TABLE 3

Sample Protocol for Single-Day Rest–Stress ^99mTc-Labeled Scans with SPECT MPI

Feature	Rest study	Stress study	Technique
Dose	296–444 MBq (8–12 mCi^*)	890–1,330 MBq (24–36 mCi^*)	Standard
Position	Supine	Supine	Standard
	Prone	Prone	Optional
	Upright/semiupright	Upright/semiupright	Optional
Delay time (intervals)
Injection to imaging	30–60 min	15–60 min	Standard
Rest to stress		30 min to 4 h	Standard
Energy window	15%–20% symmetric	Same	Standard
Collimator	Low energy high resolution	Same	Preferred
Orbit	180° (45° RAO to 45° LPO)	Same	Preferred
Orbit type	Circular	Same	Standard
	Noncircular	Same	Standard
Pixel size
64 by 64 matrix	6.4 ± 0.4 mm	Same	Standard
128 by 128 matrix	8–9 mm	Same	Optional
Acquisition type	Step and shoot	Same	Standard
	Continuous	Same	Optional
Number of projections	60–64^†	Same	Standard
Matrix	60 × 64	Same	Standard
Time/projection	25 s	20 s	Standard
ECG gated	Optional	Standard	Preferred
Frames/cycle	8	8	Standard
	16	16	Optional
R-to-R window (for ejection fraction)	100%	100%	Preferred
Attenuation correction	Measured attenuation correction before or after SPECT scan	Measured attenuation correction before or after SPECT scan	Optional

↵* Lower stress and rest doses may be used with new scanners with solid-state detectors and new software reconstruction.
↵† 64 projections are preferable for ²⁰¹Tl.
RAO = right anterior oblique; LPO = left posterior oblique.
Adapted and reproduced with permission from (5).