Gastric wall uptake of Tc-99m sestamibi: Techniques to decrease uptake and minimize its consequences in myocardial perfusion SPECT

Excerpt

Gastric uptake of Tc-99m sestamibi in patients taking proton pump inhibitors (PPIs) and its adverse consequences in the interpretation of myocardial perfusion SPECT, including photon scatter into the inferior wall of the left ventricle and a Ramp filter artifact, was initially reported by our laboratory in 2009.1 PPIs act by irreversibly blocking the hydrogen/potassium adenosine triphosphatase enzyme system (H+/K+ ATPase) or the gastric proton pump of the gastric parietal cell at the secretory surface of the cell, thereby inhibiting gastric acid secretion.2,3 It has been proposed, but not validated, that inhibition of the H+/K+ ATPase pump similarly reduces the secretion of sestamibi into the gastric lumen. …