Failure of perchlorate to inhibit Tc-99m isonitrile binding by the thyroid during myocardial perfusion studies

A. C. Civelek, K. Durski, I. Shafique, K. Matsumura, S. Sostre, H. N. Wagner, P. W. Ladenson

Research output: Contribution to journalArticlepeer-review

Abstract

The thyroid gland receives an average radiation dose of 3 rads during two Tc-99m isonitrile (MIBI) myocardial perfusion studies, if 20 mCi is administered both at rest and at peak exercise. In patients with coronary artery disease, multiple myocardial perfusion studies may be required, resulting in a high level of thyroid radiation. We attempted to reduce this radiation exposure by blocking thyroidal Tc-99m MIBI uptake with oral potassium perchlorate (KCIO4). Fourteen normal subjects received 0.6g to 0.8g KCIO4 20-25 minutes before tracer injection. Subjects who received KCIO4 at rest (n = 11) did not receive KCIO4 at their stress study, and vice versa (n = 3). Thyroid uptake values were obtained with a thyroid probe 20 minutes after injection for both rest and stress studies and were corrected for saturation effects. There was no difference between fractional thyroid uptake values with and without preceding perchlorate administration: 1.9 ± 0.5% and 1.8 ± 0.3% (mean ± SD), respectively. Failure to block Tc-99m MIBI uptake after intravenous (IV) injection is probably due to high thyroidal blood flow and nonspecific tracer accumulation. The concentration of this radioisotope in adjacent muscles also contributes to the high thyroid radiation dose. In summary, administration of KCIO4 before Tc-99m MIBI studies does not reduce the thyroidal radiation dose or uptake of this tracer, suggesting that thyroidal uptake of this tracer is not mediated by the iodine trapping mechanism.

Original languageEnglish (US)
Pages (from-to)358-361
Number of pages4
JournalClinical nuclear medicine
Volume16
Issue number5
DOIs
StatePublished - Jan 1 1991

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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