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Thallous chloride Tl-201 is a radiopharmaceutical used primarily as a diagnostic agent in nuclear medicine. It consists of the radioactive isotope thallium-201 in the form of its chloride salt. The drug is administered intravenously and is most commonly used for myocardial perfusion imaging to diagnose coronary artery disease by identifying areas of reduced blood flow to the heart muscle using planar scintigraphy or single-photon emission computed tomography (SPECT). It can detect both non-reversible defects (myocardial infarction) and reversible defects (myocardial ischemia), especially when combined with exercise or pharmacologic stress testing[2][8]. Thallous chloride Tl-201 is also indicated for localizing sites of parathyroid hyperactivity in patients with elevated serum calcium and parathyroid hormone levels[1][2]. Mechanistically, after intravenous administration, thallium ions mimic potassium and are actively transported into myocardial cells via the Na+/K+ ATPase pump; their distribution reflects regional blood flow and cell viability[6]. Thallium-201 decays by electron capture with a physical half-life of about 73 hours, emitting photons suitable for imaging[3][6].
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