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VARIOUS › DIAGNOSTIC RADIOPHARMACEUTICALS › CARDIOVASCULAR SYSTEM › Technetium (99mTc) compounds
technetium (99mTc) sestamibi
V09GA01
Forms & Strengths
- Kit for the preparation of technetium Tc 99m sestamibi injection: lyophilized powder in a 10 mL vial
Adult Dosing
- Myocardial perfusion imaging: 370-1110 MBq (10-30 mCi) intravenously via two-day or one-day protocol
- Parathyroid scintigraphy: 740-1110 MBq (20-30 mCi) intravenously
- Breast imaging (scintimammography): 740-1110 MBq (20-30 mCi) injected intravenously in a vein contralateral to the lesion
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
- If utilized, dosage is typically calculated based on body weight fractions per nuclear medicine guidelines, ranging from 7.4-14.8 MBq/kg with a minimum of 74 MBq
Indications
- Myocardial perfusion imaging for the detection of myocardial ischemia and infarction
- Evaluation of ventricular function and ejection fraction
- Detection of hyperparathyroidism in patients with primary or recurrent disease
- Scintimammography as an adjunct to mammography for the evaluation of suspected breast cancer
Mechanism of Action
- Lipophilic cationic coordination complex that passively diffuses across the sarcolemma and mitochondrial membranes
- Localizes within viable myocardial tissue proportionally to coronary blood flow and mitochondrial function
- Retention in myocardial and tumor cells is dependent on cellular and mitochondrial membrane potential
Contraindications
- Hypersensitivity to technetium Tc 99m sestamibi or any component of the formulation
- Pregnancy, unless the potential benefit outweighs the unknown risks of radiation exposure to the fetus
Adverse Reactions
- Transient metallic taste or altered sense of taste immediately after injection
- Flushing, transient headache, and dizziness
- Rare severe hypersensitivity reactions (anaphylaxis, urticaria, angioedema)
- Injection site reactions including pain and erythema
Drug Interactions
- Drugs that alter myocardial metabolism or blood flow (e.g., beta-blockers, calcium channel blockers, nitrates) may affect myocardial uptake and produce false-negative scan results
- Chemotherapeutic agents may alter tumor uptake kinetics in scintimammography
Curated Content: Needs Vetting Before Put to Clinical Use