Technetium

Technetium Tc 99m Sestamibi is a cationic Tc 99m complex which has been found to accumulate in viable myocardial tissue in a manner analogous to that of thallous chloride TI-201. Scintigraphic images obtained in humans after the intravenous administration of the drug have been comparable to those obtained with thallous chloride TI-201 in normal and abnormal myocardial tissue.

• Myocardial Imaging: Kit for the preparation of Technetium Tc 99m Sestamibi Injection is a myocardial perfusion agent that is indicated for detecting coronary artery disease by localizing myocardial ischemia (reversible defects) and infarction (non-reversible defects), in evaluating myocardial function and developing information for use in patient management decisions. Technetium Tc 99m Sestamibi evaluation of myocardial ischemia can be accomplished with rest and cardiovascular stress techniques (e.g., exercise or pharmacologic stress in accordance with the pharmacologic stress agents labeling).

• None known. None known ( 4 ).contraindicated

For Myocardial Imaging: The suggested dose range for I.V. administration of Technetium Tc 99m Sestamibi in a single dose to be employed in the average patient (70 kg) is 370 to 1110 MBq (10 to 30 mCi). For Breast Imaging: The recommended dose range for I.V. administration of Technetium Tc 99m Sestamibi is a single dose of 740 to 1110 MBq (20 to 30 mCi). For Myocardial Imaging: The suggested dose range for I.V. administration of Technetium Tc 99m Sestamibi in a single dose to be employed in the average patient (70 kg) is 370 to 1110 MBq (10 to 30 mCi) ( 2 ). For Breast Imaging: The recommended dose range for I.V. administration of Technetium Tc 99m Sestamibi is a single dose of 740 to 1110 MBq (20 to 30 mCi) ( 2 ). 2.1 Image Acquisition Breast Imaging: It is recommended that images are obtained with a table overlay to separate breast tissue from the myocardium and liver, and to exclude potential activity that may be present in the opposite breast. For lateral images, position the patient prone with the isolateral arm comfortably above the head, shoulders flat against the table, head turned to the side and relaxed, with the breast imaged pendent through an overlay cutout. The breast should not be compressed on the overlay. For anterior images, position the patient supine with both arms behind the head. For either lateral or anterior images, shield the chest and abdominal organs, or remove them from the field of view.

Pharmacologic induction of cardiovascular stress may be associated with serious adverse events such as myocardial infarction, arrhythmia, hypotension, bronchoconstriction and cerebrovascular events ( 5.1 ). Technetium Tc 99m Sestamibi has been rarely associated with acute severe allergic and anaphylactic events of angioedema and generalized urticaria. In some patients the allergic symptoms developed on the second injection during Technetium Tc 99m Sestamibi imaging ( 5.1 ). Caution should be exercised and emergency equipment should be available when administering Technetium Tc 99m Sestamibi ( 5.1 ). Before administering Technetium Tc 99m Sestamibi patients should be asked about the possibility of allergic reactions to either drug ( 5.1 ). The contents of the vial are intended only for use in the preparation of Technetium Tc 99m Sestamibi and are not to be administered directly to the patient without first undergoing the preparative procedure ( 5.2 ). 5.1 Warnings In studying patients in whom cardiac disease is known or suspected, care should be taken to assure continuous monitoring and treatment in accordance with safe, accepted clinical procedure. Infrequently, death has occurred 4 to 24 hours after Tc 99m Sestamibi use and is usually associated with exercise stress testing [ see General Precautions ( 5.2 ) ]. Pharmacologic induction of cardiovascular stress may be associated with serious adverse events such as myocardial infarction, arrhythmia, hypotension, bronchoconstriction and cerebrovascular events.

Adverse events were evaluated in 3741 adults who were evaluated in clinical studies. Of these patients, 3068 (77% men, 22% women, and 0.7 % of the patients' genders were not recorded) were in cardiac clinical trials and 673 (100% women) in breast imaging trials. Cases of angina, chest pain, and death have occurred [ see Warning and Precautions ( 5.1 ) ]. Adverse events reported at a rate of 0.5% or greater after receiving Technetium Tc 99m Sestamibi administration are shown in the following table: Table 2. Selected Adverse Events Reported in > 0.5 % of Patients Who Received Technetium Tc 99m Sestamibi in Either Breast or Cardiac Clinical Studies* Body System Breast Studies Cardiac Studies Women n = 673 Women n = 685 Men n = 2361 Total n = 3046 Body as a Whole 21 (3.1 %) 6 (0.9 %) 17 (0.7 %) 23 (0.8 %) Headache 11 (1.6 %) 2 (0.3 %) 4 (0.2 %) 6 (0.2 %) Cardiovascular 9 (1.3 %) 24 (3.5 %) 75 (3.2 %) 99 (3.3 %) Chest Pain/Angina 0 (0 %) 18 (2.6 %) 46 (1.9 %) 64 (2.1 %) ST Segment Changes 0 (0 %) 11 (1.6 %) 29 (1.2 %) 40 (1.3 %) Digestive System 8 (1.2 %) 4 (0.6 %) 9 (0.4 %) 13 (0.4 %) Nausea 4 (0.6 %) 1 (0.1 %) 2 (0.1 %) 3 (0.1 %) Special Senses 132 (19.6 %) 62 (9.1 %) 160 (6.8 %) 222 (7.3 %) Taste Perversion 129 (19.2 %) 60 (8.8 %) 157 (6.6 %) 217 (7.1 %) Parosmia 8 (1.2 %) 6 (0.9 %) 10 (0.4 %) 16 (0.5 %) * Excludes the 22 patients whose gender was not recorded. In the clinical studies for breast imaging, breast pain was reported in 12 (1.7 %) of the patients. In 11 of these patients the pain appears to be associated with biopsy/surgical procedures.

In one study of 46 subjects who received Technetium Tc 99m Sestamibi administration, the radioactivity in both children and adolescents exhibited blood PK profiles similar to those previously reported in adults ( 8.4 ). Lactation: Interruption of breastfeeding after exposure to Technetium Tc 99m Sestamibi is not necessary, however, a lactating woman should be advised to consider restricting close contact with her breast fed infant to a maximum of 5 hours in the 24 hour period after Technetium Tc 99m Sestamibi administration in order to minimize radiation exposure ( 8.2 ) 8.1 Pregnancy Risk Summary Limited available data with Technetium Tc 99m Sestamibi use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Animal reproduction and teratogenicity studies have not been conducted with Technetium Tc 99m Sestamibi. However, all radiopharmaceuticals have the potential to cause fetal harm depending on the fetal stage of development and the magnitude of the radiation dose. If considering Technetium Tc 99m Sestamibi administration to a pregnant woman, inform the patient about the potential for adverse pregancy outcomes based on the radiation dose from Technetium Tc 99m Sestamibi and the gestational timing of exposure.

Metabolism

Pulmonary activity is negligible even immediately after injection. Blood clearance studies indicate that the fast clearing component clears with a t 1/2 of 4.3 minutes at rest, and clears with a t 1/2 of 1.6 minutes under exercise conditions.

The clinical consequences of overdosing with Technetium Tc 99m Sestamibi are not known.

• Nov 23, 1973NDANDA017243Curium
• May 28, 1974NDANDA017538Curium
• Nov 16, 1976NDANDA017771Shine
• Apr 17, 1978NDANDA017858Sun Pharm Inds Inc
• Nov 28, 1978NDANDA018035Jubilant
• Feb 17, 1981NDANDA018107Cardinal Health 414
• Dec 30, 1987BLABLA017881Draximage
• Mar 20, 2020BLABLA210089Cis Bio Intl

1. 1Drug Ineffective40642%
2. 2No Adverse Event14315%
3. 3Radioisotope Scan Abnormal10811%
4. 4Nausea444.5%
5. 5Urticaria343.5%
6. 6Vomiting343.5%
7. 7Dizziness323.3%
8. 8Pruritus323.3%
9. 9Rash303.1%
10. 10Dyspnoea293.0%
11. 11Headache282.9%
12. 12Scan Myocardial Perfusion Abnormal242.5%
13. 13Radiation Overdose222.3%
14. 14Hyperhidrosis212.1%
15. 15Off Label Use202.0%

Recent PubMed references pinned to Technetium as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.

• Image quality and quantification in99mTcmyocardial SPECT-CT with a 3D CZT camera: what to expect from BSREM reconstruction methods?
  Physics in medicine and biology · 2026 · Le Rouzic G, Sacchetti M, Bailly M, et al.
  PMID 42134400DOI 10.1088/1361-6560/ae6e16
• Theranostic (99m)Tc-labeled vancomycin-functionalized cerium oxide nanoparticles: Antibacterial efficacy, in vitro cytotoxicity, and in vivo biodistribution studies.
  Journal of pharmaceutical sciences · 2026 · Abouhashim MM, Ibrahim AB, Swidan MM, et al.
  PMID 42002147DOI 10.1016/j.xphs.2026.104290
• Manufacturing of PSMA-T4 radiopharmaceutical kit for 99mTc labelling as an investigational medicinal product - considerations regarding compliance with GMP.
  European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences · 2026 · Janota B, Radzik M, Sawicka A, et al.
  PMID 41962750DOI 10.1016/j.ejps.2026.107525
• Technetium-99m labelled amine-functionalized polystyrene microplastics: An innovative approach for environmental and biological studies.
  Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine · 2026 · Yoho MD, Fırat YH, Kılçar AY, et al.
  PMID 41855604DOI 10.1016/j.apradiso.2026.112577
• Synthesis and In Vivo and In Vitro Properties of (99m)Tc-Labeled Fibroblast Activation Protein Inhibitors.
  Molecular pharmaceutics · 2026 · Tang S, Yang Z, Nie J, et al.
  PMID 41834401DOI 10.1021/acs.molpharmaceut.5c01874
• Optimizing extremity dosimetry: an investigation of thermoluminescence dosemeter ring orientation when handling radioactive sources.
  Radiation protection dosimetry · 2026 · Grieve S
  PMID 41821448DOI 10.1093/rpd/ncaf155
• Design of a Bifunctional pHLIP-RGD Scaffold for Site-Specific [(99m)Tc] Tc Labeling: Radiochemical Evaluation and Proof-of-Concept Tumor Targeting.
  Molecular imaging and biology · 2026 · Yu M, Chen Y, Yu B, et al.
  PMID 41781804DOI 10.1007/s11307-026-02091-y
• The Use of Glycine-Containing Peptide-Based Chelators for Labeling with (99m)Tc Improves the Imaging Properties of EpCAM-Targeting Designed Ankyrin Repeat Ec1.
  Molecular pharmaceutics · 2026 · Deyev S, Fominykh A, Varvashenya R, et al.
  PMID 41780028DOI 10.1021/acs.molpharmaceut.5c01498

The 10 most recently updated of 220 ClinicalTrials.gov registrations naming Technetium as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.

• Testing the Safety of the Anti-cancer Drug, Sn-117m-DTPA, for Advanced Cancers That Have Spread to Bones
  Not yet recruiting · Phase 1 · Interventional · 24 enrolled · National Cancer Institute (NCI)
  NCT06982222updated 2026-05-13
• Evaluate the Implementation of Using Indocyanine Green for Sentinel Lymph Node Mapping in Breast Cancer Patients
  Recruiting · Interventional · 40 enrolled · Casa di Cura Dott. Pederzoli
  NCT07441733updated 2026-05-11
• Superparamagnetic Iron Oxide for Sentinel Lymph Node Localization in Patients With Cutaneous Melanoma, a Randomized Phase III Multi-center Non- Inferiority Trial: MagMen-II
  Not yet recruiting · Phase 3 · Interventional · 254 enrolled · Vastra Gotaland Region
  NCT07552597updated 2026-04-27
• DCE-MRI and MBI in Assessing Tumor Response to Chemotherapy in Patients With Triple Negative Breast Cancer
  Active not recruiting · Early phase 1 · Interventional · 96 enrolled · M.D. Anderson Cancer Center
  NCT02744053updated 2026-04-21
• Comparative Analysis of Biotinylated, Irradiated and 51-Chromium Radiolabeled Red Blood Cells for Analysis of Recovery and Survival After Autologous Transfusion
  Recruiting · Phase 1 · Interventional · 20 enrolled · Jose Cancelas
  NCT07446647updated 2026-04-16
• Comparative Performance of Molecular Breast Imaging (MBI) to Magnetic Resonance Imaging (MRI) of the Breast in Identifying and Excluding Breast Carcinoma in Women at High Risk for Breast Cancer
  Recruiting · Interventional · 300 enrolled · M.D. Anderson Cancer Center
  NCT05042687updated 2026-04-15
• Indocyanine Green for Detection of Sentinel Lymph Nodes In Comparison to ICG Plus Technetium in the Evaluation of Vulvar Squamous Cell Carcinoma
  Recruiting · Observational · 58 enrolled · Hamilton Health Sciences Corporation
  NCT06039111updated 2026-04-13
• Repurposing Tilmanocept for Cardiac Sarcoidosis
  Recruiting · Phase 2 · Interventional · 15 enrolled · Duke University
  NCT07159074updated 2026-03-27
• SPECT/CT for the Characterization of Renal Masses
  Active not recruiting · Observational · 102 enrolled · Jonsson Comprehensive Cancer Center
  NCT03996850updated 2026-03-13
• EMLA Topical Cream for Treatment of Pain in Patients Receiving Intra-Dermal Technetium 99 Injections for Lymphoscintigraphy for Skin Cancers
  Recruiting · Phase 2 · Interventional · 100 enrolled · Ohio State University Comprehensive Cancer Center
  NCT06223659updated 2026-03-10

Frequently asked questions

How does Technetium work?

Technetium Tc 99m Sestamibi is a cationic Tc 99m complex which has been found to accumulate in viable myocardial tissue in a manner analogous to that of thallous chloride TI-201. Scintigraphic images obtained in humans after the intravenous administration of the drug have been comparable to those obtained with thallous chloride TI-201 in normal and abnormal myocardial tissue.

What is Technetium used for?

According to FDA labeling, Technetium carries indications including: Myocardial Imaging: Kit for the preparation of Technetium Tc 99m Sestamibi Injection is a myocardial perfusion agent that is indicated for detecting coronary artery disease by localizing myocardial ischemia (reversible defects) and infarction (non-reversible defects), in evaluating myocardial function and developing information for use in patient management decisions. Technetium Tc 99m Sestamibi evaluation of myocardial ischemia can be accomplished with rest and cardiovascular stress techniques (e.g., exercise or pharmacologic stress in accordance with the pharmacologic stress agents labeling).. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.

What are the contraindications for Technetium?

Technetium labeling lists contraindications including: None known. None known ( 4 ).. Always consult the full prescribing information and a clinician.