Difference in appearance between prone and supine myocardial perfusion images obtained on a high-efficiency cadmium zinc telluride SPECT camera.

Abstract:

OBJECTIVE:The recent introduction of high-efficiency solid-state gamma cameras for myocardial perfusion single photon emission computed tomography has enabled lower patient radiation dose, faster imaging, and improved image quality. However, artifacts still complicate interpretation. Prone imaging is a common maneuver to reduce artifacts and increase accuracy for detection of coronary artery disease, but its effect on imaging relative to supine imaging has not been fully characterized in these new systems. METHODS:In this IRB-approved, HIPAA-compliant retrospective study, 30 patients were reviewed, who underwent prone and supine imaging on the GE 530c multipinhole cadmium zinc telluride camera under both rest and stress conditions. Informed consent was waived. Perfusion was scored visually by two readers on a five-point scale according to the 17-segment model. Differences were assessed for significance using a multivariate linear effects model and restricted maximum likelihood method. RESULTS:Prone positioning resulted in increased activity in the basal inferior (P<0.001), basal inferolateral (P=0.009), basal inferoseptal (P<0.001), and mid-inferior (P<0.001) segments when taking into account factors such as stress versus rest, perfusion scores of other segments, and reader. CONCLUSION:Prone imaging on the GE 530c camera increases measured tracer activity in the basal inferior, basal inferolateral, basal inferoseptal, and mid-inferior segments. Caution is advised when diagnosing myocardial ischemia in these territories, particularly if clinical data are unavailable.

journal_name

Nucl Med Commun

authors

Howard BA,Roy Choudhury K,Oldan JD,Pagnanelli RA,Borges-Neto S

doi

10.1097/MNM.0000000000000476

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

487-92

issue

5

eissn

0143-3636

issn

1473-5628

journal_volume

37

pub_type

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