(MPI) The myocardial perfusion scan is the most common nuclear medicine procedure in cardiac imaging and allows assessing the blood-flow patterns to the heart muscles. The comparison of the radiopharmaceutical distribution after stress and at rest provides information on myocardial viability and cardiac perfusion abnormalities. ECG-gated myocardial perfusion imaging allows the assessment of global and regional myocardial function such as wall motion abnormalities.
The diagnostic accuracy of myocardial perfusion scintigraphy (also abbreviated MPS) allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularization. MPI also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly, and those with diabetes. The use of this type of cardiac scintigraphy is associated with greater cost effectiveness of treatment, in terms of life-years saved, particularly in these special patient groups.
Myocardial perfusion scintigrams are acquired with a gamma camera. Single photon emission computed tomography (SPECT) is preferred over planar imaging because of the three dimensional nature of the images and their superior contrast resolution.
Common MPI radiopharmaceuticals, approved by the U.S. Food and Drug Administration (FDA) include: Tl-201 and the Tc-99m-labeled radiopharmaceuticals, such as sestamibi, tetrofosmin, and teboroxime for single-photon imaging. Rb-82 is used for positron emission tomography (PET) imaging.

See also Gated Blood Pool Scintigraphy, Myocardial Late Enhancement, Cardiac MRI and Echocardiography.

Nonionic monomers are used as x-ray contrast agents. To create a nonionic monomer, the tri-iodinated benzene ring is made water soluble by the addition of hydrophilic hydroxyl groups to organic side chains (CM ratio=3). Nonionic monomers have an intermediate osmolarity, intermediate viscosity and elevated hydrophilicity with three atoms of iodine per molecule. Lacking a carboxyl group, nonionic monomers do not ionize in solution. A nonionic monomer is potentially less chemotoxic than an ionic monomer.
Common nonionic monomers are iohexol (Omnipaque), iopamidol (Isovue®), ioversol (Optiray®), and iopromide (Ultravist®). Nonionic monomers are contrast agents with a wide range of indications due to their nonionic nature and lower osmolalities.

See Picture Archiving and Communication System.

Different stages of testing drugs in humans, from first application in humans through limited and broad clinical tests, to postmarketing studies. Preclinical trials are the testing in animals.

The pulmonary perfusion scintigraphy records the distribution of pulmonary arterial blood flow. The most common indication for lung scintigraphy is the detection of pulmonary embolism. The most widely used radiopharmaceuticals are technetium-99m MAA (macroaggregates of albumin) or 99mTc-HAM. Other radiopharmaceuticals include sulphur colloid macroaggregated albumin, radioactive albumin microspheres and albumin labeled with I-131, or I-113m.
Perfusion imaging of the bronchopulmonary system is based on the principle of capillary blockade. The perfusion study is accomplished by injecting 40 to 160 MBq (1-4 mCi) of the radiopharmaceutical and during repeated deep inhalation. The aggregates are extracted during their first pass through the lung, thus imaging can begin immediately. Pulmonary perfusion scintigraphy is particularly useful in combination with gas ventilation scintigraphy and aerosol ventilation scintigraphy.

See also Inhalation Scintigraphy.