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Investigation of Emission–Transmission Misalignment Artifacts on Rubidium-82 Cardiac PET with Adenosine Pharmacologic Stress

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Abstract

Purpose

This study was undertaken to determine if artifacts from misalignment of cardiac emission to transmission data is present in adenosine stress studies and if the artifact could be reproduced by intentional misalignment in normal exams.

Procedures

Seventy consecutive 82Rb myocardial perfusion studies were reviewed. Utilizing a quality control program, misalignment was assessed. The study was reprocessed after manual realignment to determine if the defect extent changed. Emission and transmission acquisitions in six normal studies also were intentionally misaligned.

Results

Twenty of 69 rest studies (29.0%) and 17 of 69 (24.6%) stress studies demonstrated misalignment. In four patients with stress misalignment, there was a significant change in clinical interpretation. Upon intentionally misaligning six normal studies, a lateral wall defect was reproduced.

Conclusions

Emission–transmission misalignment occurs in 29.0% and 24.6% of 82Rb rest and adenosine stress studies, respectively. While there is a positive correlation of artifactual defects with misalignment, the presence and size of artifacts is variable and unpredictable at seemingly lesser degrees of misalignment.

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Authors and Affiliations

  1. Department of Radiology, Division of Nuclear Medicine, Emory University, Atlanta, GA, USA

    David M. Schuster, Raghuveer K. Halkar, Fabio P. Esteves, Ernest V. Garcia, C. David Cooke & John R. Votaw

  2. Department of Medicine, Division of Cardiology, Emory University, Atlanta, GA, USA

    Mushabbar A. Syed

  3. Department of Biostatistics, Emory University, Atlanta, GA, USA

    F. DuBois Bowman

  4. Department of Radiology, Emory University Hospital, Room E145, 1364 Clifton Road, Atlanta, GA, 30322, USA

    David M. Schuster

Authors
  1. David M. Schuster
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  2. Raghuveer K. Halkar
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  3. Fabio P. Esteves
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  4. Ernest V. Garcia
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  5. C. David Cooke
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  6. Mushabbar A. Syed
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  7. F. DuBois Bowman
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  8. John R. Votaw
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Correspondence to David M. Schuster.

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Schuster, D.M., Halkar, R.K., Esteves, F.P. et al. Investigation of Emission–Transmission Misalignment Artifacts on Rubidium-82 Cardiac PET with Adenosine Pharmacologic Stress. Mol Imaging Biol 10, 201–208 (2008). https://doi.org/10.1007/s11307-008-0139-2

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  • DOI: https://doi.org/10.1007/s11307-008-0139-2

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