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The Effect of Milk, Water and Lemon Juice on Various Subdiaphragmatic Activity-Related Artifacts in Myocardial
Hadi Malek1, Raheleh Hedayati2, Nahid Yaghoobi1
1Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
Background:
Subdiaphragmatic activity can produce subdiaphragmatic-related artifacts, which can degrade the quality of myocardial perfusion imaging (MPI).
Objectives:
We examined the impact of drinking milk, water, and lemon juice on different subdiaphragmatic-related artifacts by using (99m)Tc-sestamibi myocardial single-photon emission computed tomography (SPECT) in order to determine a feasible method for improving the image quality.
Patients And Methods:
A total of 179 patients (age 58 ± 9.6 years) were enrolled in this study. The patients were randomly divided into five groups. Ten minutes after injection of 740 MBq 99mTc-sestamibi in both pharmacologic stress and rest phases, the individuals in group 1 were given water and milk (125 mL of each); those in group 2 were given lemon juice (250 mL); group 3 was given milk (250 mL); and group 4 was given water (250 mL), whereas no intervention was performed in group 5. The study was double-blind for both subjects and data collectors. MPI was performed for all patients and image quality was controlled by 2 experienced nuclear physicians. Interfering activity was determined visually on reconstructed images and categorized as extracardiac normalization artifact, overlapping of activity, scattering of activity, and ramp filter artifact.
Results:
There were significant differences in terms of interfering activity among the five groups; group 3 (milk) had significantly lower interfering activity than other groups had, as defined by overlapping of activity (on both stress and rest images), ramp filter artifact (stress images), and scatter artifact (rest images) (P < 0.05). Furthermore, there was a significant difference in the incidence of good-quality images, with no interfering activity in group 3 in the resting state compared with the other groups in the study (P < 0.05).
Conclusions:
Drinking 250 mL of milk in either the stress phase or the rest phase of imaging diminishes interfering subdiaphragmatic-related artifacts, particularly overlapping of activity in MPI SPECT, resulting in better-quality images.
Insights
Drinking 250 mL of milk effectively reduces subdiaphragmatic artifacts in myocardial perfusion imaging (MPI) SPECT. This intervention significantly improves image quality by minimizing interfering activity during both stress and rest phases.
Area of Science:
- Nuclear Medicine
- Radiology
- Cardiology
Background:
- Subdiaphragmatic activity can cause artifacts in myocardial perfusion imaging (MPI), degrading image quality.
- These artifacts include extracardiac normalization, overlapping activity, scattering, and ramp filter artifacts.
Purpose of the Study:
- To evaluate the effect of consuming milk, water, or lemon juice on subdiaphragmatic artifacts in MPI SPECT.
- To identify a practical method for enhancing MPI image quality.
Main Methods:
- 179 patients undergoing (99m)Tc-sestamibi MPI SPECT were divided into five groups.
- Intervention groups received 250 mL of milk, 250 mL of water, 250 mL of lemon juice, or a combination of water and milk.
- Image quality and interfering activity were assessed visually by nuclear physicians in a double-blind manner.
Main Results:
- Drinking 250 mL of milk (Group 3) significantly reduced interfering activity compared to other groups.
- Milk consumption led to lower overlapping activity, ramp filter artifacts (stress), and scatter artifacts (rest).
- Group 3 showed a significantly higher incidence of good-quality images with no interfering activity in the resting state.
Conclusions:
- Consuming 250 mL of milk during MPI SPECT significantly diminishes subdiaphragmatic artifacts.
- Milk intake, particularly in the resting phase, improves myocardial perfusion imaging quality.
- Milk is a feasible and effective agent for reducing artifacts in MPI SPECT.
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