Poor tracking of myocardial walls and inaccurate estimation of systolic parameters in myocardial hypertrophy on gated myocardial perfusion SPECT resulted from erroneous placement of region of interest and contouring: A pitfall of commercially available software packages for cardiac analysis

  • Mohsen QutbiEmail author
  • Yaser Shiravand
  • Mehdi Soltanshahi
  • Isa Neshandar Asli
  • Abdolhamid Bagheri
Images that Teach


Hypertrophic cardiomyopathy (HCM) is a heritable disorder which is characterized by increased thickness of the ventricular walls, symmetric or asymmetric, with preserved or even hyperdynamic systolic function. Marked thickening of the septum causes obstruction in outflow tract.1 The asymmetric form, to a greater extent, poses tough challenges in SPECT myocardial perfusion imaging (MPI). One of the well-described challenges is downscaling artifact in nonhypertrophied walls in perfusion images. The quantitation of left ventricular (LV) function is affected as well.2,3 In the present note, it is intended to present a case with marked hypertrophy in whom this condition compromises the SPECT images by erroneous placement of the regions of interest (ROI) during analysis using Cedars-Sinai software.

Case Summary

A 31-year-old male with a known history of hypertrophic obstructive cardiomyopathy (HOCM) was referred for cardiac evaluation prior to kidney transplantation....



No conflict of interests is declared. No fund or financial support was assigned to this project.


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Copyright information

© American Society of Nuclear Cardiology 2018

Authors and Affiliations

  • Mohsen Qutbi
    • 1
    Email author
  • Yaser Shiravand
    • 1
  • Mehdi Soltanshahi
    • 1
  • Isa Neshandar Asli
    • 1
  • Abdolhamid Bagheri
    • 2
  1. 1.Department of Nuclear Medicine, Taleghani Educational Hospital, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
  2. 2.Department of Cardiology, Modarres Educational Hospital, School of MedicineShahid Beheshti University of Medical SciencesTehranIran

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