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Cardiolite

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...

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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.

Cardiac imaging

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).

Parathyroid imaging

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.

Read more at Wikipedia.org


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Heart Scan Accurately Evaluates Chest Pain, Decreases Hospitalizations
From American Family Physician, 5/15/00 by Harry P. Selker

(American Heart Association) Findings from the Emergency Room Assessment of Sestamibi for Evaluation (ERASE) of chest pain study suggest that the use of a noninvasive heart scan called Cardiolite (kit for the preparation of technetium Tc99m sestamibi for injection) can more accurately rule out myocardial infarction in the emergency department (ED) than standard evaluation techniques and could avoid nearly 250,000 unnecessary hospitalizations for Americans annually. Over a 20-month period, ERASE investigators studied 2,456 patients who presented at seven EDs with symptoms suggestive of a myocardial infarction or unstable angina, but without an obvious pattern of either on their initial electrocardiogram (ECG). One half of all patients were tested with Cardiolite as part of the ED evaluation, while the control group received the usual ED assessment. The patients were ethnically diverse, one half were women, and the average age was 53 years. Of the 2,127 patients whose condition was ultimately diagnosed as noncardiac in origin, patients who received the Cardiolite scan were significantly more likely to be discharged safely from the ED. Use of the Cardiolite scan reduced unnecessary hospitalizations by 20 percent with no increase in hospital discharges among patients actually having a myocardial infarction. The most frequently reported adverse effects from the use of the Cardiolite test include headache, chest pain/angina, ST segment changes on ECG, nausea and abnormal taste and smell. The Cardiolite test has also been rarely associated with acute severe allergic event of angioedema and urticaria.--HARRY P. SELKER, M.D., AND JAMES E. UDELSON, M.D., New England Medical Center, Boston, Massachusetts.

COPYRIGHT 2000 American Academy of Family Physicians
COPYRIGHT 2000 Gale Group

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