![]() The most frequently used radioactive tracer is methoxy-isobutyl-isonitrile (MIBI) labeled with technetium 99m ( 99mTc-MIBI). Other radiotracers include tetrofosmin or thallium ( 201Tl). The latter, hardly used in Poland, differs from the compounds labeled with technetium in that it undergoes redistribution in the myocardium. ![]() A one-time administration of 201Tl at peak stress enables the performance of a one-day examination that will visualize radiotracer uptake during stress as well as rest because the radiotracer is redistributed after a while. However, the use of 201Tl is not widespread for two main reasons. Firstly, it is obtained with the use of a cyclotron secondly, its long half-life requires the use of appropriately smaller activities, which in turn translates into worse image quality. ![]() Some laboratories use mixed protocols using both 201Tl and 99mTc. Notwithstanding, most current perfusion investigations are performed with the use of non-redistributable compounds labeled with 99mTc. At the Silesian Center for Heart Diseases, the only radiopharmaceutical used for myocardial perfusion imaging is 99mTc-MIBI, and the most frequently employed acquisition protocol is the two-day protocol.įigure 1 presents the 2-day and the one-day protocol using radiopharmaceuticals labeled with 99mTc. In low-risk patients, a stress SPECT-CT examination with attenuation correction is performed first to exclude coronary artery disease. If the stress examination shows normal perfusion and muscle contractility, no additional resting examination is required, which significantly reduces the patient’s exposition to radiation. In the remaining cases, the radiopharmaceutical must be administered twice. Protocols for two-day (top) and one-day (bottom) examinations.
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