Original Article

Journal of Nuclear Cardiology

, Volume 12, Issue 2, pp 195-202

First online:

Value of attenuation correction on ECG-gated SPECT myocardial perfusion imaging related to body mass index

  • Randall C. ThompsonAffiliated withMid America Heart InstituteCardiovascular Consultants Email author 
  • , Gary V. HellerAffiliated withHenry Low Heart Center, The Hartford Hospital
  • , Lynne L. JohnsonAffiliated withColumbia Presbyterian Medical Center
  • , James A. CaseAffiliated withCardiovascular Consultants
  • , S. James CullomAffiliated withCardiovascular Consultants
  • , Ernest V. GarciaAffiliated withEmory University
  • , Philip G. JonesAffiliated withMid America Heart Institute
  • , Kelly L. MoutrayAffiliated withMid America Heart InstituteCardiovascular Consultants
  • , Timothy M. BatemanAffiliated withMid America Heart InstituteCardiovascular Consultants

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Obesity is a growing problem in the United States, and attenuation artifacts are more prevalent in this patient group. This study evaluated the impact of attenuation correction in patients with a high body mass index (BMI).

Methods and Results

Three readers interpreted gated attenuation-corrected and non-attenuation-corrected rest/stress technetium 99m sestamibi myocardial perfusion imaging results in 116 patients (BMI <30, n = 60; BMI ≥30, n = 56) who had coronary angiography no more than 60 days after imaging. Readers were blinded to all clinical information and as to whether myocardial perfusion imaging was attenuation-corrected or non-attenuation-corrected. Sensitivity, specificity, and accuracy for detection of coronary artery disease of 70% or greater for attenuation-corrected versus non-attenuation-corrected single photon emission computed tomography (SPECT) were 86% versus 89%, 79% versus 50%, and 84% versus 79%, respectively. Sensitivity, specificity, and accuracy for attenuation-corrected versus non-attenu-ation-corrected SPECT for patients with BMI less than 30 were 90% versus 90%, 82% versus 64%, and 88% versus 85%, respectively. For BMI of 30 or greater, the results were 82% versus 87%, 76% versus 41%, and 80% versus 73%, respectively. There was a significant difference in specificity overall (P =.02) and for the category of BMI of 30 or greater (P =.03).


This study demonstrates that electrocardiography-gated attenuation-corrected Tc-99m sestamibi SPECT myocardial perfusion imaging improves specificity compared with electrocardiography-gated non-attenuation-corrected SPECT myocardial perfusion imaging, especially in patients with BMI of 30 or greater.

Key Words

Attenuation correction single photon emission computed tomography body mass index