Efficacy of milk versus water to reduce interfering infra-cardiac activity in 99mTc-sestamibi myocardial perfusion scintigraphy.
OBJECTIVE
Interference from infra-cardiac radionuclide activity prevents accurate interpretation of true myocardial perfusion. The study aim was to compare the efficacy of milk versus water in reducing infra-cardiac activity in myocardial perfusion scintigraphy.


METHODS
We prospectively randomized 198 patients undergoing stress-rest (99m)Tc-sestamibi SPECT with exercise or pharmacological stress to drink 300 ml of water or milk prior to imaging. A semi-quantitative grading of the relative intensity of infra-cardiac activity compared to the myocardial activity and a qualitative assessment of the effect on the overall interpretation was performed.


RESULTS
For stress images, there was no infra-cardiac activity in 37.9%, less intense infra-cardiac activity in 40.8%, equal in 11.7% and greater than infra-cardiac activity in 9.7% with milk, compared with 20.0%, 49.5%, 20.0% and 10.5%, respectively, with water (P=0.038). For rest images, there was also less intense infra-cardiac activity with milk compared to water (P=0.014). However, no change in subsequent image interpretation was seen.


CONCLUSIONS
Administration of milk resulted in a significant decrease in the intensity of infra-cardiac activity compared to water. However, this did not translate into an improvement in image interpretation.
Hofman
Michael
M
Department of Nuclear Medicine, Monash Medical Centre, Clayton, Australia.
McKay
John
J
Nandurkar
Dee
D
D000818:Animals; D016477:Artifacts; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008892:Milk; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology; D014867:Water
D004338:Drug Combinations; D014867:Water; D017256:Technetium Tc 99m Sestamibi