Nuclear Cardiology: Nuclear Cardiology:

28 Nuclear Cardiology, The BasicsThe details of a daily schedule of procedures and tests differ fromlaboratory to laboratory, owing to the radiopharmaceuticals and protocolsused, and to the availability of physicians to monitor stress tests.For example, if physicians have office hours in the morning, it maybe practical and convenient to perform rest imaging, as shown below, inthe morning and stress testing in the afternoon.Example of one-day imaging schedule (rest studies first in the morning)8:00 AM Inject Rest pt. 1 8:45 AM Image (rest) pt.18:30 AM Inject Rest pt. 2 9:15 AM Image (rest) pt.29:00 AM Inject Rest pt. 3 9:45 AM Image (rest) pt.39:30 AM Inject Rest pt. 4 10:15 AM Image (rest) pt.410:00 AM Inject Rest pt. 5 10:45 AM Image (rest) pt.510:30 AM Inject Rest pt. 6 11:15 AM Image (rest) pt.6Lunch11:15 PM Stress pt. 1 12:15 PM Image (stress) pt.112:00 PM Stress pt. 2 1:00 PM Image (stress) pt.212:45 PM Stress pt. 3 1:45 PM Image (stress) pt.31:30 PM Stress pt. 4 2:30 PM Image (stress) pt.42:15 PM Stress pt. 5 3:15 PM Image (stress) pt.53:00 PM Stress pt. 6 4:00 PM Image (stress) pt.6EQUILIBRIUM RADIONUCLIDEANGIOCARDIOGRAPHY (ERNA)Although radionuclide myocardial perfusion imaging is the most frequentlyperformed imaging modality, in many laboratories equilibriumradionuclide angiocardiographies (ERNAs) are performed to assess leftventricular function in a variety of clinical circumstances. In our laboratoryERNAs are frequently requested for 1) oncology patients beforeand during the course of therapy with potentially cardiotoxic drugs, 2)for evaluation of patients with cardiomyopathy or recent infarction, and3) to follow the effect of therapy in patients with abnormal left ventricularfunction.Time RequirementsTables 2-4 and 2-5 show the time slots required for rest and rest–exercise ERNA protocols, as well as the approximate total time requiredto perform the protocols. It is assumed that in vitro kits are used forlabeling of the patient’s red blood cells. (Refer to Chapters 8 and 9 forcomplete discussion of ERNA imaging procedures.)