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Problems of duodenogastric reflux in Tc-99m Hexa MIBI planar, tomographic and bull's eye display

I M Hassan1, M M Mohammad, C Constantinides

  • 1Department of Nuclear Medicine, Kuwait University, Faculty of Medicine, Safat.

Clinical Nuclear Medicine
|April 1, 1989
PubMed

Insights

Technetium Tc-99m hexa MIBI (RP-30) myocardial imaging can be improved by managing duodenogastric reflux (DGR). A light meal can help clear gastric activity before imaging.

Area of Science:

  • Nuclear medicine
  • Cardiology
  • Gastroenterology

Background:

  • Technetium Tc-99m hexa MIBI (RP-30) is used for myocardial imaging.
  • RP-30 is primarily excreted via hepatobiliary pathways.
  • Duodenogastric reflux (DGR) can occur during the recommended 45-60 minute uptake period for RP-30 myocardial imaging.

Observation:

  • Duodenogastric reflux (DGR) is occasionally observed during the waiting period for RP-30 myocardial imaging.
  • Fundal activity resulting from DGR can interfere with planar, tomographic, and Bull's eye display formats.
  • This gastric activity can obscure or mimic cardiac findings.

Findings:

  • Fundal activity due to duodenogastric reflux complicates myocardial imaging interpretation.
  • The presence of gastric activity requires adjustments to the standard imaging protocol.
  • Interference affects all common display methods for myocardial perfusion scans.

Implications:

  • A simple intervention of a light meal can mitigate DGR-related imaging artifacts.
  • Waiting an additional 15-30 minutes post-meal allows gastric emptying into the small intestine.
  • This strategy can improve the diagnostic accuracy and reliability of Tc-99m hexa MIBI myocardial SPECT imaging.

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