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VARIOUS › DIAGNOSTIC RADIOPHARMACEUTICALS › CARDIOVASCULAR SYSTEM › Other cardiovascular system diagnostic radiopharmaceuticals
thallium (201Tl) chloride
V09GX01
Forms & Strengths
- Thallium‑201 chloride injection solution, 2.5 mCi/mL (≈0.37 GBq/mL)
Adult Dosing
- Rest myocardial perfusion imaging: 2–4 mCi (74–148 MBq) IV
- Stress imaging (exercise or pharmacologic): additional 2–8 mCi (74–296 MBq) IV, total ≤12 mCi
- Single‑dose protocol for viability: 3–6 mCi (111–222 MBq)
Pediatric Dosing
- 0.05–0.1 mCi/kg IV (≈1.85–3.7 MBq/kg), max 2 mCi (≈74 MBq)
- For stress/rest studies, same weight‑based dose applied to each phase
Indications
- Myocardial perfusion imaging for detection of coronary artery disease
- Assessment of myocardial viability after infarction
- Evaluation of reversible ischemia in stress testing
- Occasional tumor imaging (e.g., neuroendocrine tumors)
Mechanism of Action
- Thallium‑201 acts as a potassium analog; uptake via Na⁺/K⁺‑ATPase reflects regional blood flow
- Cellular retention proportional to viable myocardial tissue; emits gamma photons (70–80 keV) for SPECT
Contraindications
- Pregnancy or suspected pregnancy
- Breast‑feeding
- Known hypersensitivity to thallium‑201 chloride
- Severe renal impairment (eGFR < 30 mL/min)
Adverse Reactions
- Nausea, vomiting, or abdominal discomfort
- Dizziness, headache, or transient hypotension
- Injection‑site pain or erythema
- Rare allergic reactions (urticaria, bronchospasm)
- Radiation‑induced stochastic effects (long‑term)
Drug Interactions
- High extracellular potassium or potassium‑sparing agents reduce myocardial uptake
- Diuretics, ACE inhibitors, β‑blockers, nitrates may alter distribution
- Digitalis may increase myocardial retention
- Concurrent radiopharmaceuticals can cause signal interference
Curated Content: Needs Vetting Before Put to Clinical Use