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

J Clin Pharm Ther. 2021 Oct;46(5):1480-1483. doi: 10.1111/jcpt.13418. Epub 2021 Mar 22.

Abstract

What is known and objectives: Poor image quality was randomly seen in [99m Tc]Tc-tetrofosmin myocardial perfusion scintigraphic imaging. The interference hampered or even precluded medical interpretation. Our objective was to identify the cause of the random interferences.

Methods: Out of 40 patients planned for [99m Tc]Tc-tetrofosmin MPS, 36 presented normal tracer uptake and 4 exhibited subdiaphragmatic artefacts. Pharmaceutical interviews (P.I.) were set up to formally identify aetiologies of subdiaphragmatic uptake of [99m Tc]Tc-tetrofosmin. Patients were questioned about their diet and current drug treatments.

Results and discussion: P.I. led to identification of dipyridamole as the cause of the artefacts. The systematic ingestion of a solid 25-gram high-fat snack bar and a glass of fresh water was introduced immediately after the injection of dipyridamole in 12 other patients undergoing [99m Tc]Tc-tetrofosmin MPS. None of the 12 patients presented subdiaphragmatic artefacts.

What is new and conclusion: P.I. identified the cause of poor scintigraphic images to allow improved diagnoses.

Keywords: pharmacist consultation; radiopharmacy; scintigraphy; single photon emission computed tomography.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dipyridamole / pharmacology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging / methods*
  • Organophosphorus Compounds / pharmacokinetics*
  • Organotechnetium Compounds / pharmacokinetics*
  • Radiopharmaceuticals / pharmacokinetics*
  • Tomography, Emission-Computed, Single-Photon
  • Vasodilator Agents / pharmacology*

Substances

  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • Vasodilator Agents
  • technetium tc-99m tetrofosmin
  • Dipyridamole