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The effect of imaging time, radiopharmaceutical, full fat milk and water on interfering extra-cardiac activity in myocardial perfusion single photon emission computed tomography

Lookup NU author(s): Dr James Lloyd

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Abstract

Background and aim Extra-cardiac activity can interfere with observer interpretation of myocardial perfusion single photon emission computed tomography (SPECT) images. Fatty meals and drinks to reduce interference have been tested; however, a simple study of delayed imaging with Tc-99m-tetrofosmin and Tc-99m-sestamibi has not been specifically addressed. The aim was to quantify the effects of imaging time, radiopharmaceutical and oral administration of full fat milk and water on interfering activity. Methods Myocardial perfusion SPECT images were acquired using either tetrofosmin or sestamibi. Patients were imaged at 0.5, 1 or 2 h post-injection (tetrofosmin, 59; sestamibi, 72). Additional groups of patients were imaged either with or without milk (tetrofosmin, 54; sestamibi, 45) and with milk and water (sestamibi, 30). A myocardial region was drawn on the anterior projection and a thin adjacent extra-cardiac region was generated automatically. The count density ratio was calculated and validated with a trial of five observers. A decreasing ratio correlated significantly with observer rank of increasing interference with SPECT image interpretation (r=0.95, P=0.001). Results The ratio improved significantly as the imaging time increased for both tetrofosmin and sestamibi groups (P<0.05). The groups given milk or milk plus water showed no significant improvement against control groups (Pgreater than or equal to0.2). There was no significant difference between tetrofosmin and sestamibi at any time point (Pgreater than or equal to0.4). Conclusions Image interpretation may be improved by delayed imaging for tetrofosmin and sestamibi. However, in contrast with common practice, the administration of milk or water appears to be of no clinical value compared with delayed imaging, and there is no significant difference between interfering activity from tetrofosmin and sestamibi. (C) 2005 Lippincott Williams Wilkins.


Publication metadata

Author(s): Peace RA, Lloyd JJ

Publication type: Article

Publication status: Published

Journal: Nuclear Medicine Communications

Year: 2005

Volume: 26

Issue: 1

Pages: 17-24

ISSN (print): 0143-3636

ISSN (electronic): 1473-5628

Publisher: Lippincott Williams & Wilkins

URL: http://dx.doi.org/10.1097/00006231-200501000-00004

DOI: 10.1097/00006231-200501000-00004


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