Nuclear Medicine performs a number of SPECT and SPECT/CT imaging procedures. The modality has already shown its benefits using different radio-labelled tracers in clinical practice and in research. Some of the indications where SPECT/CT has found to be of great benefit are as follows:

• Bone imaging
• Oncology imaging
• Cardiac imaging
• Neuro-imaging
• Endocrine imaging
• Sentinel node mapping

Advantages of hybrid PET/MRI imaging

The high resolution and sensitivity of PET/MRI captures minute details and produces superior three-dimensional images available on the 3T system.

The simultaneous image capture of the PET and MRI scans eliminates the potential imaging problems caused by involuntary patient movement, such as
breathing and muscle relaxation.

When used for anatomical imaging, the radiation dose for patients is half that of the next best technology.

The combined scanner reduces the need for patients to come for multiple visits.

Patient diagnosis is faster because imaging and overall information available from the scan is better.

The magnet is at 3T field strength based on Siemens Verio model.

Current clinical protocols include but are not limited to:
Whole body 18F-FDG with 3T MRI structural and functional imaging
Neuroimaging 18F-FDG with 3T MRI structural and functional imaging for epilepsy and dementia.

Current research projects underway include:
Differential diagnosis of dementia 18F-FDG with 3T MRI structural and functional imaging.
The role of PET/MRI in radiotherapy planning for meningioma using 68-Ga DOTATATE and 3T MRI structural and functional imaging.
Biomarkers for angiogenesis and hypoxia using 18F-FDG and 3T MRI advanced functional imaging.

Please contact Professor Ashley Groves for prospective research projects or Dr Jimmy Bomanjii for clinical referrals.

Please contact Dr Anna Barnes or Ms Celia O’Meara for technical details or MRI sequence development.

PET/MR cross-section of scanner

Diagnostic tests

Brain

Brain Imaging (Thallium) for tumour
Brain Perfusion Imaging-Ceretec (HMPAO)
Cerebral Spinal Fluid (CSF)
DATScan (Brain dopamine transporter imagin)

Cardiac

MIBG Cardiac Imaging
MUGA (Radionuclide Ventricular Function Study)
MUGA Tomo with Stress (Radionuclide Ventricular Function Study)
MUGA Tomo(Radionuclide Ventricular Function Study)
MUGA with Stress (Radionuclide Ventricular Function Study)
Myocardial Perfusion - price per study

CT

CT Angiography
CT Calcium Score
CT Diagnostic
CT Diagnostic with IV contrast
CT Perfusion
CT Perfusion

Endocrine

123- Whole Body Scans
123-I Thyroid Uptake and Imaging
131-I Whole Body Survey
Parathyroid Imaging
Technetium Thyroid Uptake and Imaging

Gastro-Intestinal

Gastro-Intestinal Bleed (RBC)
HIDA (Biliary Tree Imaging )

Lymph

Lymphoscintigraphy
SLN Study Breast
SLN Study Melanoma
SLN Study Penile
SLN Study Vulva

PET/CT

F- PET/CT (Bone)
FDG PET/CT
FDOPA PET/CT
Ga Citrate PET/CT
Ga Octreotide PET/CT
Paediatric F- PET/CT (Bone)
Paediatric FDGPET/CT

Renal

DMSA Renal Study
MAG3 Dynamic Renal Scan
MAG3 Dynamic Renal Scan + Bladder Emptying
MAG3 Dynamic Renal Scan + Captopril

Bone Scans

Bone scan
Bone scan with SPECT/CT

Bone Density

Bone Density

Other

Adrenal Imaging
Gastric Emptying
HIDA (Biliary Tree Imaging )
Lacrimal Scan (Dacroscintigraphy)
Leveen Shunt
Liver Imaging
Lung VQ Scan
Meckels Scan
MIBG Imaging
Pentavalent DMSA (DMSA(V))
Salivary Gland Imaging
SEHCAT
Spleen Imaging (Denatured RBC)
White Cell Infection Study

Laboratory tests

GFR (Chromium-51 EDTA)
Plasma Bound Iodine
Plasma Volume Study 125I-HSA
Red Cell Mass Study 246

Therapy tests

131-I Thyrotoxicosis Therapy
Bone Pain Therapy (153Sm EDTMP)
MIBG Therapy
Pain Palliation (Strontium Therapy)
Radiation Synovectomy
Rhenium Therapy
Whole Body Scan Ony - Iodine 131

We are committed to providing a world class clinical service to our patients. An essential component of achieving this has been a continuous and vigorous Governance, Quality Assurance and Quality Control Programme. We are the 1st UK Department to have successfully been twice audited by the British Nuclear Medicine Society. We are also accredited by the European Association of Nuclear Medicine, again the 1st UK site to have obtained this. We have had our patient services checked by internationally renowned specialitsts such as - Dr S Wann Wisconsin Heart Hosptital (cardiac CT), Prof  H Macapinlac, MD Anderson, Texas, Oncology PET, Prof Steiner Zurich (Thoracic CT and PET), and Prof D Anagnostopoulos, Academy of Athens, (cardiac PET).

Page last modified on 18 jul 12 10:31