Dedicated heart cameras (Dedicated Solid State Detector) cameras, as it is technically known is all set to bring about a revolution in the effective diagnosis of Coronary Artery Disease (CAD).
This technology would be a quantum jump as an effective Nuclear Medicine (NM) modality in the coming years as it would be helpful in several heart studies. The technology would help in the quantification studies of the heart by determining the rate of blood flow and Coronary Flow Reserve (CFR), which is a very important parameter to assess Coronary Artery Disease (CAD).
Dedicated Solid State Detector cameras use Caesium Zinc Telluride (CZR) material. There are dedicated solid state detector cameras for cardiac applications available globally and will be available in India soon. This technology will offer faster and higher count rate.
Experts say that this technology will come to India only once the cost of the technology comes down. Anger technology as a modality of Nuclear Medicine has also been in use for the past 70 years. With the introduction of Solid State Detector technology, it is going to replace Anger technologies in India as well.
To supplement the future modalities in the vast domain of Nuclear Medicine (NM), Single Photon Emission Computed Tomography (SPECT) and photo multiplier tubes with sodium iodide crystals will also be the future modality of NM in India.
Current trends in NM also highlight the potential of the modality. According to experts, Gamma cameras have been in use for routine NM check ups.
Besides this, Single Photon Emission Computed Tomography (SPECT) as a NM modality has also proved to be effective for the diagnosis of heart as it offers high count rates quickly.
The other effective modality, which currently is available in the country for determining CAD is Positron Emission Tomography (PET). PET is capable of doing heart studies but the only drawback with it is that the healthcare institutions in India do not have a radio-pharmaceutical called Rubidium, which can help make exact quantification of cardiac blood flow and Coronary Flow Reserve (CFR).
India is also poised to gain advantage in the field of radio diagnosis as Fusion Imaging modality popularly known as PET – CT is available in all metros and big cities like Bombay, Pune, Hydrebad, Chennai, Delhi, Ahmedabad and Kolkata. The only drawback with PET-CT is that it gives a lot of radiation. Therefore a proto-type of PET-MRI has been made in the US, where it is being studied and will find its commercial use over a period of few years globally.
Status of fusion imaging modality in India
Currently there are CT machines with 4, 8, 64 slice competency, which are in use across the country. There are in total over 22 PET-CT cameras across the country. Therefore, the country is well- equipped to address the huge volume of patient load.
Going by the economics, the infrastructure for a PET-CT costs Rs 5 to Rs 11 Crore. Besides, the recurring cost of the infrastructure is added by Isotopes produced by special machines called Cyclotrons, the infrastructure of which costs Rs 15 to Rs 20 crore.
Issues plaguing modality of NM
The unavailability of radio-pharmaceuticals in the country, which study different diseases in the brain is a major impediment in this modality. Radio-pharmaceuticals like FDNNP and Pittsburg compound, which are meant to detect Alzheimer disease and beta – CIT, which is meant to detect early Parkinson’s disease is also not available. Other issues plaguing the modality of NM are lack of technological advancements, lack of expertise, excessive government regulation and lack of awareness among medical fraternity.