Mechanisms of Thallium-201 Myocardial Accumulation

  • Frans J. Th. Wackers
  • Gerard Samson
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 9)


Thallium is a metallic element of group IIIA of the periodic table with biological similarities to potassium. Thallium was first used successfully for external imaging of the human heart by Kawana et al. [1]. In 1970 these investigators reported on the use of a mixture of short-lived thallium isotopes, mainly 199T1, for myocardial imaging. Lebowitz et al. [2] reported in 1975 the production of 201T1 and suggested that this might be a more favorable isotope for clinical imaging with the Anger scintillation camera. Scintiscans obtained in the goat, indicated that the relative myocardial concentration was sufficient to allow external imaging [3]. In the same year we reported the feasibility of myocardial imaging in patients with and without acute myocardial infarction [4].


Myocardial Blood Flow Washout Rate Myocardial Uptake Myocardial Imaging Regional Myocardial Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Kawana M, Krizek H, Porter J, Lathrop KA, Charleston D, Harper PV: Use of 199T1 as a potassium analog in scanning. J Nucl Med 11:333, 1970 (abstract).Google Scholar
  2. 2.
    Lebowitz E, Greene MW, Fairchild R, Bradley-Moore PR, Atkins HL, Ansari AN, Richards P, Belgrave E: Thallium-201 for medical use. I. J Nucl Med 16:151–155, 1975.Google Scholar
  3. 3.
    Bradley-Moore PR, Lebowitz E, Greene MW, Atkins HL, Ansari AN: Thallium-201 for medical use. II: Biologic behavior. J Nucl Med 16:156–160, 1975.PubMedGoogle Scholar
  4. 4.
    Wackers FJTh, van der Schoot JB, Busemann Sokole E, Samson G, van Niftrik GJC, Lie KI, Durrer D, Wellens HJJ: Noninvasive visualization of acute myocardial infarction in man with thallium-201. British Heart J 37:741–744, 1975.CrossRefGoogle Scholar
  5. 5.
    Negherbon WO: Handbook of toxicology, Vol III, p 750. Philadelphia: W.B. Saunders 1959.Google Scholar
  6. 6.
    Samson G, Wackers FJTh, Becker AE, Busemann Sokole E, van der Schoot JB: Distribution of thallium-201 in man. Verhandlungsbericht der 14. Internationalen Jahrtagung der Gesellschaft für Nuclear Medizin, Berlin: Band I, 15–18 Sept., 1976.Google Scholar
  7. 7.
    Hamilton GW, Narahara KA, Yee H, Ritchie JL, Williams DL, Gould KL: Myocardial imaging with thallium-201: effect of cardiac drugs on myocardial images and absolute tissue distribution. J Nucl Med 19:10–16, 1978.PubMedGoogle Scholar
  8. 8.
    Lie R, Thomas RG, Scott JK: The distribution and excretion of T1-204 in the rat with suggested MPC’s and a bio-assay procedure. Health Phys 2:334, 1960.PubMedCrossRefGoogle Scholar
  9. 9.
    Snyder WS, Ford MR, Warner GG, Watson SB: “S” absorbed dose per unit cumulated activity for selected radionuclides and organs. NM/MIRD pamphlet #11. New York: Society of Nuclear Medicine, 1975.Google Scholar
  10. 10.
    Ritchie JL, Hamilton GW: Biologic properties of thallium. In: Thallium-201 myocardial imaging, pp 9–28, Ritchie JL, Hamilton GW, Wackers FJTh, eds. New York: Raven Press, 1978.Google Scholar
  11. 11.
    Atkins HL, Budinger TF, Lebowitz E, Ansari AN, Greene MW, Fairchild RG, Ellis KJ: Thallium-201 for medical use. III: Human distribution and physical imaging properties. J Nucl Med 18:133–140, 1977.PubMedGoogle Scholar
  12. 12.
    Boucher CA, Zir LM, Beer GA, et al.: Increased lung uptake of thallium-201 during exercise myocardial imaging: clinical, hemodynamic and angiographic implications in patients with coronary artery disease. Am J Cardiol 46:189, 1980.PubMedCrossRefGoogle Scholar
  13. 13.
    Mullins LJ, Moore RD: The movement of thallium ions in muscle. J. Gen Phys 43:759–773, 1960.CrossRefGoogle Scholar
  14. 14.
    Gehring PJ, Hammond PB: The interrelationship between thallium and potassium in animals. J Pharmacol Exp Ther155:187–201, 1967.PubMedGoogle Scholar
  15. 15.
    Britten JS, Blank M: Thallium activation of the (Na+-K+ )-activated ATPase of rabbit kidney. Biochim Biophys Acta159:160–166, 1968.PubMedGoogle Scholar
  16. 16.
    Gelbart A, Doherty PW, McLaughlin PR, Harrison DC: Na+, K+-ATPase and coronary blood flow as determinants of thallium-201 uptake by ischemic myocardium. Circulation 54,suppl II, 11:70, 1976.Google Scholar
  17. 17.
    Adolph R, Romhilt, D, Hishiyama H, Sodd V, Blue J, Gabel M: Use of positive and negative imaging agents to visualize myocardial ischemia. Circulation 54,suppl II, 11:220, 1976.Google Scholar
  18. 18.
    Strauss HW, Harrison K, Langan JK, Lebowitz E, Pitt B: Thallium-201 for myocardial imaging: relation of thallium-201 to regional myocardial perfusion. Circulation 51:641–645, 1975.PubMedGoogle Scholar
  19. 19.
    Mueller TM, Marcus ML, Ehrhardt JC, Chaudhuri T, Abboud FM: Limitations of thallium-201 myocardial perfusion scintigrams. Circulation 54:640–646, 1976.PubMedGoogle Scholar
  20. 20.
    DiCola VC, Downing SE, Donabedian RK, Zaret BL: Pathophysiological correlates of thallium-201 myocardial uptake in experimental infarction. Cardiol Res XI: 141–146, 1977.Google Scholar
  21. 21.
    Weich HF, Strauss HW, Pitt B: The extraction of thallium-201 by the myocardium. Circulation 56:188–191, 1977.PubMedGoogle Scholar
  22. 22.
    L’Abbate A, Biagini A, Michelassi C, Maseri A: Myocardial kinetics of thallium and potassium in man. Circulation 60:776–785, 1979.Google Scholar
  23. 23.
    Nishiyama H, Sodd VJ, Adolph RJ, Saenger EL, Lewis JT, Gabel M: Intercomparison of myocardial imaging agents: 201T1, 129Cs, 43K, and 81Rb. J Nucl Med 17:880–889, 1976.PubMedGoogle Scholar
  24. 24.
    Sapirstein LA: Regional blood flow by fractional distribution of indicators. Am. J. Physiol193:161–168, 1958.PubMedGoogle Scholar
  25. 25.
    Strauss HW, Harrison K, Pitt B: Thallium-201: non-invasive determination of the regional distribution of cardiac output. J Nucl Med 18:1167–1170, 1977.PubMedGoogle Scholar
  26. 26.
    Ritchie JL, Zaret BL, Strauss HW, Pitt B, Berman DS, Schelbert HR, Ashburn WL, Berger HJ, Hamilton GW: Myocardial imaging with thallium-201: a multicenter study in patients with angina pectoris or acute myocardial infarction. Am J Cardiol 42:345–350, 1978.PubMedCrossRefGoogle Scholar
  27. 27.
    Patterson R, Halgash D, Micelli K, Miao J, Rogers J, Eng Horowitz S, Goldsmith S: “Steady state” problems in myocardial perfusion imaging to detect transient ischemia: critical role of the duration of the ischemic state after thallium-201 injection. Am J Cardiol 43:357, 1979.Google Scholar
  28. 28.
    Wharton TP, Neill WA, Oxendine JM, Painter LN: Duration of regional ischemia and degree of reactiva hyperemia following ischemia affect magnitude of initial thallium-201 defect. Circulation 60:suppl II, 11:173, 1979.Google Scholar
  29. 29.
    Pohost GM, Zir LM, Moore RH, McKusick KA, Guiney TE, Beller GA: Differentiation of transiently ischemic from infarcted myocardium by serial imaging after a single dose of thallium-201. Circulation 55:294–302, 1077.Google Scholar
  30. 30.
    Gewirtz H, O’Keefe DD, Pohost GM, Strauss HW, Mcllduff JB, Daggett WH: The effect of ischemia on thallium-201 clearance from the myocardium. Circulation 58:215–219, 1978.PubMedGoogle Scholar
  31. 31.
    Pohost GM, O’Keefe DD, Gewirtz H, Strauss HW, Beller GA, Newell JB, Chaffin JS, Daggett WM: Thallium redistribution in the presence of severe fixed coronary stenosis. J Nucl Med 19:680, 1978.Google Scholar
  32. 32.
    Berger Watson DD, Sipes JN, Pohost GM, Teates CD, Beller GA: Redistribution of thallium at rest in patients with coronary artery disease. J Nucl Med 19:680, 1978.Google Scholar
  33. 33.
    Watson DD, Beller GA, Berger The mechanism of thallium-201 redistribution. Am J. Cardiol 43:357, 1979.Google Scholar
  34. 34.
    Watson DD, Beller GA, Irving JF, Teates CD: A kinetic model for thallium myocardial redistribution. J Nucl Med 19:680, 1978.Google Scholar
  35. 35.
    Beller GA. Pohost GM: Time course and mechanism of resolution of thallium-201 defects after transient myocardial ischemia. Am J Cardiol 41:379, 1978.CrossRefGoogle Scholar
  36. 36.
    Beller GA, Watson DD, Pohost GM: Kinetics of thallium distribution and redistribution: clinical applications in sequential myocardial imaging. In: Cardiovascular nuclear medicine, 2nd edition, pp 225–242, Strauss HW, Pitt B, eds. St. Louis: Mosby, 1970.Google Scholar
  37. 37.
    Pohost GM, Alpert NM, Ingwall JS, Strauss HW: Thallium redistribution: mechanisms and clinical utility. Semin Nucl Med 10:70, 1980.PubMedCrossRefGoogle Scholar
  38. 38.
    Okada RD, Jacobs ML. Newell JB, Strauss HW, Daggett WM, O’Keefe DD, Pohost GM: Thallium-201 kinetics in nonischemic canine myocardium. Circulation 60suppl II, II–172, 1979.Google Scholar
  39. 39.
    Grunwald AM, Holzgrefe HH, Teates CD, Watson DD, Beller GA: Altered thallium-201 transport in ischemie myocardium. Circulation 60,suppl II, 11:172, 1979.Google Scholar
  40. 40.
    Schelbert H, Schuler G, Ashburn W, Covell J: Time course of redistribution of Tl-201 after transient ischemia. J Nucl Med 18:598, 1977.Google Scholar
  41. 41.
    Costin JC, Zaret BL: Effect of propanolol and digitalis upon radioactive thallium and potassium uptake in myocardial and skeletal muscle. J. Nucl Med 17:535, 1976.Google Scholar
  42. 42.
    Schelbert H, Inwall J, Watson R, Askburn W: Factors influencing the myocardial uptake of thallium-201, J Nucl Med 18:598, 1977.Google Scholar
  43. 43.
    Zimmer L, McCall D, D’Addabbo L, Whitney K: Kinetics and characteristics of thallium Exchange in cultured cells. Circulation 60,suppl II, 11:138, 1979.Google Scholar
  44. 44.
    Krivokapich J. Shine KI: The effects of hyperkalemia and glycoside on 201thallium exchange in rabbit myocardium. Circulation 60,suppl II, 11:173, 1979.Google Scholar
  45. 45.
    Gould KL, Westcott RJ, Albro PC, Hamilton GW: Noninvasive assessment of coronary stenoses by myocardial imaging during pharmacologie coronary vasodilatation. Am J. Cardiol 41:279–287, 1978.PubMedCrossRefGoogle Scholar
  46. 46.
    Huising WB, DeJong RBJ: Calculation of radiation dose in humans from i.v. injected thallous chloride (Tl-201) based on human distribution data. Internal report Philips-Duphar, BV, Petten, The Netherlands, 1978.Google Scholar
  47. 47.
    New England Nuclear. Package Insert: Catalog #NRP-427, 1978.Google Scholar
  48. 48.
    Feller PA, Sodd VJ: Dosimetry of four heart-imaging radionuclides: 43K, 81Rb, 129Cs, and 201T1. J Nucl Med 16:1070–1075, 1975.PubMedGoogle Scholar
  49. 49.
    Wackers FJTh, Busemann Sokole E, Samson G, van der Schoot JB: Atlas of 201T1 myocar-dial scintigraphy. Clin Nucl Med, 2:64–74, 1977.Google Scholar

Copyright information

© Martinus Nijhoff Publishers bv. The Hague 1980

Authors and Affiliations

  • Frans J. Th. Wackers
  • Gerard Samson

There are no affiliations available

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