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Myocardial Perfusion Imaging - Beyond the Left Ventricle pp 5–7Cite as

Technical Principles

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Abstract

Understanding the normal biodistribution and kinetics of the three most common cardiac radiopharmaceuticals (99mTc sestamibi, 99mTc tetrofosmin, 201Tl chloride) is fundamental to the practice of gamma camera-based MPI. The gamma camera instrumentation may be dedicated to imaging the heart with two small perpendicularly oriented detectors, or it may be a system with general purpose large field-of-view detectors that can be configured for SPECT MPI. During image acquisition, the perfusion data may be gated to the R-R interval of the ECG monitor to create gated SPECT images. There are many accepted SPECT MPI stress test protocols. Traditionally, patients undergo two scans, one during rest and the other after stress. Scan patterns, incidental findings, and imaging artifacts may vary considerably depending on the protocol followed. There are many sources of imaging artifacts, including patient motion, soft-tissue attenuation, filtering and windowing, and subdiaphragmatic activity.

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References

  • ACR–SNM–SPR practice guideline for the performance of cardiac scintigraphy (revised 2009). http://snmmi.files.cms-plus.com/docs/Cardiac_Scintigraphy_1382731812393_3.pdf. Accessed 4 June 2015.

  • Boz A, Gungor F, Karayalçin B, Yildiz A. The effects of solid food in prevention of intestinal activity in Tc-99m tetrofosmin myocardial perfusion scintigraphy. J Nucl Cardiol. 2003;10(2):161–7.

    Article  PubMed  Google Scholar 

  • Burrell S, MacDonald A. Artifacts and pitfalls in myocardial perfusion imaging. J Nucl Med Technol. 2006;34:193–211.

    PubMed  Google Scholar 

  • Chamarthy M, Travin MI. Altered biodistribution and incidental findings on myocardial perfusion imaging. Semin Nucl Med. 2010;40:257–70.

    Article  PubMed  Google Scholar 

  • Cherng SC, Chen YH, Lee MS, Yang SP, Huang WS, Cheng CY. Acceleration of hepatobiliary excretion by lemon juice on 99mTc-tetrofosmin cardiac SPECT. Nucl Med Commun. 2006;27(11):859–64.

    Article  PubMed  Google Scholar 

  • Gedik GK, Ergun EL, Aslan M, Caner B. Unusual extracardiac findings detected on myocardial perfusion single photon emission computed tomography studies with Tc-99m sestamibi. Clin Nucl Med. 2007;32:920–6.

    Article  PubMed  Google Scholar 

  • Germano G, Chua T, Kiat H, Areeda JS, Berman DS. A quantitative phantom analysis of artifacts due to hepatic activity in technetium-99m myocardial perfusion SPECT studies. J Nucl Med. 1994;35:356–9.

    CAS  PubMed  Google Scholar 

  • Hassan IM, Mohammad MMJ, Constantinides C, Nair M, Belan N, Abdel-Dayem HH. Problems of duodeno-gastric reflux in Tc-99m HexaMIBI planar, tomographic and bull’s eye display. Clin Nucl Med. 1991;14:286–9.

    Article  Google Scholar 

  • Hassan IM, Mohammad MMJ, Constantinides C, Nair M, Belan N, Abdel-Dayem HH. Problems of duodeno-gastric reflux in Tc-99m HexaMIBI planar, tomographic and bull’s eye display. Clin Nucl Med. 1991;14:286–9.

    Google Scholar 

  • Hesse B, Tägil K, Cuocolo A, Anagnostopoulos C, Bardiés M, Bax J, Bengel F, Busemann Sokole E, Davies G, Dondi M, Edenbrandt L, Franken P, Kjaerl A, Knuutil J, Lassmann M, Ljungberg M, Marcassa C, Marie PY, McKiddie F, OConnor M, Prvulovich E, Underwood R, van Eck-Smit B. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology. Eur J Nucl Med Mol Imaging. 2005;32:855–97. Epub 21 May 2005. http://www.eanm.org/publications/guidelines/gl_cardio_myocard_perf.pdf. Accessed June 8, 2015.

    Article  CAS  PubMed  Google Scholar 

  • Hofman M, McKay J, Nandurkar D. Efficacy of milk versus water to reduce interfering infra-cardiac activity in 99mTc-sestamibi myocardial perfusion scintigraphy. Nucl Med Commun. 2006;27(11):837–42.

    Article  PubMed  Google Scholar 

  • Holly TA, Abbott BG, Al-Mallah M, Calnon DA, Cohen MC, DiFilippo FP, Ficaro EP, Freeman M, Hendel RC, Jain D, Leonard SM, Nichols KJ, Polk DM, Soman P. ASNC Imaging Guidelines for Nuclear Cardiology Procedures. (2010) Single photon-emission computed tomography. J Nucl Cardiol. Epub 15 June 2010. http://asnc.org/imageuploads/ImagingGuidelineSPECTJune2010.pdf. Accessed 8 June 2015.

  • Hurwitz GA, Clark EM, Slomka PJ, Siddiq KS. Investigation of measures to reduce interfering abdominal activity on rest myocardial images with Tc-99m sestamibi. Clin Nucl Med. 1993;18:735–41.

    Article  CAS  PubMed  Google Scholar 

  • Malhotra G, Upadhye TS, Nabar A, Asopa RV, Nayak UN, Rajan MG. Can carbonated lime drink intake prior to myocardial perfusion imaging with Tc-99m MIBI reduce the extracardiac activity that degrades the image quality and leads to fallacies in interpretation? Clin Nucl Med. 2010;35(3):160–4. doi:10.1097/RLU.0b013e3181cc63a1.

    Article  PubMed  Google Scholar 

  • Middleton GW, Williams JH. Significant gastric reflux of technetium-99m-MIBI in SPECT myocardial imaging. J Nucl Med. 1994;35:619–20.

    CAS  PubMed  Google Scholar 

  • Middleton GW, Williams JH. Interference from duodeno-gastric reflux of 99Tcm radiopharmaceuticals in SPET myocardial perfusion imaging. Nucl Med Commun. 1996;17:114–8.

    Article  CAS  PubMed  Google Scholar 

  • Rehm PK, Atkins FB, Ziessman HA, Green SE, Fox LM, Hixson DJ. Frequency of extra-cardiac activity and its effect on 99mTc-MIBI cardiac SPET interpretation. Nucl Med Commun. 1996;17:851–6.

    Article  CAS  PubMed  Google Scholar 

  • Seo I, Del Priore E, Almonte A, Kappes R, Fedida A, Ong K. Extracardiac lesions: why more prominent on the rest SPECT? J Nucl Cardiol. 2005;12:S122 (abstr).

    Article  Google Scholar 

  • Sorrell V, Figueroa B, Hansen CL. The “hurricane sign”: evidence of patient motion artifact on cardiac single-photon emission computed tomography. J Nucl Cardiol. 1996;3:86–8.

    Article  CAS  PubMed  Google Scholar 

  • Strauss HW, Miller DD, Wittry MD, Cerqueira ME, Garcia EV, Iskandrian AS, Schelbert HR, Wackers FJ, Balon HR, Lang O, Machac J. Procedure guideline for myocardial perfusion imaging 3.3 (2008). J Nucl Med Technol. 2008;36:155–61. http://snmmi.files.cms-plus.com/docs/Myocardial%20Perfusion%20Imaging%203.3.pdf. Accessed 8 June 2015.

    Article  PubMed  Google Scholar 

  • van Dongen AJ, van Rijk PP. Minimizing liver, bowel, and gastric activity in myocardial perfusion SPECT. J Nucl Med. 2000;41:1315–7.

    PubMed  Google Scholar 

  • Wackers FJ, Berman DS, Maddahi J, Watson DD, Beller GA, Strauss HW, Boucher CA, Picard M, Holman BL, Fridrich R, et al. Technetium-99m hexakis 2-methoxybutyl isonitrile: human biodistribution, dosimetry, safety, and preliminary comparison to thallium-201 for myocardial perfusion imaging. J Nucl Med. 1989;30:301–11.

    CAS  PubMed  Google Scholar 

  • Weinmann P, Moretti JL. Metoclopramide has no effect on abdominal activity of sestamibi in myocardial SPET. Nucl Med Commun. 1999;20(7):623–5.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Nuclear Medicine and Molecular Imaging Department of Radiology, University of Kentucky, Lexington, Kentucky, USA

    M. Elizabeth Oates

  2. Division of Cardiovascular Medicine Department of Internal Medicine Gill Heart Institute, University of Kentucky, Lexington, Kentucky, USA

    Vincent L. Sorrell

Authors
  1. M. Elizabeth Oates
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  2. Vincent L. Sorrell
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Oates, M.E., Sorrell, V.L. (2017). Technical Principles. In: Myocardial Perfusion Imaging - Beyond the Left Ventricle. Springer, Cham. https://doi.org/10.1007/978-3-319-25436-4_2

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  • DOI: https://doi.org/10.1007/978-3-319-25436-4_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-25434-0

  • Online ISBN: 978-3-319-25436-4

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