The new 99mTc myocardial perfusion imaging agents

99mTc-sestamibi and 99mTc-teboroxime

Daniel S. Berman*, Hosen Kiat, Jamshid Maddahi

*Corresponding author for this work

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

The two new 99m (99mTc) labeled myocardial perfusion agents, 99mTc-Sestamibi and 99mTc-Teboroxime, are now available for routine clinical application. Both agents allow assessment of ejection fraction by the first-pass technique at rest or during exercise, thus providing additional information not available with thallium-201. 99mTc-Sestamibi has long myocardial residence time, as well as adequate myocardial extraction, providing images of higher count density and superior quality compared with thallium-201. 99mTc-Teboroxime has excellent myocardial uptake characteristics but is cleared very rapidly from the myocardium. Both tracers have shown results similar to those obtained with thallium-201 for detection of coronary artery disease and the assessment of defect reversibility. 99mTc-Sestamibi studies using the rest/stress imaging sequence can be accomplished in approximately 5 hours; studies using dual-isotope imaging (rest thallium-201 and stress 99mTc-Sestamibi injection) can be completed in 1 to 2 hours. Gated stress images can be performed with 99mTc-Sestamibi, providing simultaneous information of myocardial perfusion at stress and resting wall motion or thickening and allowing rapid differentiation of ischemic from infarcted tissue. Because of its slow myocardial clearance and absence of redistribution, 99mTc-Sestamibi allows uncoupling of the time of injection from the time of imaging and thus can be valuable in the evaluation of acute myocardial infarction and outcome of thrombolytic therapy. With 99mTc-Teboroxime, rapid serial studies are feasible. Pharmacologic stress and rest studies with 99mTc-Teboroxime single photon emission computed tomography potentially can be completed in under 30 minutes. Because of its linear myocardial uptake even at very high coronary flow levels, 99mTc-Teboroxime with pharmacologic stress may be particularly well suited to the detection of early coronary disease.

Original languageEnglish
Pages (from-to)I7-I21
Number of pages15
JournalCirculation
Volume84
Issue number3 SUPPL.
Publication statusPublished - Sep 1991
Externally publishedYes

Keywords

  • Tc methoxy-isobutyl-isonitrile
  • Tc teboroxime
  • Tc-sestamibi
  • Myocardial perfusion imaging
  • Myocardial scintigraphy
  • Radionuclide imaging
  • Stress testing

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