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      Kinetics of Technetium-99m- SestamibiandThallium-201 in a Transient Ischemic Myocardium Animal Model: Insight into the ‘Redistribution’ Phenomenon

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          Abstract

          This study was designed to determine the redistribution potential for technetium-99m (<sup>99m</sup>Tc)-hexakis-2-methoxy isobutyl isonitrile (<sup>99m</sup>Tc-Sestamibi) as compared to thallium-201 (<sup>201</sup>T1) in a transiently ischemic swine heart model. The left anterior descending coronary artery (LAD) was totally occluded for 10 min. One minute prior to the release of the LAD, <sup>99m</sup>Tc-Sestamibi, <sup>201</sup>TI and a set of <sup>95</sup>Nb-radiolabeled microspheres (15 µm) were injected. A second set of <sup>51</sup>Cr-radiolabeled microspheres was injected prior to sacrifice in order to document reflow. Animals were sacrificed at different times post-LAD release (ranging from 1 min to 4 h). The left ventricle was sectioned into 0.2- to 0.5-gram pieces for the gamma spectroscopic counting of the <sup>99m</sup>Tc-Sestamibi, <sup>201</sup>TI and radiolabeled microspheres. Linear regression analysis of radiotracer localization versus microsphere-determined regional myocardial blood flow (rMBF) demonstrates an initial slight filling in of <sup>99m</sup>Tc-Sestamibi into transiently ischemic zones, with subsequent stable kinetics up to 4 h (i.e., it does not further redistribute). In comparison, the ischemic to normal ratios for <sup>201</sup>TI activity increase progressively in a time-dependent manner. These differences between<sup>99m</sup> Tc-Sestamibi and <sup>201</sup>TI might be explained on the basis of their blood clearance kinetics and/or their net clearance from normal and ischemic zones of the heart. It is concluded that <sup>99m</sup>Tc-Sestamibi is a stable and reliable indicator for rMBF over time, and that the lack of normalization of <sup>99m</sup>Tc-Sestamibi into transient ischemic zones will necessitate two separate injections for differentiation between ischemia and persistent defects.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1992
          1992
          14 November 2008
          : 81
          : 2-3
          : 157-163
          Affiliations
          The Du Pont Merck Pharmaceutical Company, Diagnostic Imaging Division, North Billerica, Mass., USA
          Article
          175790 Cardiology 1992;81:157–163
          10.1159/000175790
          1286474
          © 1992 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 7
          Categories
          Diagnostic Cardiology

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