Efficacy of milk versus water to reduce interfering infra-cardiac activity in 99mTc-sestamibi myocardial perfusion scintigraphy

Nucl Med Commun. 2006 Nov;27(11):837-42. doi: 10.1097/01.mnm.0000237989.60196.71.


Objective: Interference from infra-cardiac radionuclide activity prevents accurate interpretation of true myocardial perfusion. The study aim was to compare the efficacy of milk versus water in reducing infra-cardiac activity in myocardial perfusion scintigraphy.

Methods: We prospectively randomized 198 patients undergoing stress-rest (99m)Tc-sestamibi SPECT with exercise or pharmacological stress to drink 300 ml of water or milk prior to imaging. A semi-quantitative grading of the relative intensity of infra-cardiac activity compared to the myocardial activity and a qualitative assessment of the effect on the overall interpretation was performed.

Results: For stress images, there was no infra-cardiac activity in 37.9%, less intense infra-cardiac activity in 40.8%, equal in 11.7% and greater than infra-cardiac activity in 9.7% with milk, compared with 20.0%, 49.5%, 20.0% and 10.5%, respectively, with water (P=0.038). For rest images, there was also less intense infra-cardiac activity with milk compared to water (P=0.014). However, no change in subsequent image interpretation was seen.

Conclusion: Administration of milk resulted in a significant decrease in the intensity of infra-cardiac activity compared to water. However, this did not translate into an improvement in image interpretation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Animals
  • Artifacts*
  • Coronary Circulation
  • Coronary Vessels / diagnostic imaging*
  • Drug Combinations
  • Female
  • Humans
  • Image Enhancement / methods*
  • Male
  • Middle Aged
  • Milk*
  • Myocardial Infarction / complications
  • Myocardial Infarction / diagnostic imaging
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Technetium Tc 99m Sestamibi*
  • Tomography, Emission-Computed, Single-Photon / methods
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / etiology
  • Water*


  • Drug Combinations
  • Water
  • Technetium Tc 99m Sestamibi