There is only one Cardiolite

Imaging Protocols

Suggested Cardiolite® One-Day Stress/Rest1,2

An alternative, one-day protocol places the stress portion first.

Stress Portion
  • Patient undergoes exercise stress
  • Inject with 10 mCi of Cardiolite® at peak exercise stress
  • Begin exercise stress scan 10–20 minutes after Cardiolite® injection
  • Upon completion of the stress imaging and review for quality approval, it is recommended that the patient wait 2-4 hours before receiving rest injection 
Rest Portion
  • Inject with 25–30 mCi of Cardiolite®
  • Administer rest injections 30–60 minutes prior to imaging

 

One-Day Stress/Rest Algorithm

Stress Portion

Rest Portion

One-Day Stress/Rest Imaging Sequence:
  • Imaging after stress injection with a technetium agent is much more flexible than with Tl-201 due to different redistribution characteristics of the agents
  • Image acquisition can be repeated if there is significant patient motion or instrument malfunction
  • Rest image is not considered a true rest image, but rather a post-exercise rest image.  The general recommendation is to wait 3–4 hours after the exercise study is complete.

 

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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