Nuclear Cardiology: Nuclear Cardiology:

22 Nuclear Cardiology, The BasicsTable 2-1Type of Stress ProceduresPhysical ExerciseTreadmill exerciseBruce protocolModified Bruce protocolNaughton protocolSupine or upright bicycle exerciseCardiopulmonary exercise testingPharmacological StressDipyridamole vasodilation stressAdenosine vasodilation stressDobutamine adrenergic stressTable 2-2Type of Imaging ProtocolsThallium-201 (Tl-201) Perfusion ImagingOne-dayExercise–redistributionPharmacologic stress–redistributionRest (or reinjection)–redistributionTechnetium-99m (Tc-99m) Agents (Sestamibi or Tetrofosmin) PerfusionImagingTwo-dayRest onlyStress (exercise or pharmacologic) onlyOne-day (low dose-high dose)Exercise–restPharmacologic stress–restRest–exerciseRest–pharmacologic stressDual Isotope Perfusion ImagingOne-dayRest Tl-201/stress Tc-99m Agentimaging protocols, as well as the approximate total time required toperform each protocol.From Table 2-3 it should be clear that the one-day imaging protocolswith Tc-99m-labeled agents may be the most difficult protocols to fitinto a daily schedule. However, if the stress study of a one-day protocolis unequivocally normal, a rest study is generally not needed (see below).