Planar and SPECT Radiopharmaceuticals in Nuclear Cardiology: Current Status and Limitations
The branch of nuclear cardiology is ever expanding with newer indications for imaging the heart. Technical advancement in the instrumentation together with better radiopharmaceuticals has revolutionized the field of nuclear cardiology. Assessment of myoca
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Planar and SPECT Radiopharmaceuticals in Nuclear Cardiology: Current Status and Limitations
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Gopinath Gnanasegaran, Akhtar Ahmed, Jilly Croasdale and John R. Buscombe
19.1
Contents
19.1 19.2 19.2.1 19.2.2 19.2.3
19.3 19.3.1 19.3.2 19.3.3
19.3.4 19.3.5 19.4
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . Common Radiopharamaceuticals Used in Nuclear Cardiology . . . . . . . . . . . . . . . . . . 201Thallium: Physical Characteristics, Biodistribution and Dosimetry . . . . . . . . . . 99m Tc-Sestamibi [99mTc-Methoxyisobutyl Isoinitrile]: Physical Characteristics, Biodistribution and Dosimetry . . . . . . . . . . 99m Tc-Tetrofosmin [99mTc-1, 2-bis [bis (2-Ethoxyethyl) Phosphino] Ethane]: Physical Characteristics, Biodistribution and Dosimetry . . . . . . . . . . . . . . . . . . . . . . . . Miscellaneous Radiopharamaceuticals in Nuclear Cardiology . . . . . . . . . . . . . . . . . . 99m Tc-Teboroxime(Cardiotec): Physical Characteristics, Biodistribution and Dosimetry . . . . . . . . . . . . . . . . . . . . . . . . 99m Tc-Furifosmin: Physical Characteristics, Biodistribution and Dosimetry . . . . . . . . . . 99m TcN-NOEt (N-Ethoxy-N-EthylDithiocarbamate) Nitrido: Physical Characteristics, Biodistribution and Dosimetry . . . . . . . . . . . . . . . . . . . . . . . . Iodophenylpentadecanoic Acid (I-123 IPPA, and I-123-BMIPP) . . . . . . . . . Metaiodobenzylguanide (MIBG) . . . . . . . . Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . .
Introduction
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The branch of nuclear cardiology is ever expanding with newer indications for imaging the heart. Technical advancement in the instrumentation together with better radiopharmaceuticals has revolutionized the field of nuclear cardiology. Assessment of myocardial perfusion, function and metabolism using radiopharmaceuticals is a well-established method. There is a volume of literature supporting the role of radionuclide imaging in the assessment of a patient with suspected or diagnosed heart disease. Many different classes of radionuclide myocardial imaging agents are available. However, all these compounds have some advantages and disadvantages [1–6], and the final responsibility for choosing the right agent and protocols depends on the physician in charge. In general the team involved in providing a nuclear cardiology service should be made aware of the procedural guidelines for the use of radiopharmaceuticals [7] (Table 19.1). The agents used to image perfusion and function of the myocardium should possess some ideal or near ideal properties [1,8–10] (Table 19.2).The radiopharmaceutical or radiotracer should be taken up by the myocardium in proportion to the regional myocardial blood flow. The myocardial uptake should be high and long enough in the myocardium to detect the difference over different regions of the myocardium [1, 8–10]. Most importantly the initial distributi
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