Soft Tissue Attenuation Patterns Associated with Supine Acquisition SPECT Myocardial Perfusion Imaging: A Descriptive Study

Abstract

Purpose: Soft-tissue attenuation patterns in SPECT-myocardial perfusion imaging (MPI) of supine acquisition systems are well recognized. Their prevalence and interaction with body-habitus and gender are ill-defined, which we sought to describe in this study.Methods: In a cross-sectional study, we described the prevalence of soft-tissue attenuation patterns in normal SPECT-MPI studies acquired with a supine patient-position SPECT system.Results: In 263 normal, clinically-indicated, supine-acquisition SPECT-MPIs the attenuation patterns observed were: anterior (35.4%), inferior (41.8%) and lateral (13.3%). Anterior attenuation was more prevalent among women (50.7% vs. 15.7%, P<0.001) and was associated with chest circumference among men. Conversely, inferior attenuation was more prevalent among men (78.3% vs. 13.5%, P<0.001) and was not affected by body-habitus. Lateral attenuation was more common among women (19.6% vs. 5.2%, p=0.001) and was associated with obesity (p=0.015).Conclusions: Soft-tissue attenuation artifacts are common in supine-acquisition SPECT-MPI. The recognition of their prevalence and association with body-habitus and gender is critical for the accurate interpretation of SPECT-MPI.

Myocardial Perfusion and Viability Imaging in Coronary Artery Disease: Clinical Value in Diagnosis, Prognosis, and Therapeutic Guidance

“…Attenuation from an elevated diaphragm can cause an apparent inferior defect, while persistent breast attenuation may simulate anterior infarction. 11,12 Lateral wall defects may be observed in women and obese patients. 12…”

Myocardial Perfusion Imaging (Mpi)

“…Myocardial perfusion SPECT imaging (MPI) with superior quality of images in minimum acquisition time is imperative for diagnostic purpose. Soft tissue attenuation is a noticeable origin of SPECT artifacts 1 , which may result in reduced diagnostic exactness. MPI is a non-invasive procedure utilized for diagnosis of coronary artery disease and so an effective gatekeeper to the cardiac catheterization.…”