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Research ArticlePractical Protocol Tip

Gated Myocardial Perfusion Imaging

Maria L. Mackin
Journal of Nuclear Medicine Technology June 2020, 48 (2) 139-140; DOI: https://doi.org/10.2967/jnmt.120.245035
Maria L. Mackin
CNMT, RT(N)
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    TABLE 1

    Radiopharmaceutical Identity, Dose, and Route of Administration

    ProtocolSestamibi or tetrofosminImaging time
    1-d rest/stress8–12 mCi rest/24–36 mCi stress30–45 or 15–45 min (latter if pharmacologic stress)
    1-d stress/rest8–12 mCi stress/24–26 mCi rest15–45 or 30–45 min (latter if pharmacologic stress)
    2-d24–36 mCi for rest and stress30–45 or 15–45 min (latter if pharmacologic stress)
    Dual-isotope2.5–4 mCi 201Tl rest/24–36 mCi 99mTc-labeled agents10–15 or 15–45 min (latter if pharmacologic stress)
    201Tl stress/rest2.5–4 mCi 201Tl stressWithin 10–15 min/3, 4, 24 h
    201Tl stress/rest reinjection2.5–4 mCi 201Tl stress/1–2 mCi restWithin 10–15 min/3, 4, 24 h
    Viability only3−4 mCi 201Tl restWithin 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.

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    TABLE 2

    SPECT Acquisition Parameters

    ParameterStandard or optional
    Camera type
     NaI(Tl) Anger multidetectorStandard
     CZT or CsI(Tl) dedicated cardiac cameraOptional
    Energy peak
     201Tl: 70 and 167 keVStandard
     99mTc: 140 keVStandard
    Energy window
     201Tl: 30% and 20%Standard
     99mTc: 20%Standard
    Collimator
     LEHR 99mTc-labeled agentsStandard
     ConvergingOptional
     MultipinholeOptional
    Patient position
     SupineStandard
     ProneOptional
     SittingOptional
     ReclinedOptional
    Camera set-up of 45° RAO to 45° LPOStandard
    180° camera orbitStandard
    Circular or noncircular orbitStandard
    Pixel size of 6.4 ± 0.4 mmStandard
    64 projections for 99mTc-labeled agents; 32 for 201TlStandard
    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 shootStandard
     Continuous dynamic SPECTOptional
    64 × 64 matrixStandard
    Time per projection
     Rest: 25 sStandard
     Stress: 20 sStandard
    Electrocardiography-gatedStandard
    Frames per cycle
     8Standard
     16Optional
     32Optional
    100% R–R intervalStandard
    • LEHR = low-energy high resolution; RAO = right anterior oblique; LPO = left anterior oblique; p.i. = after injection; pharm = pharmacologic.

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Journal of Nuclear Medicine Technology: 48 (2)
Journal of Nuclear Medicine Technology
Vol. 48, Issue 2
June 1, 2020
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Gated Myocardial Perfusion Imaging
Maria L. Mackin
Journal of Nuclear Medicine Technology Jun 2020, 48 (2) 139-140; DOI: 10.2967/jnmt.120.245035

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Gated Myocardial Perfusion Imaging
Maria L. Mackin
Journal of Nuclear Medicine Technology Jun 2020, 48 (2) 139-140; DOI: 10.2967/jnmt.120.245035
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