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Cardiac Blood Pool Scan:

Cardiac Blood Pool Scan:. BY Amparo Acevedo Arianna Gonzalez Zenia Kuder Albert Arias Carlos Quintero. Objectives:. What is a Cardiac Blood Pool Scan Radiopharmacy Common indications Contraindications Patient preparation Equipment How is done In Vivo – in Vitro

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Cardiac Blood Pool Scan:

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  1. Cardiac Blood Pool Scan: BY Amparo Acevedo Arianna Gonzalez Zenia Kuder Albert Arias Carlos Quintero

  2. Objectives: • What is a Cardiac Blood Pool Scan • Radiopharmacy • Common indications • Contraindications • Patient preparation • Equipment • How is done • In Vivo – in Vitro • Normal and abnormal results

  3. Cardiac Blood Pool Scan: • A cardiac blood pool scan shows how well your heart is pumping blood to the rest of your body. • During this test, a small amount of a radioactive substance called a tracer is injected into a vein. • A gamma camera detects the radioactive material as it flows through the heart and lungs. • The percentage of blood pumped out of the heart with each heartbeat is called the ejection fraction. It provides an estimate of how well the heart is working • The multiple-gated acquisition (MUGA) scan, also called a cardiac blood pool study

  4. Radiopharmacy: • Radionuclide:99mTc t 1/2 6 hr • Radiopharmaceutical: Tagged red blood cells by PYP or stannous chloride kit or 99mTc UltraTag RBC • Adult dose: 20-30 mCi

  5. Common Indications: • Global ventricular systolic function • Regional wall motion • Ventricular volumes (qualitative or quantitative) • Responses of above parameters to exercise or other interventions • Systolic and diastolic indices • Stroke volume ratios

  6. Contraindications: • Patient experiencing a chest pain • Patient with a severe arrhythmia • Patient allergic to the radiopharmaceuticals

  7. Patient Preparation: • Patient must be fasting for 4-8 hours before the study (NPO) • No caffeine • No beta or channel blockers • Must have comfortable clothing and shoes

  8. Equipment: • Camera  large field of view • Collimator  300 slant hole – low energy – low energy high resolution LEHR or LEAP • Computer Set-up  16 frames/sec 20-50 ms/frame matrix 64x64 3 million counts

  9. How is done: • If a Stress Study is indicated, the rest study is performed first. • In a stress study, the patient usually lies on a special bed fitted with a bicycle apparatus. • While an image is being recorded, the patient is asked to cycle for about two minutes, then the resistance of the wheels is increased. After two more minutes of exercise, another image is obtained and the resistance is increased again. • Blood pressure and ECG are monitored during the procedure. After the stress portion is finished, one more resting, or recovery, study is obtained.

  10. In Vivo and In Vitro: • In Vivo • Prepared the cold PYP kit  2-3ml normal saline into PYP vial. Let sit for 5 minutes • Inject patient 1-3ml PYP • wait 20 minutes • Inject patient the TC99m (in opposite arm as PYP) • In Vitro • Withdraw patient blood (2-5ml) into heparinized syringe • Inject blood into RBC reaction vial • In the same vial inject 30mCi of Tc99m • Wait 20-30 minutes • Reinject patient with tagged RBC’s

  11. Normal & Abnormal results: • Normal Results: • Good tag blood • Circulation and heart should present clearly • Septal image show easily definable –separation between the right and left ventricles • EF = left ventricle 50-70% and right ventricle 40-60% • Abnormal Results: • Cine showing one or more walls with abnormal movement – akinesis - dyskinesis or hypokinesis • Low EF less than 35-45% • Regional wall abnormalities indicate CAD

  12. BPGS - Blood Pool Gated SPECT Analysis:

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