Cardiolite® is the brand name of sestamibi, a radiopharmaceutical used in nuclear medicine imaging. It is also known as methoxyisobutylisonitrile or MIBI. The radioisotope attached to the sestamibi molecule is technetium-99m, forming 99Tcm-sestamibi (or Tc99m MIBI). more...
Its main use is for imaging the myocardium (heart muscle). It is also used for imaging hyperparathyroidism of the parathyroid glands and for radioguided surgery of the parathyroid.
When injected intravenously into a patient, it concentrates in the myocardium dependent on the myocardial blood flow. Single photon emission computed tomography (SPECT) imaging of the heart is performed using a gamma camera to detect the gamma rays emitted by the technetium-99m as it decays. Two sets of images are acquired. For one set, the patient is stressed either by exercising on a treadmill or by using a drug. The Tc99m MIBI is injected at peak stress and then imaging is performed. In the second set the Tc99m MIBI is injected whilst the patient is at rest and then imaged. The resulting two sets of images can be compared to distinguish ischaemic from infarcted areas of the myocardium. The imaging is also known as myocardial perfusion imaging (MPI).
In hyperparathyroidism, one or more of the four parathyroid glands have developed a benign tumour called an adenoma. The affected gland takes up Tc99m MIBI following an intravenous injection. The patient's neck is imaged with a gamma camera to show the tumour.
Radioguided surgery of the parathyroids
Following the administration of Tc99m MIBI it collects in overactive parathyroid glands. During surgery, the surgeon can use a probe sensitive to gamma rays to locate the overactive parathyroid before removing it.
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