title: Impact of metoclopramide on image quality in myocardial perfusion imaging.
abstract: BACKGROUND
  The effectiveness of metoclopramide in reducing gastrointestinal-induced artifacts in myocardial perfusion imaging (MPI) is a subject of debate. We examined the significance of this pharmacological intervention in the quality of images obtained from MPI studies.
  
  
  METHODS
  A total of 211 suspected or known cases with coronary artery disease routinely referred to our nuclear medicine department for MPI were randomly assigned to group A and group B. Group A (N=125) comprised patients who received 10 mg of metoclopramide orally after the injection of the radiotracer [technetium-99m-labeled methoxyisobutyl isonitril (99mTc-MIBI)] 1 h before image acquisition, and group B (N=86) comprised patients who did not receive any pharmacological intervention and were considered the control group. All the scans in each group were assessed in the rest phase of a routine 2-day protocol. The single-photon emission computerized tomography (SPECT) images were visually evaluated in terms of extracardiac activities and their effects on image quality by three nuclear medicine physicians, who were blinded to the details of the protocol.
  
  
  RESULTS
  Of the 125 patients who had received metoclopramide, 16 (13%) had nonacceptable, 72 (57.6%) had acceptable (interpretable), and 37 (29.6%) had good image quality. The image quality in group B was nonacceptable in 10 (11.23%), acceptable in 48 (50.23%), and good in 28 (33.56%) patients. The overall interobserver agreement was good (κ: 0.6-0.9, P<0.05) among the three readers.
  
  
  CONCLUSIONS
  There was no statistically significant difference in terms of MPI-SPECT image quality between patients who received metoclopramide and those in the control group. Metoclopramide, therefore, did not exert a remarkable effect on the quality of our MPI scans.
authors: Department of Nuclear Medicine, Shaheed Rajaie Cardiovascular, Medical and Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Nahid
authors: N
authors: Yaghoobi
authors: Alireza
authors: A
authors: Mardanshahi
authors: Fereydoon
authors: F
authors: Rastgou
authors: Hadi
authors: H
authors: Malek
authors: Seyed-Hassan
authors: SH
authors: Firouzabady
authors: Ahmad Bitarafan
authors: AB
authors: Rajabi
authors: Hedieh
authors: H
authors: Amouzadeh
authors: Samaneh
authors: S
authors: Vaseghi
mesh_terms: D016477:Artifacts; D005260:Female; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000494:pharmacology*; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011786:Quality Control
chemical_list: D008787:Metoclopramide