Name of the Procedure:

Technetium Tc-99m Sestamibi Scan

• Common Names: Sestamibi Scan, Tc-99m MIBI Scan
• Technical Term: Technetium Tc-99m Sestamibi Scintigraphy

Summary

A Technetium Tc-99m Sestamibi is a nuclear medicine diagnostic test where a small amount of radioactive material called Technetium Tc-99m Sestamibi is injected into a vein. This material travels through the bloodstream to the target organs, including the heart and parathyroid glands. Special cameras then capture detailed images that help doctors diagnose medical conditions.

Purpose

This procedure helps to:

• Identify heart disease, especially coronary artery disease.
• Locate abnormal parathyroid glands.
• Evaluate myocardial perfusion (blood flow to the heart muscle).
• Detect and monitor certain cancers.

Indications

• Chest pain or angina.
• Unexplained shortness of breath.
• Abnormal ECG or stress test.
• Suspected parathyroid gland issues like hyperparathyroidism.
• Cancer diagnosis and monitoring, including breast cancer.

Preparation

• Fasting for a specified period, usually 4-6 hours before the test.
• Medication adjustments: Certain medications might need to be paused.
• Pre-procedure Diagnostic Tests: Blood tests, stress tests, or other imaging studies.

Procedure Description

1. Injection: The patient receives an intravenous injection of Technetium Tc-99m Sestamibi.
2. Distribution Phase: It takes some time for the radiotracer to travel to and concentrate in the target tissues.
3. Imaging: Using a gamma camera, the patient lies still while images are taken. These cameras detect the radiation emitted by the Technetium Tc-99m Sestamibi and create detailed images.
4. Stress Testing (for Heart Assessments): Sometimes, images are taken while the patient is at rest and again after physical exercise or pharmacological stress.

Duration

Typically, the procedure lasts about 1-2 hours, although the total exam may take longer if resting and stress images are both required.

Setting

Performed in a hospital nuclear medicine department, an outpatient clinic, or an imaging center.

Personnel

• Nuclear Medicine Technologist
• Radiologist or Nuclear Medicine Physician
• Cardiologist (if related to heart imaging and stress testing)
• Nurse (for assistance and patient care)

Risks and Complications

• Minor reaction at the injection site.
• Rare allergic reactions to the radiotracer.
• Slight risk of radiation exposure; however, it's minimal and closely monitored.

Benefits

• Accurate diagnosis of various medical conditions.
• Helps guide treatment decisions.
• Non-invasive and highly sensitive imaging technique.
• Results usually available within a few days.

Recovery

• Typically, no recovery time is needed; patients can resume normal activities immediately.
• Hydration is recommended to help flush the radiotracer from the body.
• Follow-up appointments to discuss results and next steps.

Alternatives

• Cardiac MRI or CT for heart conditions.
• Ultrasound for parathyroid gland evaluation.
• Traditional biopsy and imaging for cancer diagnosis.
• Each alternative has different pros and cons concerning accuracy, complexity, and patient comfort.

Patient Experience

• During the injection: A slight pinch and minor discomfort.
• During imaging: Required to lie still, may feel coolness or discomfort from staying in one position.
• Post-procedure: Usually no pain, minimal discomfort, and normal activities can often be resumed; increased fluid intake is advised to speed up the elimination of the radiotracer.
• Pain Management: Generally not needed, but over-the-counter pain relief can be used if necessary.