SPECT Attenuation Artifacts in Normal and Overweight Persons

Freedman, Nanette; Schechter, David Charles; Klein, Martine; Marciano, Rami; Rozenman, Yoseph; Chisin, Roland

doi:10.1097/00003072-200012000-00014

Cited by 46 publications

(5 citation statements)

References 9 publications

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“…An important confounding factor of myocardial scintigraphy is that 201 Tl myocardial perfusion scintigraphy is subjected to artifacts from the breast and liver [ 19 , 20 ]. As shown in Figure 1 , a thick chest wall or implants in the chest may cause artifacts in SPECT figures of 201 Tl.…”

Section: Discussionmentioning

confidence: 99%

“…As these scores were near the maximum value (full score was 68) of the tests, we regarded them as outliers. These patients were asymptomatic in spite of maximum uptake scores, which suggested that they had some disorders in 123 I-BMIPP uptake, such as CD36 deficiency or triglyceride deposit cardiomyovasculopathy (TGCV) [ 20 , 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Echocardiography and Myocardial Scintigraphy to Detect Cancer Therapy-Related Cardiovascular Toxicity in Breast Cancer Patients

Harada,

Shimada,

Harada

et al. 2024

J. Imaging

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The mortality rate of cancer patients has been decreasing; however, patients often suffer from cardiac disorders due to chemotherapy or other cancer therapies (e.g., cancer-therapy-related cardiovascular toxicity (CVR-CVT)). Therefore, the field of cardio-oncology has drawn more attention in recent years. The first European Society of Cardiology (ESC) guidelines on cardio-oncology was established last year. Echocardiography is the gold standard for the diagnosis of CVR-CVT, but many breast cancer patients are unable to undergo echocardiography due to their surgery wounds or anatomical reasons. We performed a study to evaluate the usefulness of myocardial scintigraphy using Iodine-123 β-methyl-P-iodophenyl-pentadecanoic acid (123I-BMIPP) in comparison with echocardiography and published the results in the Journal of Imaging last year. This is the secondary analysis following our previous study. A total of 114 breast cancer patients who received chemotherapy within 3 years underwent echocardiography, as well as Thallium (201Tl) and 123I-BMIPP myocardial perfusion and metabolism scintigraphy. The ratio of isotope uptake reduction was scored by Heart Risk View-S software (Nihon Medi-Physics). The scores were then compared with the echocardiography parameters. All the patients’ charts and data from January 2022 to November 2023 were reviewed for the secondary analysis. Echocardiogram parameters were obtained from 99 patients (87% of total patients). No correlations were found between the echocardiography parameters and Heart Risk View-S scores of 201Tl myocardial perfusion scintigraphy, nor those of the BMIPP myocardial metabolism scintigraphy. In total, 8 patients out of 114 (7.0%) died within 22 months, while 3 patients out of 26 CVR-CVT patients (11.5%) died within 22 months. Evaluation by echocardiography was sometimes difficult to perform on breast cancer patients. However, other imaging modalities, including myocardial scintigraphy, cannot serve as alternatives to echocardiography. Cardiac scintigraphy detects circulation disorder or metabolism disorder in the myocardium; therefore, it should be able to reveal myocardial damage to some extent. The mortality rate of breast cancer patients was higher with CVR-CVT. A new modality to detect CVR-CVT besides echocardiography can possibly be anticipated for patients who cannot undergo echocardiography.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of Echocardiography and Myocardial Scintigraphy to Detect Cancer Therapy-Related Cardiovascular Toxicity in Breast Cancer Patients

Harada,

Shimada,

Harada

et al. 2024

J. Imaging

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“…There are fewer reports regarding the accuracy of myocardial perfusion imaging in severely obese patients. One study [4] using Thallium-201 myocardial perfusion imaging demonstrated lower accuracy in patients with BMI > 30 kg/m 2 , and comparing single photon emission computed tomography (SPECT) results with positron emission tomography (PET), discordance was encountered with greater frequency in obese patients, mostly in the territories supplied by left anterior descending or right coronary arteries, as a result of more prominent attenuation artefacts [22]. In a study by Bhat et al, 7 severely obese patients were evaluated with TE-DSE prior to bariatric surgery to determine cardiac risk.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of an accelerated transoesophageal stress echocardiography in the preoperative evaluation of high risk severely obese subjects awaiting bariatric surgery

Legault

Sénéchal

Bergeron

et al. 2010

Cardiovasc Ultrasound

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BackgroundSevere obesity is associated with an increased risk of coronary artery disease (CAD). Bariatric surgery is an effective procedure for long term weight management as well as reduction of comorbidities. Preoperative evaluation of cardiac operative risk may often be necessary but unfortunately standard imaging techniques are often suboptimal in these subjects. The purpose of this study was to demonstrate the feasibility, safety and utility of transesophageal dobutamine stress echocardiography (TE-DSE) using an adapted accelerated dobutamine infusion protocol in severely obese subjects with comorbidities being evaluated for bariatric surgery for assessing the presence of myocardial ischemia.MethodsSubjects with severe obesity [body mass index (BMI) >40 kg/m2] with known or suspected CAD and being evaluated for bariatric surgery were recruited.ResultsTwenty subjects (9M/11F), aged 50 ± 8 years (mean ± SD), weighing 141 ± 21 kg and with a BMI of 50 ± 5 kg/m2 were enrolled in the study and underwent a TE-DSE. The accelerated dobutamine infusion protocol used was well tolerated. Eighteen (90%) subjects reached their target heart rate with a mean intubation time of 13 ± 4 minutes. Mean dobutamine dose was 31.5 ± 9.9 ug/kg/min while mean atropine dose was 0.5 ± 0.3 mg. TE-DSE was well tolerated by all subjects without complications including no significant arrhythmia, hypotension or reduction in blood arterial saturation. Two subjects had abnormal TE-DSE suggestive of myocardial ischemia. All patients underwent bariatric surgery with no documented cardiovascular complications.ConclusionsTE-DSE using an accelerated infusion protocol is a safe and well tolerated imaging technique for the evaluation of suspected myocardial ischemia and cardiac operative risk in severely obese patients awaiting bariatric surgery. Moreover, the absence of myocardial ischemia on TE-DSE correlates well with a low operative risk of cardiac event.

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“…In general, SPECT imaging is inferior to PET owing to poorer spatial resolution, because resolution is dependent on the distance from the detectors, and the inherent difficulty of performing attenuation correction in SPECT. PET has been shown to have improved specificity in obese patients (84% PET versus 69% SPECT) (30). In practice, PET examinations reduce diagnostic uncertainty compared to SPECT (29, 31).…”

Section: Positron Emission Tomography (Pet) and Coronary Artery DImentioning

confidence: 99%

Quantitative imaging of coronary blood flow

Alessio¹,

Butterworth

Caldwell

et al. 2010

Nano Reviews

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Positron emission tomography (PET) is a nuclear medicine imaging modality based on the administration of a positron-emitting radiotracer, the imaging of the distribution and kinetics of the tracer, and the interpretation of the physiological events and their meaning with respect to health and disease. PET imaging was introduced in the 1970s and numerous advances in radiotracers and detection systems have enabled this modality to address a wide variety of clinical tasks, such as the detection of cancer, staging of Alzheimer's disease, and assessment of coronary artery disease (CAD). This review provides a description of the logic and the logistics of the processes required for PET imaging and a discussion of its use in guiding the treatment of CAD. Finally, we outline prospects and limitations of nanoparticles as agents for PET imaging.

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SPECT Attenuation Artifacts in Normal and Overweight Persons

Cited by 46 publications

References 9 publications

Comparison of Echocardiography and Myocardial Scintigraphy to Detect Cancer Therapy-Related Cardiovascular Toxicity in Breast Cancer Patients

Comparison of Echocardiography and Myocardial Scintigraphy to Detect Cancer Therapy-Related Cardiovascular Toxicity in Breast Cancer Patients

Usefulness of an accelerated transoesophageal stress echocardiography in the preoperative evaluation of high risk severely obese subjects awaiting bariatric surgery

Quantitative imaging of coronary blood flow

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