title: CT-based attenuation correction versus prone imaging to decrease equivocal interpretations of rest/stress Tc-99m tetrofosmin SPECT MPI.
abstract: BACKGROUND
  The purpose of this study was to compare stress supine single photon emission computed tomography (SPECT) imaging with attenuation correction (AC) via computed tomography-based attenuation maps with stress prone SPECT imaging with regard to the rate of equivocal interpretation of rest/stress myocardial perfusion imaging.
  
  
  RESULTS
  Interpretations for 324 consecutive patients referred for rest/stress myocardial perfusion imaging were performed by use of the following sets of poststress SPECT images: supine with no AC (NC), supine NC/AC, supine NC/prone, and all images. The number of equivocal studies decreased with additional imaging: supine NC, 40%; supine NC/prone, 18%; supine NC/AC, 11%; and all images, 8%. The supine NC/AC sets of images reduced the number of defects to a greater extent than the supine NC/prone images for all patients (P = .01), men (P = .002), and women (P = .425). For the inferior (but not the anterior) wall, the percent decrease in defects with supine NC/AC images was lower as compared with supine NC/prone images.
  
  
  CONCLUSIONS
  Interpretation with all images resulted in the fewest equivocal studies. The supine NC/AC images reduced the number of equivocal studies to a greater extent than the supine NC/prone images. AC and prone imaging were more helpful in men than women and were more helpful to resolve inferior than anterior wall defects. Adding prone imaging to supine imaging without and with AC does not significantly alter the number of equivocal interpretations.
authors.affiliation: Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232-2675, USA.
authors.forename: Dee
authors.initials: D
authors.lastname: Malkerneker
authors.forename: Reuven
authors.initials: R
authors.lastname: Brenner
authors.forename: William H
authors.initials: WH
authors.lastname: Martin
authors.forename: Uchechukwu K A
authors.initials: UK
authors.lastname: Sampson
authors.forename: Irene D
authors.initials: ID
authors.lastname: Feurer
authors.forename: Marvin W
authors.initials: MW
authors.lastname: Kronenberg
authors.forename: Dominique
authors.initials: D
authors.lastname: Delbeke
mesh_terms: D016477:Artifacts; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005080:Exercise Test; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D016684:Prone Position; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012146:Rest; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin