Evaluating the Role of Routine Prone Acquisition on Visual Evaluation of SPECT Images

Journal of Nuclear Medicine Technology

Tamer Aksoy¹  Billur Caliskan¹  Levent A. Guner¹  Afsin Parspur¹  Erkan Vardareli¹  Ilknur Isik¹ 

关键词: prone imaging;    SPECT;    myocardial perfusion;   

DOI  :  10.2967/jnmt.115.165936

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Attenuation artifacts reduce our ability to evaluate perfusion of affected myocardial segments. The aim of this study was to evaluate the impact of routine prone-position image evaluation within a stepwise visual interpretation of myocardial perfusion studies. Methods: We have included 279 consecutive patients who were referred for evaluation of myocardial ischemia. All patients underwent routine electrocardiogram-gated supine SPECT imaging and non–electrocardiogram-gated prone-position SPECT imaging. Three nuclear medicine physicians interpreted the images in the following order: polar maps, supine images, raw images, motion-frozen gated images, and prone images, using a scale of 0–4. Segments with perfusion abnormalities were noted. Results: All physicians reported lower proportions of equivocal evaluations after evaluating prone images (18.3% vs. 4.7%, 19% vs. 11.1%, and 12.2% vs. 6.1%, P < 0.0001, P = 0.0077, and P = 0.0125, respectively). At the prone stage, normalcy rates were 89%, 87%, and 91%. Two physicians had significantly increased normalcy rates at the prone stage (72%–89%, P = 0.039, and 66%–87%, P = 0.006). At the prone stage, a decision reversal to normal or probably normal was observed in 40% (29/72), 33% (17/51), and 43% (21/48). In men, apical, mid, and basal inferior walls and in women apical and mid parts of anterior walls were more likely to be attributed to attenuation. The 2 steps that increased normalcy rates for interpreters were the review of raw images and of prone images. Conclusion: Routine prone imaging increases interpretive certainty and interobserver agreement and changes the final evaluation in a substantial number of patients and significantly decreases the number of equivocal evaluations.

【 授权许可】

Unknown