Pharmaceutical interviews to overcome digestive artefacts on [ ^99m Tc]Tc‐tetrofosmin myocardial perfusion scintigraphy

Abstract

99m Tc]Tc-tetrofosmin is widely used for myocardial perfusion scintigraphy (MPS) as a lipophilic cationic radiopharmaceutical that is rapidly cleared from the blood, passively crosses barriers and accumulates in viable myocytes. 1,2 The absence of infracardiac background noise is necessary to ensure the quality of MPS interpretation. However, poor image quality with digestive and hepatic artefacts is randomly described in patients undergoing [ 99m Tc]Tc-tetrofosmin MPS, hampering or even precluding the medical interpretation. The problem is as old as MPS: numerous case-or monocentric cohort-studies have reported subdiaphragmatic activities not only with [ 99m Tc] Tc-tetrofosmin but also with [ 99m Tc]Tc-sestamibi MPS despite valid radiochemical purities. Still, their respective pharmacokinetic and pharmacological interactions with other medications remain poorly studied. To prevent artefacts, different volumes of carbonated water, 3 soda, 4 lime, 5 lemon juice, 6 milk, 7 caffeine 8 or several of them combined 9 have already been empirically experimented as more or less efficient and accessible corrective actions. Their benefits were