title: Soft Tissue Attenuation Patterns Associated with Upright Acquisition SPECT Myocardial Perfusion Imaging: A Descriptive Study.
abstract: BACKGROUND
  Little is known about soft tissue attenuation artifacts when an upright patient-position SPECTmyocardial perfusion imaging (MPI) system is used. In this investigation we sought to describe the patterns and frequency of attenuation artifacts associated with this type of instruments and we explored the impact of gender and body habitus on these artifacts.
  
  
  METHODS
  In a cross-sectional study, we described the prevalence of various soft-tissue attenuation patterns in 212 normal SPECT-MPI studies acquired with an upright patient-position imaging system.
  
  
  RESULTS
  In these 212 normal, clinically-indicated, upright-acquisition SPECT-MPIs the attenuation patterns observed were: anterior (6.1%), inferior (63.7%) and lateral (24.1%). Though uncommon, anterior attenuation trended to being more prevalent among women [9.5% vs. 3.4%, P=0.07] and was independently associated with chest circumference. Lateral attenuation was more common among women [34.7% vs. 15.4%, p=0.001] and was strongly associated with obesity (p<0.001). Inferior attenuation was more prevalent among men than women (75.2% vs. 49.5% respectively, P<0.001).
  
  
  CONCLUSIONS
  Soft-tissue attenuation artifacts are common in upright-acquisition SPECT-MPI. Recognizing the frequency of these attenuation patterns and their interaction with gender and body habitus is critical for the accurate interpretation of SPECT-MPI.
authors.affiliation: Section of Cardiology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Rami
authors.initials: R
authors.lastname: Doukky
authors.forename: Mouyyad
authors.initials: M
authors.lastname: Rahaby
authors.forename: Dave
authors.initials: D
authors.lastname: Chawla
authors.forename: Raj
authors.initials: R
authors.lastname: Vashistha
authors.forename: Tareq
authors.initials: T
authors.lastname: Alyousef
authors.forename: Amit P
authors.initials: AP
authors.lastname: Amin