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Tables
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.
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 LEHR = low-energy high resolution; RAO = right anterior oblique; LPO = left anterior oblique; p.i. = after injection; pharm = pharmacologic.
