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Q: Stress MIBI Test - reaction to radioactive tracer solution ( Answered 5 out of 5 stars,   1 Comment )
Subject: Stress MIBI Test - reaction to radioactive tracer solution
Category: Health > Men's Health
Asked by: sestamibi-ga
List Price: $7.50
Posted: 23 Jul 2005 15:10 PDT
Expires: 22 Aug 2005 15:10 PDT
Question ID: 547034
I am scheduled for a MIBI Test (SestaMIBI) this coming week and am
concerned about reacting to the small quantity of radioactive tracer
solution that will be introduced. I have a history of reacting badly
to contrast dye solutions when having MRI's,Angiograms etc. Do I have
cause for concern and if so what are the statistics of people reacting
to this solution?
Subject: Re: Stress MIBI Test - reaction to radioactive tracer solution
Answered By: crabcakes-ga on 23 Jul 2005 20:37 PDT
Rated:5 out of 5 stars
Hello Sestamibi,

   As with all medical procedures, there is a risk you may have a
reaction to the SestaMIBI contrast medium. My research indicates
however, that reactions are not frequent, and that SestaMIBI has a
good safety record.

According to this study, the benefits far outweigh the small risk of
allergies or reactions to the contrast media.
?A multicenter study (10) with this protocol in the emergency room
revealed that myocardial perfusion nuclear imaging reduced the rate of
myocardial infarction from 1.8% to 0.1% in patients discharged with
chest pain. Compared with the era before the protocol was started,
there were fewer hospital admissions and fewer cardiac
catheterizations performed in patients without obstructive coronary
artery disease.?

MRIs and CT scans do not use radioactive dyes, but a non-radioactive
contrast media, usually gadolinium. (Gadolinium has no iodine, so it
causes few allergies.) While SestaMIBI, used for stress testing,
thyroid scans and mammograms,  is radioactive, it appears that
reactions to SestaMIBI are few:

Side effects of SestaMIBI:
?nausea, erythema, flushing, diffuse rash, pruritus, seizures,
headache, metallic taste, tingling.?

Reactions to angiograms:

?To have a computed tomography scan (CT scan) done, you may need to
have an injection of "contrast" or "dye." This liquid is visible on
X-ray pictures or CT scans, so once it is injected it will cause your
blood vessels to be visible to the radiologists. This makes your
anatomy very clear. "Contrast" also can highlight areas with
inflammation because blood flows more generously to inflamed areas.
The reason that contrast dye is visible on X-rays is because it
contains highly concentrated iodine.?

?Some reactions to contrast dye are allergic, but the trigger for the
allergy has not been precisely identified. Doctors have noticed that
older dye preparations that have a high concentration of iodine are
more likely to trigger a reaction. Contrast dye has been adjusted in a
variety of ways in order to make it less likely to cause a reaction.
Iodine has not been removed from contrast dye, but the dye is now
prepared so that the iodine is chemically "hidden" from your immune
system. Your immune system does not detect the iodine easily since
each iodine particle is packaged inside a complex salt. The newer dye
is called "non-ionic" or "low-osmolar" contrast.?

According to this site, you can ask your doctor to use one of the
newer dyes, which while are more expensive, are far less allergenic.
You may also be prescribed an antihistamine of cortisone before the
procedure to lessen the chance of an allergic reaction.

These were the few side effects reported in a large European study of SestaMIBI:
Four people reported the following side effects :
?Swelling and pain in left arm above injection site, with pain in back
of neck and left side of head
Rash all over body, with red itchy lumps
Metallic taste?

Click the link below, and then look for ?European system for reporting
adverse reactions to and defects in?? Page two of the following

?Of the 933 patients, 520 (55.7%) demonstrated no adverse reaction to
intravenous dypridamole; 413 patients (44.3%) had adverse reactions of
some type. Many of these patients had multiple types of reactions, and
a total of 604 reactions were recorded. The most prevalent adverse
reaction was headache (224 reactions; 37.1%), followed by chest pain
(73 reactions; 12.1%), and nausea (67 reactions; 11.1%). A sex
comparison revealed 271 of 454 male patients (59.7%) and 249 of 479
female patients (52%) demonstrated no adverse reaction to intravenous
dypridamole. An evaluation of the most prevalent adverse reaction
(headache) demonstrated a significant difference between males (37.9%)
and females (62.1%).
An adverse reaction scale characterizing common noncardiac side
effects of dipyridamole in nuclear medicine cardiac patients
demonstrated the most prevalent adverse reaction was headache.
Analysis by sex revealed that significantly more females than males
complained of headaches.?

Have you mentioned your reaction to your doctor? If not, be sure you
advise her/him and radiology of past reactions. However, according to
the following site: (I know you are having a stress test and not a
thyroid procedure)
?Remember, a Sestamibi scan is a VERY safe procedure. There is NO
cross-reactivity for other types of x-ray dye, so parathyroid patients
with allergies to x-ray dye can have a Sestamibi scan. Also note that
the Sestamibi drug used to show the over-active parathyroid gland is
the exact same drug that is used to perform cardiac stress tests--it
is very safe! ALSO, the type of radioactivity used is the most mild
radioactive agent used in all of medicine. You are in no danger and
your family can stay with you--it is not dangerous to them either (or
your doctor!).?

?The biggest problem with Sestamibi scanning is the variability in
scans from hospital to hospital. Sestamibi scans are not like any
other type of x-ray test. It doesn't actually use x-rays, so the
pictures are extremely dependent upon the skill of the technician. CAT
scans, MRIs, and regular x-rays all are very similar throughout the
world. It is easy to do these x-rays because of the technology used.
All these x-rays are done the same way everywhere and they are all
very excellent quality. Because most hospitals and radiology
departments see only a few parathyroid patients per year, they do not
get many opportunities to perform a sestamibi scan. IMPORTANT!! There
is a very high correlation between hospitals that do a lot of
Sestamibi scanning (more than 100 per year) and their accuracy. Like
other aspects of treating parathyroid disease, the experience of the
doctors involved makes all the difference!?

?Technetium 99m-2-methoxyisobutil-isonitrile (Tc-99m-MIBI), also
called sestaMIBI, has been used successfully to detect malignant
tumours at diagnosis. Recently, it has been proposed as a safe and
effective tracer in patients with multiple myeloma (MM).?

?There are usually no special precautions to observe for
radiopharmaceuticals when they are used in small amounts for
Some radiopharmaceuticals may accumulate in your bladder. Therefore,
to increase the flow of urine and lessen the amount of radiation to
your bladder, your doctor may instruct you to drink plenty of liquids
and urinate often after certain tests.?

SestaMIBI does not contain iodine, which may be what you were allergic
to. This medium does contain albumin, so be sure to mention this to
your doctor.

?It is often surprising to people that the radioactivity from a
particular procedure does not immediately disappear from their body.
You probably had a scan with a radionuclide known as 99mTc
(technetium-99m) which has a physical half-life of six hours. This
means that every six hours, one-half of the radioactive material is no
longer present. Radioactivity is also eliminated as the compound onto
which the radionuclide was tagged is eliminated from the body.
Typically, this elimination is via urine.
Obviously, the radioactive emissions had to be detected outside the
body or there would be no ability to perform the scan. However,
detectability does not mean hazardous. There simply is enough
radiation still left in the body to be detected by a very sensitive
radiation detector.?

Hope this helps you out! If any part of my answer is unclear, please
request an Answer Clarification, before rating.

I wish you the best with your procedure!

Sincerely, Crabcakes

Search Terms
SestaMIBI media
SestaMIBI + adverse reactions
MRI contrast medium
sestamibi-ga rated this answer:5 out of 5 stars and gave an additional tip of: $2.50

Subject: Re: Stress MIBI Test - reaction to radioactive tracer solution
From: crabcakes-ga on 24 Jul 2005 07:21 PDT
Thank you, Sestamibi, for the 5 stars and tip! Good luck!
Regards, Crabcakes

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