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Research ArticleImaging

Can a Carbonated Lemon Drink Reduce Extracardiac Activity in Myocardial Perfusion Imaging?

Nora AL-Somali, Hossam El-Zeftawy, Salman Al-Qurashi, Nabeel Mishah, Jose Norwin Catipay, Leen Albalbeesi, Yasser Al-Eatany, Narjes Al-Alahmadii, Ali Alghamdi, Ahmed A. Osman and Nadia Batawil
Journal of Nuclear Medicine Technology September 2024, 52 (3) 239-246; DOI: https://doi.org/10.2967/jnmt.124.267965
Nora AL-Somali
1Nuclear Medicine Section, Department of Radiology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia;
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Hossam El-Zeftawy
2Nuclear Medicine Section, Department of Radiology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; and
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Salman Al-Qurashi
2Nuclear Medicine Section, Department of Radiology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; and
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Nabeel Mishah
1Nuclear Medicine Section, Department of Radiology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia;
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Jose Norwin Catipay
1Nuclear Medicine Section, Department of Radiology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia;
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Leen Albalbeesi
1Nuclear Medicine Section, Department of Radiology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia;
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Yasser Al-Eatany
2Nuclear Medicine Section, Department of Radiology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; and
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Narjes Al-Alahmadii
2Nuclear Medicine Section, Department of Radiology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; and
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Ali Alghamdi
1Nuclear Medicine Section, Department of Radiology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia;
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Ahmed A. Osman
3Faculty of Public Health and Health Informatics, Umm Al-Qura University, Mecca, Saudi Arabia
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Nadia Batawil
1Nuclear Medicine Section, Department of Radiology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia;
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Abstract

Myocardial perfusion imaging (MPI) provides physiologic and functional information about the heart muscle and its blood flow. Extracardiac radioactivity can interfere with visualization of the inferior wall of the myocardium, leading to poor-quality images, difficulties in interpretation, and delays in routine practice. This study aimed to identify the efficiency of having the patient consume a carbonated lemon drink to minimize the extracardiac radioactivity of 99mTc-sestamibi in comparison to 99mTc-tetrofosmin during MPI. Methods: This was a retrospective study that recruited 158 patients with known or suspected coronary artery disease referred to undergo 99mTc-sestamibi or 99mTc-tetrofosmin rest/stress single-day MPI. The patients were divided into 2 groups of mixed sexes and different ages. The first group comprised 78 patients injected with 99mTc-sestamibi, and the second group comprised 80 patients injected with 99mTc-tetrofosmin. For both groups, the patients drank 30 mL of fresh lemon juice diluted with 150 mL of soda water, and then we gave the patients about 100 mL of straight soda water, before imaging for both the rest and the stress phases. Results: Generally, in both groups, the 99mTc-tetrofosmin produced a good-quality image in comparison with the 99mTc-sestamibi. The mean rank of the total score for 99mTc-tetrofosmin (62.75) was less than that for 99mTc-sestamibi (96.68), and this difference was highly statistically significant (P = 0.000). There were statistically significant differences in the ratios and mean ranks for both groups in favor of 99mTc-tetrofosmin in patients having coronary artery disease. Conclusion: The use of a carbonated lemon drink minimizes extracardiac activity from both 99mTc-labeled MPI radiopharmaceuticals. This finding was more statistically significant for 99mTc-tetrofosmin MPI, providing better image quality and earlier imaging in both the rest and the stress phases because of faster hepatobiliary clearance.

  • 99mTc-MIBI
  • 99mTc-tetrofosmin
  • myocardial perfusion
  • SPECT

Footnotes

  • Published online Aug. 13, 2024.

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Journal of Nuclear Medicine Technology: 52 (3)
Journal of Nuclear Medicine Technology
Vol. 52, Issue 3
September 1, 2024
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Can a Carbonated Lemon Drink Reduce Extracardiac Activity in Myocardial Perfusion Imaging?
Nora AL-Somali, Hossam El-Zeftawy, Salman Al-Qurashi, Nabeel Mishah, Jose Norwin Catipay, Leen Albalbeesi, Yasser Al-Eatany, Narjes Al-Alahmadii, Ali Alghamdi, Ahmed A. Osman, Nadia Batawil
Journal of Nuclear Medicine Technology Sep 2024, 52 (3) 239-246; DOI: 10.2967/jnmt.124.267965

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Can a Carbonated Lemon Drink Reduce Extracardiac Activity in Myocardial Perfusion Imaging?
Nora AL-Somali, Hossam El-Zeftawy, Salman Al-Qurashi, Nabeel Mishah, Jose Norwin Catipay, Leen Albalbeesi, Yasser Al-Eatany, Narjes Al-Alahmadii, Ali Alghamdi, Ahmed A. Osman, Nadia Batawil
Journal of Nuclear Medicine Technology Sep 2024, 52 (3) 239-246; DOI: 10.2967/jnmt.124.267965
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Keywords

  • 99mTc-MIBI
  • 99mTc-tetrofosmin
  • myocardial perfusion
  • SPECT
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