The Use of Water To Reduce Physiological Infra-Cardiac Tracer Uptake in Stress Myocardial Perfusion Imaging Using Single Photon Emission Computed Tomography: First Experience in Indonesia

Abstract BackgroundCoronary artery disease (CAD) remains an important cause of morbidity and the main global cause of death. Myocardial perfusion imaging (MPI) used in diagnosing and evaluating in myocardial ischemia has been shown to be more cost effective and sensitive than other modalities. Milk is usually used to reduce the physiological uptake by infra-cardiac organs. However, some of our patients were lactose intolerant that can cause diarrhea and abdominal discomfort. The aim of this study was to evaluate the use of water, instead of milk, to reduce the physiological infra-cardiac tracer uptake.MethodsSixty patients were referred to undergo MPI procedure between October 2020 to December 2020. They were divided into 2 groups, first group received 500 mL of milk and the second group received 330 mL of water after MIBI injection. Stress procedure was performed using treadmill with modified Bruce protocol. Image acquisitions were performed 30 minutes after MIBI injection. A semi-quantitative assessment was made by evaluating the myocardial activity and the infra-cardiac tracer uptake. Qualitative assessment was made by determining whether the infra-cardiac tracer uptake interferes the MPI interpretation.ResultsPatients consist of 30 males and 30 females. The age of the patients was between 29 – 80 years old (mean: 53.3). The semi-quantitative and qualitative images were done in both groups. The results showed that, there were no physiological infra-cardiac tracer uptake in both groups, which caused interference.ConclusionsWater is able to reduce physiological infra-cardiac tracer uptake and it can be used in patients with lactose intolerant. Trial registrationNot applicable.