There is only one Cardiolite

Imaging Protocols

Suggested Cardiolite® Two-Day Stress/Rest1,2

A two-day protocol may be attractive to patients unable to schedule both the stress and rest portions on the same day.  This protocol optimizes image quality for heavier patients and is recommended for patients weighing more than 250 pounds or Body Mass Index (BMI) >30 .1

Stress Portion — Day One
  • Patient undergoes exercise of pharmacologic stress
  • Inject with 20–30 mCi of Cardiolite® at peak (exercise) stress, or at the specified time if pharmacologic stress agent is used
  • Begin exercise stress scan 10–20 minutes after Cardiolite® injection
  • When using pharmacologic stress, begin imaging 45–60 minutes after Cardiolite® injection
Rest Portion — Day Two
  • Inject with 20–30 mCi of Cardiolite®
  • Administer rest injections 30–60 minutes prior to imaging

 

Two-Day Stress/Rest Algorithm

Stress Portion — Day One

Rest Portion — Day Two

Two-Day Stress/Rest Protocol Sequence:
  • Provides flexibility in scheduling because a patient only needs to be scheduled for a single study given a specified day
  • Image quality is likely improved because the patient receives a maximal dose for both the stress and rest image
  • Preferable for heavier patients (those patients weighing more than 250 pounds)1
  • Both the stress and rest studies can be gated to obtain functional information
  • Image acquisition can be repeated if there is significant patient motion or instrument malfunction
  • This sequence may be more inconvenient for patients with their work schedule or the availability of transportation to the clinic
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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