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Nuclear Cardiology

In nuclear cardiology, radioactive tracers are used to evaluate cardiac disease.  The quantity and location of the tracers within the heart are then imaged with a special camera.  A powerful computer is then used to analyze the data and create the pictures that the doctor reads to interpret the results. 

The nuclear cardiology laboratory is staffed by a team that includes cardiologists, registered nurses, and nuclear medicine technologists. 

Dr. Roy S. Wiener - Director of Nuclear Cardiology
(585) 338-2700

 

About the Tests

Thallium/Sestamibi Stress Test

This study is performed to evaluate the presence and severity of coronary artery disease, the extent of myocardial damage, and the pumping function of the heart.  The radionuclides are absorbed by heart muscle in proportion to blood flow.  If the patient can walk adequately, the test is done in conjunction with an exercise test on the treadmill.  However, many people cannot walk to a satisfactory workload; in these cases, the heart is stressed with a drug such as dipyridamole.

A normal scan shows both uniform uptake of the radionuclide and normal cardiac wall motion.

 

 

 


An abnormal perfusion scan shows a defect from 3 to 6 o’clock on the stress image that normalizes on the rest image. 

 

 

 

This corresponds with a blockage in the circumflex artery which supplies this region of the heart.  An abnormal wall motion study in a different patient demonstrates severe impairment of pumping function throughout the heart.

Preparation

The test will take approximately 3½ hours.  Report to the Radiology Registration Office on the ground floor of Rochester General Hospital at the assigned time.  The radionuclides you will receive are expensive and have been ordered specifically for you.  If you need to cancel the test, please call (585) 922-4047 by the day before the test.

Do not consume any coffee, tea, cocoa, cola, chocolate, or any food/drug containing caffeine for at least one day prior to the test.  This includes decaffeinated coffee.  If you are taking medications containing theophylline for asthma or emphysema, call (585) 922-4047 to receive further instructions.

Restrict diet to small amounts of clear liquids after midnight on the day of the test.  Medications can be taken with a sip of water.  Do not take oral diabetes medicines on the day of the test.  If you are on insulin, call (585) 922-4047 for advice you how to adjust your dose on the day of the test. 

Wear comfortable clothing appropriate for exercise; i.e. shorts, sweat suit, etc.  The shoes you wear should have a non-slip sole and be very easy to walk in, such as sneakers; (no high heels).  Ladies should not wear dresses or pantyhose.

Procedure

After arrival, an intravenous line will be placed and the first dose of radionuclide will be administered.  The patient then lies down within the camera for approximately twenty minutes of image acquisition.  Next, the patient undergoes either and exercise or pharmacologic stress test.  Then, the patient is asked to go to eat a snack or lunch followed by another image acquisition under the camera.  Please remember to bring money for food.  After computer processing is complete, the cardiologist interprets the scans and a report is sent to the referring physician.

MUGA Scan

This test is used to make precise measurements of cardiac pumping function.  This test is most often used to monitor the effects of chemotherapy that can potentially damage the heart.  

This example of a MUGA scan shows a mildly enlarged left ventricle with normal pumping function.

There is no preparation required for this study.

Procedure

After arrival, the patient receives an intravenous injection of a tin containing reagent.  About twenty minutes later, the patient is injected with a small amount of radioactive material that labels the red blood cells.  The patient then lies within the camera for about 30 minutes of image acquisition.