Hospital Report
My visit was done to the cardiac Centre in a department called the “Nuclear Cardiology Department”. There are a maximum of three staff members in this department and who are concerned with the examination as well as a nurse.
The Protocol Used in the Hospital
The indications of images are as follows: Detection of coronary artery disease, the classification of left ventricular myocardium as normal, irreversibly ischemic, and reversibly ischemic. This also entails detection of the myocardial perfusion abnormalities which are secondary to causes other than coronary artery disease.
The examinations which are undertaken with regard to rest test and stress scans are completed within the same day. The total time allocated for rest acquisition is:
- One to one and a half hours for treadmill stress study.
- One to one and half hours for persantine stress study and
- Ten minutes for stress prone acquisition.
The study requires that the patient have to discontinue all medicines which affect myocardial perfusion. This will enable the success of the study. The discontinuation of all medicines is characterized with limited long acting Beta blockers for at least 48 hours, propranolol for at least 24 hours, and long acting nitrates for at least 4 hours and finally, an hour prohibition of the Nitro-glycerine.
For the patients who are non-diabetic, water is acceptable for consumption and they are as well prohibited from eating and drinking from midnight prior to the study. On the other hand, patients suffering from diabetic are allowed to eat a light meal very early in the morning and take their medicine.
Before the stress acquisition exercise is performed, the patients are required to undergo a tolerant test exercise. It is very vital that the patient accomplishes the maximum amount of exercise that he can safely perform.
The height and weight of the patient should be recorded and in the case of female, the size of the breast should be noted. Recording of this information in each of the cases enables in identifying attenuation artefacts in the tomography images.
It is fundamental that the outlined procedures be indicated to the patients so that they are well aware of what is taking place. In my view, the radiopharmaceutical is Technetium Sestamibi/Cardiolite or Tetrofosmin.
The dose required for rest is 250 MBq while the stress dose is 750 MBq while intravenous is the technique of administration.
The image processing;
The imaging processing is performed in two ways, analysis as well as display. After the patients name have been chosen, the row data is then started. One is then required to choose an area of interest for instance the heart and it is important that a part of the heart is not chopped or cut off. After the orientation is done, the short and long axis are chosen to convert them to display the parts with different views
It has done in two parts, analysis and display. They chose the patient name then they start with row data. Chose the area of interest ‘heart’ and make sure we didn’t cut part from the heart. after that the reorientation they chose the axis short and long to convert them to display part with 3 views, short axis, horizontal axis and vertical axis.
They can calculate the ‘EF’ ejection fraction which calculated by using Cardiac packages QPS AND QGS.
QGS: quantitative gated SPECT provide cardiac function quantitation using perfusion datasets:ED and ES volumes, ejection fraction. The image data can be viewed in a variety of modes, from selected slices in 2D view to a rendered 3D surface of the myocardium with function maps (perfusion, motion, thickening and regional EF).
QPS: quantitative perfusion SPECT is an interactive atand-alone application for the automatic segmentation, quantification, analysis and display of static (ungated) short axis myocardial perfusion SPECT images. QPS provides automatic computation of functional metrics including LV chamber volume and mid-myocardial surface area and generation of stress, rest and reversibility surfaces and Polar Maps. These Polar maps are displayed in parametric fashion, the pattern of LV myocardial perfusion.
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