Technetium 99m SESTAMIBI myocardial perfusion imaging: comparison between treadmill, dipyridamole and trans-oesophageal atrial pacing ?stress? tests in normal subjects (original) (raw)
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Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1990
SQ30217 is a new, technetium-99m-(99mTc) labeled perfusion agent introduced for cardiac imaging. To evaluate the myocardial tracer kinetics, 99mTc-SQ30217, was injected intracoronarily in open-chested dogs under baseline conditions and after administration of intravenous (i.v.) dipyridamole. Myocardial first-pass retention fraction averaged 0.90 +/- 0.04. Clearance of the tracer occurred in a biexponential manner. Sixty-seven percent of retained activity cleared with a half-time of 2.3 +/- 0.6 min, while the residual activity demonstrated slow clearance. The clearance rate of the rapid phase correlated with myocardial blood flow (r = 0.72, p less than 0.001). Myocardial SQ30217 clearance rate following i.v. injection as determined by dynamic imaging with tomography (SPRINT) averaged 21 +/- 4 min and increased to 13 +/- 4 min following dipyridamole. Thus, 99mTc-SQ30217 is a promising flow tracer with high initial myocardial retention and rapid tissue clearance, which allow repeated f...
Clinical Cardiology, 1992
To assess the diagnostic value of technetium-99m-MIBI (99mTc-MIBI) as a myocardial perfusion imaging agent, and if rest and exercise scans could be performed on the same day, 21 patients with coronary artery disease were studied. Qualitative planar 201-thallium (201Tl) scans, coronary angiography, or both were also performed (median between studies 11 days). In 10 patients an injection of 740 mBq of 99mTc-MIBI at stress was followed by a second injection of 740 mBq at rest 24 h later (long interval) (LI). In 11 patients injection of 370 mBq at rest was followed 3 h later by an injection of 740 mE3q at stress (short interval) (SI). Exercise scans were performed to similar maximal work load (LI = 6.6 k 1.8 METs;
Evaluation in dogs and humans of three potential technetium-99m myocardial perfusion agents
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1986
The biodistribution of the three cationic 99mTc complexes [99mTc(TMP)6]+, [99mTc(POM-POM)3]+, and [99mTc(TBIN)6]+--where TMP represents trimethylphosphite, POM-POM represents 1,2-bis(dimethyoxyphosphino)ethane, and TBIN represents t-butylisonitrile--have been evaluated in humans and dogs. Each agent was studied in three normal volunteers at rest, while [99mTc(POM-POM)3]+ and [99mTc(TBIN)6]+ were each studied in one normal volunteer at exercise. Even though all three agents yield good myocardial images in dogs, none appear suitable for clinical use as myocardial perfusion imaging radiopharmaceuticals. In humans, [99mTc(TMP)6]+ and [99mTc(POM-POM)3]+ clear very slowly from the blood and provide myocardial images only several hours after injection. [99mTc(TBIN)6]+ clears rapidly from the blood, but accumulation in the lung obscures the myocardial image for the first hour after injection; at later times, activity in the liver and spleen masks the apical wall. These results correlate wit...
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To study the potential usefulness of technetium-99m hexakis-2-methoxy-2-methylpropyl-isonitrile (Tc-MIBI) as a cardiac perfusion imaging agent, the left circumflex coronary arteries of 12 dogs were partially occluded. Eight additional control dogs had no coronary artery stenosis. Myocardial Tc-MIBI activities in the left circumflex and left anterior descending zones were continuously monitored by miniature implantable radiation detectors for 4 hr after administration of the isotope. The dogs were then killed. Serial gamma camera images were also acquired during the study. Heart rate, arterial blood pressure, pressure distal to the stenosis, and cardiac output did not change significantly during the experiment. Microsphere-determined regional myocardial blood flow was significantly reduced in the left circumflex distribution in the 12 dogs with coronary artery stenoses. In the 12 dogs with left circumflex coronary artery stenoses, the 4 hr fractional Tc-MIBI clearances from the norma...
Myocardial imaging with technetium-99m CPI: initial experience in the human
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1987
The hexakis(isonitrile)technetium(I) analog [99mTc]carbomethoxyisopropyl isonitrile (CPI) has high myocardial uptake and rapid lung and liver clearance in most animal species. To evaluate [99mTc]CPI as a myocardial imaging agent in the human, we evaluated this tracer in three normals and in six patients with coronary artery disease (CAD). In normals, [99mTc]CPI cleared quickly from the lungs and accumulated in the liver and heart. The liver activity peaked at 10-15 min and cleared through the hepatobiliary system. Planar images were of excellent technical quality with high myocardial to background ratios as early as 10 min after injection. Myocardial activity fell gradually to 76.1 +/- 2.9 (s.d.)% of initial activity by 60 min after injection. In six patients with CAD, myocardial defects were present on planar images up to 2 hr after exercise and injection. In one out of six patients, the defect was not seen 3 hr after injection. In five of the six patients, normal perfusion pattern...
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1993
Technetium-99m-teboroxime (CardioTec) is a promising new myocardial perfusion imaging agent. The purposes of this study were to define teboroxime clearance kinetics in normal and flow-restricted myocardium over a 1-hr period and to determine whether teboroxime kinetics are useful in detecting myocardial hyperperfusion. Accordingly, the circumflex arteries of 23 dogs were stenosed. By using miniature cadmium-telluride radiation detectors, myocardial teboroxime activities were continuously monitored in both the control and the stenosed zones. Myocardial clearance of teboroxime was modeled and found to be biexponential over 1 hr. A significant difference in myocardial clearance between the normal and stenosed zones (t1/2 = 4.5 +/- 0.9 min versus 10.2 +/- 2.6 min, respectively; p < 0.05) was observed for the first exponential phase (the first 5 min following initial uptake), but not for the second exponential phase (t1/2 = 160.7 +/- 35.9 min versus 140.4 +/- 27.4 min, respectively; p...
extraction and prolonged myocardial retention of @Tc sestamibi, results in a higher imaging count density on single-photon emission computed tomography (SPEC!') than can be obtained with @°‘Tl. Higher counts result in improved SPEC!' image quality, a principal advantage of @â€oe@Tc-sestamibi. In general, @‘@Tc-sestamibi produces higher-qualityimages than @°‘11, thus increasing observer certainty and the probability that other laboratories can reproduce the results of reported clinical trials (1â€"3). Another important characteristic of @â€oe@Tc-sestamibi is its slow myocardial washout (4), which ameliorates con cern regardingthe prolongedimagingtimes associated with SPEC!'. If, for example, the patient moves during the initial @9'c-sestamibi SPEC!' study, the acquisition can be repeated without major compromise to the amount of clinical information obtained. Conversely, with 201'fl,the possibility of early redistribution decreases the reliability of a repeat acquisition.