Technetium (Sup99m/Suptc) Sestamibi

What it is and how it works

Technetium-99m sestamibi is a lipophilic cationic complex that diffuses passively into cells and is retained within mitochondria in proportion to regional blood flow and mitochondrial membrane potential. It shows minimal redistribution, so images reflect perfusion at the time of injection. It also accumulates in metabolically active tissues such as hyperfunctioning parathyroid tissue and some tumours.

Indications

Myocardial perfusion scintigraphy at rest and stress for diagnosis of coronary artery disease and assessment of ventricular function; parathyroid imaging in hyperparathyroidism; second-line breast imaging.

Dosage and administration (summary)

Activity and rest/stress protocol are individualised by the nuclear medicine specialist according to local protocols.

Contraindications

Hypersensitivity to sestamibi or kit components; contraindications to the stress agent or exercise testing also apply.

Warnings and precautions

Stress testing should be performed only with resuscitation facilities available. Radiation exposure should be justified and minimised; breast-feeding should be interrupted temporarily. Transient metallic or bitter taste and rare hypersensitivity reactions may occur.

Pregnancy

Use only when clearly necessary, weighing diagnostic benefit against fetal radiation exposure.

Storage and supply

Store the unlabelled kit below 25 °C; the labelled preparation is used within the time stated by the manufacturer, in lead shielding.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.