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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.