Abstract
Objective
In myocardial perfusion single-photon emission computed tomography (SPECT), abdominal activity often interferes with the evaluation of perfusion in the inferior wall, especially after pharmacological stress. In this randomized study, we examined the effect of carbonated water intake versus still water intake on the quality of images obtained during myocardial perfusion images (MPI) studies.
Methods
A total of 467 MIBI studies were randomized into a carbonated water group and a water group. The presence of intestinal activity adjacent to the inferior wall was evaluated by two observers. Furthermore, a semi-quantitative analysis was performed in the adenosine subgroup, using a count ratio of the inferior myocardial wall and adjacent abdominal activity.
Results
The need for repeated SPECT in the adenosine studies was 5.3 % in the carbonated water group versus 19.4 % in the still water group (p = 0.019). The inferior wall-to-abdomen count ratio was significantly higher in the carbonated water group compared to the still water group (2.11 ± 1.00 vs. 1.72 ± 0.73, p < 0.001). The effect of carbonated water during rest and after exercise was not significant.
Conclusions
This randomized study showed that carbonated water significantly reduced the interference of extra-cardiac activity in adenosine SPECT MPI.
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References
Matsumoto N, Sato Y, Suzuki Y, Yoda S, Kunimasa T, Kato M, et al. Usefulness of rapid low-dose/high-dose 1-day 99 mTc-sestamibi ECG-gated myocardial perfusion single-photon emission computed tomography. Circ J. 2006;70:1585–9.
Hofman M, McKay J, Nandurkar D. Efficacy of milk versus water to reduce interfering infra-cardiac activity in 99 mTc-sestamibi myocardial perfusion scintigraphy. Nucl Med Commun. 2006;27:837–42.
Iqbal SM, Khalil ME, Lone BA, Gorski R, Blum S, Heller EN. Simple techniques to reduce bowel activity in cardiac SPECT imaging. Nucl Med Commun. 2004;25:355–9.
Cherng SC, Chen YH, Lee MS, Yang SP, Huang WS, Cheng CY. Acceleration of hepatobiliary excretion by lemon juice on 99 mTc-tetrofosmin cardiac SPECT. Nucl Med Commun. 2006;27:859–64.
Hara M, Monzen H, Futai R, Inagaki K, Shimoyama H, Morikawa M, et al. Reduction of infracardiac intestinal activity by a small amount of carbonated water in technetium-99m tetrofosmin myocardial perfusion scintigraphy with adenosine stress. J Nucl Cardiol. 2008;15:241–5.
Boz A, Karayalcin B. Which is better for inferior wall evaluation: a full or empty stomach? J Nucl Med. 1996;37:1916–7.
Malhotra G, Upadhye TS, Nabar A, Asopa RV, Nayak UN, Rajan MG. Can carbonated lime drink intake prior to myocardial perfusion imaging with Tc-99m MIBI reduce the extracardiac activity that degrades the image quality and leads to fallacies in interpretation? Clin Nucl Med. 2010;35:160–4.
Edlund A, Sollevi A, Linde B. Haemodynamic and metabolic effects of infused adenosine in man. Clin Sci (Lond). 1990;79:131–8.
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The authors declare that they have no conflict of interest.
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Vermeltfoort, I.A.C., van Dijk, A.B., de Jong, J.A.F. et al. A randomized study of the effect of carbonated water prior to myocardial SPECT. Ann Nucl Med 28, 669–673 (2014). https://doi.org/10.1007/s12149-014-0863-4
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DOI: https://doi.org/10.1007/s12149-014-0863-4