title: Influence of proton-pump inhibitors on stomach wall uptake of 99mTc-tetrofosmin in cadmium-zinc-telluride SPECT myocardial perfusion imaging.
abstract: BACKGROUND
  Proton-pump inhibitors (PPIs) induce potentially interfering stomach wall activity in single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) with technetium-99m ((99m)Tc)-sestamibi. However, no data are available for (99m)Tc-tetrofosmin. We assessed the influence of prolonged (>2 weeks) PPI use on the stomach wall uptake of (99m)Tc-tetrofosmin in patients referred for stress MPI with a cadmium-zinc-telluride-based SPECT camera and its relation with dyspepsia symptoms.
  
  
  RESULTS
  Consecutive patients (n=127) underwent a 1-day adenosine stress-first SPECT-MPI with (99m)Tc-tetrofosmin, of whom 54 (43%) patients had been on PPIs for more than 2 weeks. Stomach wall activity was identified on stress SPECT using computed tomographic attenuation maps and was scored using a four-point grading scale into clinically relevant (scores 2 or 3) or nonrelevant (scores 0 or 1).Patients on PPIs had stomach wall uptake more frequently as compared with patients not using PPIs (22 vs. 7%, P=0.017). Dyspepsia was similar in both groups.
  
  
  CONCLUSIONS
  Prolonged use of PPIs is associated with stomach wall uptake of (99m)Tc-tetrofosmin in stress cadmium-zinc-telluride-SPECT images. Gastric symptoms were not associated with stomach wall uptake.
authors.affiliation: Departments of aNuclear Medicine bCardiology cRadiopharmacy, GE Healthcare, Isala klinieken, Zwolle, The Netherlands.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mouden
authors.forename: Karlijn S
authors.initials: KS
authors.lastname: Rijkee
authors.forename: Nanno
authors.initials: N
authors.lastname: Schreuder
authors.forename: Jorik R
authors.initials: JR
authors.lastname: Timmer
authors.forename: Pieter L
authors.initials: PL
authors.lastname: Jager
mesh_terms: D000368:Aged; D016477:Artifacts; D001692:Biological Transport / Q000187:drug effects; D002104:Cadmium; D004415:Dyspepsia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D009943:Organophosphorus Compounds / Q000378:metabolism*; D015609:Organotechnetium Compounds / Q000378:metabolism*; D054328:Proton Pump Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D013270:Stomach / Q000000981:diagnostic imaging / Q000187:drug effects*; D013312:Stress, Physiological; D013691:Tellurium; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D015032:Zinc
chemical_list: C474490:CdZnTe; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D054328:Proton Pump Inhibitors; D002104:Cadmium; C078700:technetium tc-99m tetrofosmin; D015032:Zinc; D013691:Tellurium