There is only one Cardiolite

Imaging Protocols

Suggested Cardiolite® One-Day Rest/Stress1,2

Using this protocol, you can complete imaging in one day. A low-dose Cardiolite® rest study is followed by a higher-dose stress study.  The higher dose Cardiolite® in the stress study overcomes the lower dose of the rest study, permitting high-quality gated SPECT imaging.1,2

Rest Portion
  • Inject with 10 mCi of Cardiolite®
  • Administer rest injection 60–90 minutes prior to imaging
  • Upon completion of rest imaging and review for quality approval, the patient may be prepared for stress testing. Patient should wait 1–4 hours from injection before proceeding to stress portion
Stress Portion
  • Patient undergoes exercise or pharmacologic stress
  • Inject with 25–30 mCi of Cardiolite® at peak (exercise) stress, or at the specified time if a pharmacologic stress agent is used
  • Begin exercise stress scan 10–60 minutes after Cardiolite® injection
  • When using pharmacologic stress, begin imaging 45–60 minutes after Cardiolite® injection

 

One-Day Rest/Stress Algorithm

Rest Portion

Stress Portion

One-Day Rest/Stress Imaging Sequence:
  • The rest image represents a true rest perfusion image because the patient has not previously been stressed
  • One-day protocol offers convenience for patients and rapid availability of results
  • Preferable when using a 1-day protocol with a short time interval (less than 2 hours) in between
    • Note that using a dose ratio less than 1:3 will necessitate increasing the time interval between the two injections1
  • Rest/stress protocols are now perfomed almost universally with no delay between the rest and subsequent stress images.1
  • Image acquisition can be repeated if there is significant patient motion or instrument malfunction
  • The ejection fraction is a post-stress EF, not a stress EF, since the image acquisition occurs after the exercise

 

Click here to view footnotes
  1. Henzlova MJ, Duvall WL, Einstein AJ, et al. ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers. J Nucl Cardiol. 2016;23(3):606-39.
  2. Cardiolite® [package insert]. N. Billerica, MA: Lantheus Medical Imaging.

 

INDICATIONS AND USAGE FOR CARDIOLITE®:
Myocardial Imaging:  Cardiolite® (Kit for the Preparation of Technetium Tc99m Sestamibi for Injection), is a myocardial perfusion agent that is indicated for detecting coronary artery disease by localizing myocardial ischemia (reversible defects) and infarction (non-reversible defects), in evaluating myocardial function and developing information for use in patient management decisions.  Cardiolite® evaluation of myocardial ischemia can be accomplished with rest and cardiovascular stress techniques (e.g. exercise or pharmacologic stress in accordance with the pharmacologic stress agent’s labeling).

CONTRAINDICATIONS:
None known.

IMPORTANT SAFETY INFORMATION: 
Cardiolite® has been rarely associated with acute severe allergic and anaphylactic events of angioedema and generalized urticaria.  In some patients the allergic symptoms developed on the second injection during Cardiolite® imaging.  The most frequently reported adverse events include headache, chest pain/angina, ST segment changes on ECG, nausea, and abnormal taste and smell.

Infrequently, death has occurred 4 to 24 hours after Tc99m Sestamibi use and is usually associated with exercise stress testing (See Section 5.2). Pharmacologic induction of cardiovascular stress may be associated with serious adverse events such as myocardial infarction, arrhythmia, hypotension, bronchoconstriction and cerebrovascular events.

WARNINGS AND PRECAUTIONS:
In studying patients in whom cardiac disease is known or suspected, care should be taken to assure continuous monitoring and treatment in accordance with safe, accepted clinical procedure.

Caution should be exercised and emergency equipment should be available when administering Cardiolite®.

Before administering Cardiolite® patients should be asked about the possibility of allergic reactions to either Cardiolite® or Miraluma®. Miraluma® is an identical compound used in breast imaging.

The contents of the vial are intended only for use in the preparation of Technetium Tc99m Sestamibi and are not to be administered directly to the patient without first undergoing the preparative procedure.

Please see full Prescribing Information: Cardiolite® (Kit for the Preparation of Technetium Tc99m Sestamibi for Injection)

 

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