Abstract
Background
ECG-gated SPECT myocardial perfusion imaging is usually acquired in supine position. However, some patients are not comfortable in this position for a variety of personal or medical reasons. Our aim was to investigate the effect of patient positioning on quantitative SPECT imaging results using normal supine database.
Methods
55 patients (mean age 58.5 ± 8.3 years) were enrolled in this prospective study. Each patient had a pair of ECG-gated stress SPECT myocardial perfusion images acquired on two gamma cameras: one in supine position and the other in upright sitting position. Left ventricular (LV) ejection fraction (EF), end-diastolic (ED), and end-systolic (ES) left ventricular volumes (V), LV mass, summed stress perfusion defect score (SSS), and total severity score (TSS) were calculated automatically relative to a supine normal reference database.
Results
There were no significant differences in LVEF using the two cameras (0.65 ± 0.08 vs. 0.66 ± 0.10; P > 0.1). However, EDV, ESV, and LV mass were significantly smaller in sitting position than in supine position (89 vs. 80 ml; 33 vs. 29 ml and 115 vs. 109 ml, respectively, all P < 0.0001). On the other hand, SSS and TSS were significantly higher in sitting position than in supine position (5.16 vs. 8.73 and 166.82 vs. 288.27, both P < 0.0001). Overall, more studies in sitting position were interpreted as abnormal than in supine position (P < 0.05).
Conclusion
Patient positioning has a significant impact on quantitative gated SPECT imaging results. Using a supine normal reference database, SSS and TSS were larger in sitting position than in supine position. Thus, for imaging in sitting position, separate normal limits are required.
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Abbreviations
- MPI:
-
Myocardial perfusion imaging
- SPECT:
-
Single photon emission computed tomography
- SSS:
-
Summed stress score
- TSS:
-
Total severity score
- LVEF:
-
Left ventricular ejection fraction
- EDV:
-
End-diastolic volume
- ESV:
-
End-systolic volume
- ECTb:
-
Emory cardiac tool box
- BMI:
-
Body mass index
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Acknowledgments
This article was finalized under the auspices of the “Mentorship at Distance” committee of the Journal of Nuclear Cardiology. The authors gratefully acknowledge the editorial suggestions by Frans J. Th. Wackers, MD, PhD.
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Kracskó, B., Barna, S., Sántha, O. et al. Effect of patient positioning on the evaluation of myocardial perfusion SPECT. J. Nucl. Cardiol. 25, 1645–1654 (2018). https://doi.org/10.1007/s12350-017-0865-4
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DOI: https://doi.org/10.1007/s12350-017-0865-4