Gated Myocardial Perfusion Imaging

Article Figures & Data

TABLE 1

Radiopharmaceutical Identity, Dose, and Route of Administration

Protocol	Sestamibi or tetrofosmin	Imaging time
1-d rest/stress	8–12 mCi rest/24–36 mCi stress	30–45 or 15–45 min (latter if pharmacologic stress)
1-d stress/rest	8–12 mCi stress/24–26 mCi rest	15–45 or 30–45 min (latter if pharmacologic stress)
2-d	24–36 mCi for rest and stress	30–45 or 15–45 min (latter if pharmacologic stress)
Dual-isotope	2.5–4 mCi ²⁰¹Tl rest/24–36 mCi ^99mTc-labeled agents	10–15 or 15–45 min (latter if pharmacologic stress)
²⁰¹Tl stress/rest	2.5–4 mCi ²⁰¹Tl stress	Within 10–15 min/3, 4, 24 h
²⁰¹Tl stress/rest reinjection	2.5–4 mCi ²⁰¹Tl stress/1–2 mCi rest	Within 10–15 min/3, 4, 24 h
Viability only	3−4 mCi ²⁰¹Tl rest	Within 10–15 min/4, 6, 24 h

1 mCi = 37 MBq.
There should always be 1:3 ratio between activity of first dose and activity of second dose (e.g., 8-mCi first dose followed by 24-mCi second dose). In dual-isotope imaging, resting ²⁰¹Tl study must be performed first.

TABLE 2

SPECT Acquisition Parameters

Parameter	Standard or optional
Camera type
NaI(Tl) Anger multidetector	Standard
CZT or CsI(Tl) dedicated cardiac camera	Optional
Energy peak
²⁰¹Tl: 70 and 167 keV	Standard
^99mTc: 140 keV	Standard
Energy window
²⁰¹Tl: 30% and 20%	Standard
^99mTc: 20%	Standard
Collimator
LEHR ^99mTc-labeled agents	Standard
Converging	Optional
Multipinhole	Optional
Patient position
Supine	Standard
Prone	Optional
Sitting	Optional
Reclined	Optional
Camera set-up of 45° RAO to 45° LPO	Standard
180° camera orbit	Standard
Circular or noncircular orbit	Standard
Pixel size of 6.4 ± 0.4 mm	Standard
64 projections for ^99mTc-labeled agents; 32 for ²⁰¹Tl	Standard
Injection-to-scan time
^99mTc agents, rest: 30–45 min p.i.	Standard
^99mTc agents, stress: 15 min p.i. (exercise) or 30–45 min p.i. (pharm stress)	Standard
Thallium, rest: 20 min p.i.	Standard
Thallium, stress: 10–15 min p.i. (both exercise and pharm stress)	Standard
Acquisition type
Step and shoot	Standard
Continuous dynamic SPECT	Optional
64 × 64 matrix	Standard
Time per projection
Rest: 25 s	Standard
Stress: 20 s	Standard
Electrocardiography-gated	Standard
Frames per cycle
8	Standard
16	Optional
32	Optional
100% R–R interval	Standard