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IMAGE INTERPRETATION · CARDIAC IMAGING

Myocardial Perfusion Tracers: Sestamibi and Tetrofosmin

Nuclear medicine myocardial perfusion scan — normal study
Nuclear medicine myocardial perfusion scan — normal study

CC BY-SA 4.0 · Sincefalastrum / Wikimedia Commons · source file

Question

This myocardial perfusion scan is labeled as a normal study. Which radiopharmaceutical is most commonly used for myocardial perfusion SPECT in clinical practice?

  1. ATl-201 thallous chloride
  2. BTc-99m sestamibi (MIBI) or tetrofosmin
  3. CRb-82 chloride
  4. DN-13 ammonia
Show the answer and explanation

B. Tc-99m sestamibi (MIBI) or tetrofosmin

Tc-99m sestamibi (Cardiolite) and Tc-99m tetrofosmin (Myoview) are the most commonly used radiopharmaceuticals for myocardial perfusion SPECT. They are lipophilic cations retained in myocardial mitochondria proportional to blood flow. Rb-82 and N-13 ammonia are used for PET myocardial perfusion imaging. Tl-201 was the original agent but has been largely replaced by Tc-99m agents due to better imaging characteristics.

More cardiac imaging images

Cardiac SPECT without attenuation correction (top row) vs. with attenuation correction (bottom row)Diaphragmatic Attenuation Artifact on Cardiac SPECT Myocardial perfusion SPECT — short axis slices, stress and restFixed Perfusion Defect: Myocardial Scar on SPECT Myocardial perfusion SPECT — lateral wall defect present at stress, resolved at restReversible Lateral Wall Defect: Circumflex Ischemia Myocardial perfusion SPECT — polar map (bull's-eye plot)Bull’s-Eye Polar Map: What the Center Shows Myocardial perfusion SPECT — anteroapical fixed perfusion defectAnteroapical Fixed Defect: LAD Infarction on MPI Myocardial perfusion SPECT — lateral wall stress/rest defect comparisonTransient Ischemic Dilation (TID) on Gated SPECT
← Normal Myocardial Perfusion SPECT, Stress and RestDiaphragmatic Attenuation Artifact on Cardiac SPECT →

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