Journal of Nuclear Medicine Vol. 47 No. 10 1732b-1733
© 2006 by Society of Nuclear Medicine
CT Attenuation Correction Is Clinically Superior to Supine–Prone MPS
Mirzaei Siroos,
Knoll Peter and
Koehn Horst
Wilhelminenspital, Vienna, Austria
TO THE EDITOR: We read with great interest the paper by Nishina et al. (1). The authors concluded from their study that, compared with supine MPS alone, combined supine–prone quantification significantly improves the specificity of myocardial perfusion scintigraphy (MPS) in the identification of obstructive coronary artery disease. Supine acquisition is known to result in diaphragmatic attenuation of inferior wall counts. In our limited experience using the combined supine–prone imaging method, we achieved results similar to those of Nishina et al. indicating that the specificity of MPS for perfusion abnormalities in the posterior wall of the myocardium can be improved. However, we emphasize that in many patients with "true" perfusion abnormalities, cardiac symptoms develop during the stress procedure and—not only in these patients but also in obese patients—the additional prone positioning may be quite inconvenient. Therefore, with the growing number of new devices enabling attenuation correction by means of CT, we suggest that combined SPECT/CT be preferred to the combined supine–prone protocol to improve the specificity of MPS in routine clinical workups (2–4).
References
- Nishina H, Slomka PJ, Abidov A, et al. Combined supine and prone quantitative myocardial perfusion SPECT: method development and clinical validation in patients with no known coronary artery disease. J Nucl Med. 2006;47:51–58.[Abstract/Free Full Text]
- Dondi M, Fagioli G, Salgarello M, Zoboli S, Nanni C, Cidda C. Myocardial SPECT: what do we gain from attenuation correction (and when)? Q J Nucl Med Mol Imaging. 2004;48:181–187.[Medline]
- Fricke E, Fricke H, Weise R, et al. Attenuation correction of myocardial SPECT perfusion images with low-dose CT: evaluation of the method by comparison with perfusion PET. J Nucl Med. 2005;46:736–744.[Abstract/Free Full Text]
- Grossman GB, Garcia EV, Bateman TM, et al. Quantitative Tc-99m sestamibi attenuation-corrected SPECT: development and multicenter trial validation of myocardial perfusion stress gender-independent normal database in an obese population. J Nucl Cardiol. 2004;11:263–272.[Medline]
