Myocardial perfusion imaging (MPI) is a form of functional cardiac imaging, used for the diagnosis of ischemic heart disease. The underlying principle is, under conditions of stress, diseased myocardium receives less blood flow than normal myocardium. MPI is one of several types of cardiac stress test. As a nuclear stress test, the average radiation exposure is 9.4 mSv, which when compared with a typical 2 view chest X-ray (.1 mSv) is equivalent to 94 Chest X-rays.
Several radiopharmaceuticals and radionuclides may be used for this, each giving different information. In the myocardial perfusion scans using Tc, the radiopharmaceuticals Tc-tetrofosmin (Myoview, GE Healthcare) or Tc-sestamibi (Cardiolite, Bristol-Myers Squibb) are used. Following this, myocardial stress is induced, either by exercise or pharmacologically with adenosine, dobutamine or dipyridamole(Persantine), which increase the heart rate or by regadenoson(Lexiscan), a vasodilator. (Aminophylline can be used to reverse the effects of dipyridamole and regadenoson). Scanning may then be performed with a conventional gamma camera, or with SPECT/CT.