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Effect of patient positioning on the evaluation of myocardial perfusion SPECT

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

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.

Disclosure

The authors have no conflict of interest.

Author information

Authors and Affiliations

  1. Institute of Cardiology, University of Debrecen, Móricz Zs. krt. 22., Debrecen, 4032, Hungary

    Bertalan Kracskó MD

  2. ScanoMed Ltd., Debrecen, Hungary

    Sándor Barna MD, Orsolya Sántha MD, Anett Kiss BSc, Attila Forgács MSc & Ildikó Garai MD, PhD

  3. Department of Nuclear Medicine, University of Debrecen, Debrecen, Hungary

    József Varga PhD

Authors
  1. Bertalan Kracskó MD
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  2. Sándor Barna MD
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  3. Orsolya Sántha MD
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  4. Anett Kiss BSc
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  5. József Varga PhD
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  6. Attila Forgács MSc
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  7. Ildikó Garai MD, PhD
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Correspondence to Bertalan Kracskó MD.

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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

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