Influence of proton-pump inhibitors on stomach wall uptake of 99mTc-tetrofosmin in cadmium-zinc-telluride SPECT myocardial perfusion imaging

Nucl Med Commun. 2015 Feb;36(2):143-7. doi: 10.1097/MNM.0000000000000222.


Background: Proton-pump inhibitors (PPIs) induce potentially interfering stomach wall activity in single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) with technetium-99m ((99m)Tc)-sestamibi. However, no data are available for (99m)Tc-tetrofosmin. We assessed the influence of prolonged (>2 weeks) PPI use on the stomach wall uptake of (99m)Tc-tetrofosmin in patients referred for stress MPI with a cadmium-zinc-telluride-based SPECT camera and its relation with dyspepsia symptoms.

Methods and results: Consecutive patients (n=127) underwent a 1-day adenosine stress-first SPECT-MPI with (99m)Tc-tetrofosmin, of whom 54 (43%) patients had been on PPIs for more than 2 weeks. Stomach wall activity was identified on stress SPECT using computed tomographic attenuation maps and was scored using a four-point grading scale into clinically relevant (scores 2 or 3) or nonrelevant (scores 0 or 1).Patients on PPIs had stomach wall uptake more frequently as compared with patients not using PPIs (22 vs. 7%, P=0.017). Dyspepsia was similar in both groups.

Conclusion: Prolonged use of PPIs is associated with stomach wall uptake of (99m)Tc-tetrofosmin in stress cadmium-zinc-telluride-SPECT images. Gastric symptoms were not associated with stomach wall uptake.

MeSH terms

  • Aged
  • Artifacts*
  • Biological Transport / drug effects
  • Cadmium*
  • Dyspepsia / diagnostic imaging
  • Dyspepsia / drug therapy
  • Dyspepsia / metabolism
  • Female
  • Gastric Mucosa / metabolism
  • Humans
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging*
  • Organophosphorus Compounds / metabolism*
  • Organotechnetium Compounds / metabolism*
  • Proton Pump Inhibitors / pharmacology*
  • Proton Pump Inhibitors / therapeutic use
  • Stomach / diagnostic imaging
  • Stomach / drug effects*
  • Stress, Physiological
  • Tellurium*
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon*
  • Tomography, X-Ray Computed
  • Zinc*


  • CdZnTe
  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Proton Pump Inhibitors
  • Cadmium
  • technetium tc-99m tetrofosmin
  • Zinc
  • Tellurium