Table of Contents
Hull University Teaching Hospitals NHS Trust - Nuclear Medicine
Uncontrolled if printed
| SOP Code | Title | Review Date |
|---|---|---|
| REF001 | Myocardial Perfusion Scintigraphy Referral Criteria | 2027-07-08 |
| Authorised By | Authorising Role | Authorisation Signature (only on master paper copy) | Date Authorised |
|---|---|---|---|
| Dr I Sunderji | ARSAC Licence Holder | 2024-07-08 |
REF001 - Myocardial Perfusion Scintigraphy Referral Criteria
See REF000 - Referring to Nuclear Medicine (HUTH) for details of how to refer.
Description
Myocardial perfusion scintigraphy is a non-invasive technique to evaluate myocardial perfusion and ventricular function. It is used to detect functional abnormalities of the coronary arteries, myocardial scar, and ventricular function; and to stratify cardiac risk. A radioactive tracer is administered intravenously, usually during exercise which can be dynamic (treadmill) or pharmacological. The distribution of the tracer within the myocardium is imaged using a gamma camera, the degree of uptake of tracer representing a combination of myocardial viability and perfusion. Further images after a resting injection of tracer are usually obtained to distinguish between defects caused by scan and inducible perfusion defects.
Three dimensional images are acquired (SPECT) and can be combined with CT images on the same scanner to allow for the correction of soft-tissue attenuation and, if required, coronary calcium scoring.
| ARSAC Licence Holders | Indication |
|---|---|
| Prof Stephen Richard Underwood | myocardial imaging |
| Dr Imran Sunderji | myocardial imaging |
| Prof Ged Avery | myocardial imaging |
| Dr Najeeb Ahmed | myocardial imaging |
| Radiopharmaceutical | CT component of SPECT/CT | |
|---|---|---|
| Typical Radiation Dose (mSv) | 2-17 | 0.5-2 |
Staff Entitled to Refer
- All UK registered medical practitioners
Supplementary Drugs
Sodium chloride for parenteral use (0.9% w/v).
Regadenoson, Adenosine, Dobutamine, GTN.
In addition we may administer any pharmaceutical considered necessary to mitigate the effects of the agents listed above
Contraindications
Pregnancy
Clinical Indications
| Detecting the presence, location, and extent of ischaemic coronary artery disease[1] |
| As part of the investigational strategy in the management of established coronary artery disease in people who remain symptomatic following myocardial infarction or reperfusion interventions [2] |
| Evaluating the functional significance or sequelae of coronary artery stenosis[1] |
| To determine the likelihood of future events for patients with known coronary artery disease |
| To guide myocardial revascularisation by determining the haemodynamic significance of coronary lesions |
| Monitoring the effects of treatment of coronary artery disease, including revascularisation and medical therapy[1] |
| Detecting myocardial infarction [1] |
| Evaluating the viability of dysfunctional myocardium (hibernating myocardium)[1] |
| Stratifying the risk assessment of acute coronary syndromes, including preoperative risk[1] |
| Stratifying the risk after myocardial infarction[1] |
| Assessment of the haemodynamic significance of known or suspected anomalous arteries and muscle bridging |
| Assessment of the haemodynamic significance of coronary artery disease in Kawasaki’s syndrome/other anatomical and functional abnormalities |
| Assessment of the presence, extent and severity of endothelial dysfunction |
| Assessment of coronary calcium score on CT (as part of MPS) |
