Quantitative Radio-Cardiography with the Digital Autofluoroscope

The Digital Autofluoroscope was designed primarily to permit a quantitative evaluation of the rapid flow of short-lived radioisotopes through compartments within organs. To perform these studies, the instrument is operated in the dynamic mode. In this mode the patient is positioned in front of the detector, the radioactive material is administered, and the instrument automatically accumulates data in a magnetic core memory for a preset period of time varying from 30 milliseconds to 1 minute. At the end of the accumulation period, the stored information is dumped on computer-compatible digital magnetictape, the memory is cleared, and a new accumulation cycle commences. Upon completion of a study, the tape is replayed and anatomical sites identified from the images of the distribution of the radioactive material. A memory flagging system is then used to obtain quantitative information on a regional basis. Radio-cardiograms are performed following the intravenous injection of a bolus of 10 millicuries of 99mTc, and rapid sequence recording of the cardiac inflow and outflow data is obtained at the rate of five frames per second. Upon completion of the study, the digital tape is played back and the locations of the four chambers of the heart are identified. The memory elements corresponding to each of these anatomical sites are then flagged, the data is replayed, and the inflow and outflow curves for each chamber are recorded separately. An EKG trigger device can be used to initiate every count-record cycle to permit the accumulation of data only during diastole. The resulting data is easier to interpret as changes in cardiac volume due to normal contractions are not recorded. This technique has been evaluated in 20 volunteers to establish normal values. Over 50 patients with congenital and acquired heart disease have been studied, and the following parameters evaluated: (1) cardiac output, (2) pulmonary blood transit time, (3) pulmonary blood volume, and (4) the quantitation of blood flow through abnormal shunts. (author)