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RE: Thalium Stress Test
This sounds to me as being an unnecessary test given the limited
information. However to comment on the information provided, I'd make the
following observations.
1. Cardiac imaging is now done frequently with technetium
cardiolite. Some physicians prefer Tl-210 but the half-life is longer and
will likely lead to a higher exposure to the patient.
2. Based on the history (and giving the disclaimer that I'm not a
physician), I probably wouldn't be reluctant to not have the test if I were
the patient unless there were other reasons such as history or other events
before or after this one.
3. The dose though is quite low. The cardiolite results in a total
body absorbed dose of ~0.5 rem - though higher than background, not
something I'd worry about.
There are certainly other diagnostic procedures that can be
preformed but rad tracer stress testing is a good procedure. It identifies
areas of muscle that have limited uptake due to poor uptake of the tracer.
This poor uptake can be caused by limited blood flow to the muscle. I would
note that if this test is read as positive, the next likely place your
friend will find himself is in the cath lab and that does result in high
doses.
"These are my opinions and my opinions only!"
Louie Tonry
louie.tonry@se.amedd.army.mil
-----Original Message-----
From: GRAHNK@aol.com [mailto:GRAHNK@aol.com]
Sent: Monday, January 08, 2001 11:23 AM
To: Multiple recipients of list
Subject: Thalium Stress Test
OK,
Here's one for all you medical folks out there. One of my people (40 year
old male) had a 3 week bout with pneumonia last year. This year when
exposed
to cold outside air (0 degrees and below) he has experienced some central
(sternum) chest pain that goes away when he doesn't breathe the cold air.
He
doesn't have any history or family history of cardiac illness.
His family practice physician (not a cardiologist) has ordered a thalium
stress test. He's been asking me and we're both wondering why? It's not
clear what the doc is looking for.
Does this make sense from an ALARA perspective? Is there an alternate
diagnostic procedure that doesn't involve radioactive material? i.e. echo
or
stress echo
If he proceeds with this procedure what might his expected dose be?
Thanks
Kelly Grahn
Illinois Department of Nuclear Safety
West Chicago Field Office
grahnk@aol.com
or
grahn@idns.state.il.us
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