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Technetium (99m Tc) sestamibi (commonly sestamibi; USP: technetium Tc 99m sestamibi; trade name Cardiolite) is a pharmaceutical agent used in nuclear medicine imaging. The drug is a coordination complex consisting of the radioisotope technetium-99m bound to six (sesta=6) methoxyisobutylisonitrile (MIBI) ligands. The anion is not defined.
These employ the same radioligands and have the same uses as SPECT scanning, but are able to provide even finer 3-D localization of high-uptake tissues, in cases where finer resolution is needed. An example is the sestamibi parathyroid scan which is performed using the 99m Tc radioligand sestamibi, and can be done in either SPECT or SPECT/CT ...
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Perfusion stress test (with 99mTc labelled sestamibi [15]) is appropriate for select patients, especially those with an abnormal resting electrocardiogram. Intracoronary ultrasound or angiogram can provide more information but is invasive and carries the risk of complications associated with cardiac catheterization procedures.
A cardiac specific radiopharmaceutical is administered, e.g., 99m Tc-tetrofosmin (Myoview, GE healthcare), 99m Tc-sestamibi (Cardiolite, Bristol-Myers Squibb) or Thallium-201 chloride. Following this, the heart rate is raised to induce myocardial stress, either by exercise on a treadmill or pharmacologically with adenosine , dobutamine , or ...
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The most common radiopharmaceutical used in MBI is 99m Tc-sestamibi, with doses of 240-300 MBq in current protocols, resulting in an effective dose to a patient of around 2.4 mSv. Earlier iterations of MBI required much higher doses of radiation up to 1100 MBq, which in part led to MBI falling out of favor in the latter part of the last century.
In stable patients whose symptoms have resolved by the time of evaluation, Technetium (99mTc) sestamibi (i.e. a "MIBI scan"), thallium-201 chloride or Rubidium-82 Chloride can be used in nuclear medicine to visualize areas of reduced blood flow in conjunction with physiologic or pharmacologic stress.