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NCI: Nuclear Cardiology: Challenges, Problems and Solutions AO Osman, SMA Siddig Background: Nuclear Medicine Department, National Cancer Institute, University of Gezira, NCI - is considered as a unique center outside the capital of Sudan (Khartoum), and has advanced diagnostic equipment’s to help in diagnosis of malfunction organ, such as thyroid, kidneys function and spreading of cancer cells, heart disease …etc, Myocardial perfusion scintigraphy (MPI), provides anatomical, physiological, and functional information about the heart muscle and its blood flow. Ventricular ejection fraction and wall motion evaluation are now possible with the introduction of technetium myocardial perfusion radiopharmaceuticals and the use of gated single photon emission tomography (SPECT) techniques. Methodolgy: In 2006 SPECT gamma camera has been installed in our center and since that time; there were shy and simple attempts to gain benefits in doing myocardial perfusion scintigraphy of a cardiac patient. However it was failed for the many reasons, (e.g. a lack of knowledge of relevant specialists to the possibility of our section in doing this kind of scan at that time, and the lack of personal training for this type of scan, and the weakness of good relations and coordination among the relevant centers). In 2012, the serious attempts to cardiac imaging began, whereas, they made sure of the existence and a viability of all components and liability such as: gamma camera, ECG, treadmill, infusion pump, and software program of cardiac and so on. Then all these components and gamma camera program were tested and checked by scanning of a volunteer in a rest study, and his images was reviewing and processed and approved in all levels, and also displayed in the final shape for reporting. Rest images of the first patient: There have been several contacts and consultations with Wad Medani heart center for the possibility of helping doing myocardial perfusion imaging for their patients. It was agreed to transfer the patients whom were involved in imaging to our department for the preparation of patients and making necessary arrangements before nuclear imaging. Also it was agreed that a cardiologist is to be attended or alternate to oversee the exercise study. Results: These efforts resulted in imaging four patients till now. Two of them were in of resting studies and two in of exercise studies at first and then at rest in one day protocol, Stress and rest images: Conclusion: Still there are some obstacles need to be solved: No NM specialist resident in our department, only one cardiologist collaborates with our department. Most of the relevant specialists do not know the possibility of the work of this diagnosis in the department. All this resulted in lack of the number of patients who were attended to the center for Cardiac imaging. Also the difficulties of obtaining pharmacological stress agents like Persantine injection which was not authorized in Sudan. We recommend ; distributing more media release to relevant specialists and centers. Also to train and to employ more NM specialists collaborated with more cardiologist, and work on the provision and maintenance of gamma camera.