Document Detail


Artifactual reverse distribution pattern in myocardial perfusion SPECT with technetium-99m sestamibi.
MedLine Citation:
PMID:  11144478     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The reverse distribution pattern (RDP), in which resting perfusion imaging demonstrates a de novo or more marked regional defect than that present in stress images, is observed frequently in patients with a low likelihood of coronary artery disease. METHODS AND RESULTS: To determine whether this scan pattern is artifactual and to investigate its causes, we retrospectively evaluated scans in 202 patients with a low likelihood of coronary artery disease (77 men and 125 women) undergoing single-day rest/stress technetium-99m sestamibi single photon emission computed tomography (SPECT). The presence and location of RDP was correlated with relevant body habitus parameters. RDP was observed in 15.3% of patients. The finding was significantly more frequent in patients who were obese (P<.02 in men, P<.03 in women), in men with abdominal protuberance (P<.05), and in women with prominent breast "shadows" observed on planar projection images (P<.008). RDP was most frequent in the right coronary artery territory in men and the left anterior descending coronary artery territory in women. It was demonstrated by means of a cardiac SPECT phantom experiment that soft tissue attenuation effects were most evident in low count density SPECT studies with localized soft tissue attenuation, accounting for the higher than clinical observation of RDP in obese patients undergoing low-dose rest/high-dose imaging. CONCLUSIONS: RDP is a frequently encountered artifact in obese patients undergoing rest/stress Tc-99m sestamibi SPECT, particularly in men with abdominal protuberance and in women with large, dense breasts.
Authors:
W Araujo; E G DePuey; M Kamran; M Undavia; M Friedman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  7     ISSN:  1071-3581     ISO Abbreviation:  J Nucl Cardiol     Publication Date:    2000 Nov-Dec
Date Detail:
Created Date:  2000-12-28     Completed Date:  2001-02-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  633-8     Citation Subset:  IM    
Affiliation:
Diagnostico Medico Nuclear, Campinas, Sao Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Artifacts*
Body Constitution
Body Mass Index
Coronary Circulation*
Coronary Disease / physiopathology,  radionuclide imaging*
Female
Humans
Male
Phantoms, Imaging
Radiopharmaceuticals / diagnostic use*
Retrospective Studies
Technetium Tc 99m Sestamibi / diagnostic use*
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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