The Appropriate Acquisition Time Interval Following Injection of 99mTc-Sestam ibi with Water Protocol in Single Photon Emission Computed Tomography Myocardial Perfusion Imaging: First Experience in Indonesia

Nora Anggun Prasetyo, Erwin Affandi Soeriadi, Hendra Budiawan, Achmad Hussein Sundawa Kartamihardja

Abstract


Introduction: According to EANM/ESC guideline, image acquisitions in stress test should be begun at 30-60 minutes after tracer administration. Our center is a referral hospital for nuclear medicine imaging with many patients but limited number of gamma camera. The shorter time between injection of radiopharmaceutical and imaging acquisition will add to the number of examinations that can be performed. The aim of this study was to evaluate the appropriate acquisition time interval with water protocol in 99mTc-Sestamibi SPECT myocardial perfusion imaging.

Methods: Patients who were referred to undergo stress MPI between October 2020 to December 2020 were included in this study. Cardiac stress procedure was performed using treadmill with modified Bruce Protocol. Subjects drank a total of 330 mL water following 99mTc-Sestamibi injection. Image acquisitions were performed 10 and 30 minutes afterwards. Quantitative assessment was done by calculating target background ratio (TBR). Statistical analysis was performed using student t-test with Microsoft Excel version 2019. P-value < 0.05 was considered to be statistically significant.

Result: Thirty out of 35 subjects were included in this study. Sixteen of them are male and 14 are female with a mean age of 48.7 years old (28 – 80). Mean target background uptake ratio (TBR) in 10- and 30-minutes images were 0.67 (0.44 – 1.11) and 0.76 (0.43 – 1.18) respectively (p-value = 0.15).

Conclusion: There was no significant difference of target to background ratio between 10- and 30-minutes acquisition time interval following injection of 99mTc- Sestamibi with water protocol in myocardial perfusion imaging.


Keywords


Acquisition time; SPECT; Stress Myocardial Perfusion Imaging procedure; Water protocol



DOI: http://dx.doi.org/10.19166/med.v10i2.7016

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References


1. Organization WH. The top 10 causes of death 2021.

2. Hesse B, Tagil K, Cuocolo A, Anagnostopoulos C, Bardies M, Bax J, et al. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology. Eur J Nucl Med Mol Imaging. 2005;32(7):855-97. https://doi.org/10.1007/s00259-005-1779-y

3. Loong CY, Anagnostopoulos C. Diagnosis of coronary artery disease by radionuclide myocardial perfusion imaging. Heart. 2004;90 Suppl 5:v2-9.

4. Zellweger MJ, Lewin HC, Lai S, Dubois EA, Friedman JD, Germano G, et al. When to stress patients after coronary artery bypass surgery? Risk stratification in patients early and late post-CABG using stress myocardial perfusion SPECT: implications of appropriate clinical strategies. J Am Coll Cardiol. 2001;37(1):144-52. https://doi.org/10.1016/s0735-1097(00)01104-9

5. Zaret BL, Strauss HW, Martin ND, Wells HP, Jr., Flamm MD, Jr. Noninvasive regional myocardial perfusion with radioactive potassium. Study of patients at rest, with exercise and during angina pectoris. N Engl J Med. 1973;288(16):809-12. https://doi.org/10.1056/nejm197304192881602

6. Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. Comparison of the short- term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation. 2003;107(23):2900-7. https://doi.org/10.1161/01.cir.0000072790.23090.41

7. Hambye AS, Delsarte P, Vervaet AM. Influence of the different biokinetics of sestamibi and tetrofosmin on the interpretation of myocardial perfusion imaging in daily practice. Nucl Med Commun. 2007;28(5):383-90. https://doi.org/10.1097/mnm.0b013e3280e40d85

8. Germano G, Chua T, Kiat H, Areeda JS, Berman DS. A quantitative phantom analysis of artifacts due to hepatic activity in technetium-99m myocardial perfusion SPECT studies. J Nucl Med. 1994;35(2):356-9.

9. Dongen AJ, van Rijk PP. Minimizing liver, bowel, and gastric activity in myocardial perfusion SPECT. J Nucl Med. 2000;41(8):1315-7.

10. Boz A, Gungor F, Karayalcin B, Yildiz A. The effects of solid food in prevention of intestinal activity in Tc-99m tetrofosmin myocardial perfusion scintigraphy. J Nucl Cardiol. 2003;10(2):161-7. https://doi.org/10.1067/mnc.2003.398

11. Peace RA, Lloyd JJ. The effect of imaging time, radiopharmaceutical, full fat milk and water on interfering extra-cardiac activity in myocardial perfusion single photon emission computed tomography. Nucl Med Commun. 2005;26(1):17-24. https://doi.org/10.1097/00006231-200501000-00004

12. Weinmann P, Moretti JL. Metoclopramide has no effect on abdominal activity of sestamibi in myocardial SPET. Nucl Med Commun. 1999;20(7):623-5. https://doi.org/10.1097/00006231-199907000-00005

13. Hurwitz GA, Clark EM, Slomka PJ, Siddiq SK. Investigation of measures to reduce interfering abdominal activity on rest myocardial images with Tc-99m sestamibi. Clin Nucl Med. 1993;18(9):735-41. https://doi.org/10.1097/00003072-199309000-00001

14. 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(4):355-9. https://doi.org/10.1097/00006231-200404000-00007

15. Lukito W, Malik SG, Surono IS, Wahlqvist ML. From 'lactose intolerance' to 'lactose nutrition'. Asia Pac J Clin Nutr. 2015;24 Suppl 1:S1-8. https://doi.org/10.6133/apjcn.2015.24.s1.01

16. Swagerty DL, Jr., Walling AD, Klein RM. Lactose intolerance. Am Fam Physician. 2002;65(9):1845-50.

17. Hegar B, Widodo A. Lactose intolerance in Indonesian children. Asia Pac J Clin Nutr. 2015;24 Suppl 1:S31-40. https://doi.org/10.6133/apjcn.2015.24.s1.06

18. O'Malley HZJ, Thrall J. Nuclear medicine and molecular imaging : the requisites. 5th ed. St. Louis, MO: Elsevier Inc.; 2019. pages cm p.

19. Dorbala S, Di Carli MF, Delbeke D, Abbara S, DePuey EG, Dilsizian V, et al. SNMMI/ASNC/SCCT guideline for cardiac SPECT/CT and PET/CT 1.0. J Nucl Med. 2013;54(8):1485-507. https://doi.org/10.2967/jnumed.112.105155

20. Strauss HW, Miller DD, Wittry MD, Cerqueira MD, Garcia EV, Iskandrian AS, et al. Procedure guideline for myocardial perfusion imaging 3.3. J Nucl Med Technol. 2008;36(3):155-61. https://doi.org/10.2967/jnmt.108.056465


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MEDICINUS is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Copyright © Fakultas Kedokteran | Universitas Pelita Harapan | Lippo Karawaci, Tangerang, Indonesia, 15811 . All rights reserved. p-ISSN 1978-3094 | e-ISSN 2622-6995