Assessment of Myocardial CZT SPECT Recording in a Forward-Leaning Bikerlike Position.

Abstract

This prospective randomized study assessed myocardial perfusion imaging with the high-sensitivity D.SPECT cadmium-zinc-telluride camera in a forward-leaning bikerlike position, which may potentially lower diaphragmatic attenuation and reduce breathing-related cardiac motion, in a manner comparable to the prone position proposed with other SPECT cameras. <b>Methods:</b> Patients referred for a stress-rest ^99mTc-sestamibi protocol and positioned in the biker position, with the chest leaning forward on the D.SPECT camera-head at 35° from vertical, had an additional resting D.SPECT recording in the supine position (<i>n</i> = 40) or in the sitting position with the back rearward at 30° from vertical (<i>n</i> = 40). Segments with attenuation artifacts were defined as those with less than 65% uptake but with strictly normal contractility at gated SPECT and no defect reversibility from stress images. <b>Results:</b> The biker position was associated with lower heart-to-detector distances than the supine or sitting positions (both <i>P</i> < 0.001); lower cardiac motion amplitudes, assessed on panograms, than the supine position (<i>P</i> < 0.001); and fewer segments with attenuation artifacts than the supine position (on average, 1.10 ± 1.01 vs. 1.90 ± 1.74, <i>P</i> = 0.010) or the sitting position (0.75 ± 0.93 vs. 1.38 ± 1.60, <i>P</i> = 0.011). <b>Conclusion:</b> Myocardial perfusion images from D.SPECT are enhanced for patients positioned in a forward-leaning bikerlike position comparatively to sitting or supine positions, with a notably lower rate of attenuation artifacts.