Image Wisely, a joint initiative of ACR, RSNA, ASRT and AAPM,
provides information to the medical community to promote safety in medical imaging.
E. Gordon DePuey, MD, St. Luke’s-Roosevelt Hospital, New York, NY
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Myocardial perfusion single-photon emission computed tomography (SPECT) is a well-established, highly standardized test to detect significant coronary artery disease and to risk-stratify patients with regard to cardiac event-free survival. Recently there have been significant advancements in scintillation camera hardware and software that allow for decreased image acquisition times and considerably lower injected radiopharmaceutical activity, resulting in lower patient radiation doses. Moreover, there has been a recent emphasis on patient-centered imaging, whereby SPECT imaging protocols are tailored to specific patient needs and diagnostic expectations. These patient-centered protocols have been designed to preserve or improve image quality and, when possible, also decrease patient radiation dose.
Study | Injected Activity | Effective Dose Estimate |
1-day rest/stress 99mTc based | 10 mCi rest 30 mCi stress |
9.3 mSv 99mTc tetrofosmin 11.4 mSv 99mTc sestamibi |
1-day stress/rest 99mTc based | 10 mCi stress 30 mCi rest |
9.3 mSv 99mTc tetrofosmin 11.4 mSv 99mTc sestamibi |
2-day stress/rest or rest/stress 99mTc based | 25 mCi stress 25 mCi rest |
11.6 mSv 99mTc tetrofosmin 14.8 mSv 99mTc sestamibi |
Stress-only 99mTc based | 25 mCi stress | 5.8 mSv 99mTc tetrofosmin 6.8 mSv 99mTc sestamibi |
1-day 201Tl rest/99mTc based stress | 3.5 mCi 201Tl 25 mCi 99mTc m |
21.2 mSv 201Tl /99mTc tetrofosmin 22.1mSv 201Tl /99mTc sestamibi |
1-day stress/redistribution 201Tl | 3.5 mCi 201Tl stress | 15.3 mSv |
1-day stress/reinjection/redistribution 201Tl | 3.0 mCi 201Tl stress 1.0 mCi 201Tl reinjection |
19.7 mSv |
Attenuation correction 153Gd X-ray CT |
< 0.3 mSv < 1 mSv |