Mudassar Iqbal, Muhammad Hassan Iqbal, Aamir Hussain, Muhammad Aleem Khan, Irfan Majeed, Ahmad Noeman, Syed Asif Ali, Shazia Chaudhry.
Comparison of full fat milk and lemon juice infacilitation of hepato-biliary clearance of radiopharmaceutical 99MTC-MIBI during myocardial perfusion imaging.
J Cardiovascular Dis Jan ;16(3):107-11.

BACKGROUND: Subdiaphragmatic activity observed during myocardial perfusion imaging (MPI) is a potential source of inducing artifacts during reconstruction of raw images. Present study was planned to assess which intervention (full fat milk or lemon juice) is better in reducing the subdiaphragmatic (SD) activity. This minimize the need of rest imaging in cases where stress imaging is normal, resulting in reducing unnecessary radiation exposure. We compared the effectiveness of lemon juice versus full fat milk in hepatobiliary clearance of radioactivity in patients undergoing myocardial perfusion imaging. MATERIAL AND METHODS: It was a randomized controlled trial conducted at Nuclear Cardiology department, PIC, Lahore during April 2019 to October 2019 (Six months). A total of seventy (n=70) patients of both gender between age 25-75 years, referred for MPI for the evaluation of coronary artery disease were enrolled and randomized into two groups (full fat milk or lemon juice) by lottery method. The images obtained after 30 minutes were analyzed. At SD:C ratio of less than 1 was taken to be present and determined for assessing the effectiveness for two interventions. RESULTS: Results of the present study demonstrates that effectiveness was found present in 57.1% (n=20/35) in milk group and it was 80.0% (n=28/35) in lemon juice group as per our operational definition (P=0.039). Effectiveness was found better among older males (P<0.05). No other significant difference was noted (p>0.05 in rest of variable subsets). CONCLUSIONS: The effectiveness was significantly better in patients who took lemon juice as compared to those who took full fat milk after the administration of radiopharmaceutical.

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