Subdiaphragmatic activity-related artifacts in myocardial perfusion scintigraphy
Categoría del artículo: Review
Publicado en línea: 15 sept 2024
Páginas: 313 - 319
Recibido: 08 jun 2024
Aceptado: 21 jun 2024
DOI: https://doi.org/10.2478/raon-2024-0053
Palabras clave
© 2024 Anja Strok et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Background
Myocardial perfusion imaging (MPI) with single photon emission computed tomography is an established non-invasive technique for assessing myocardial ischemia. This method involves the intravenous administration of a radiopharmaceutical that accumulates in the heart muscle proportional to regional blood flow. However, image quality and diagnostic accuracy can be compromised by various technical and patient-related factors, including high non-specific radiopharmaceutical uptake in abdominal organs such as the stomach, intestines, liver, and gall-bladder, leading to subdiaphragmatic artifacts. These artifacts are particularly problematic for evaluating inferior wall perfusion and often necessitate repeated imaging, which decreases gamma camera availability and prolongs imaging times.
Conclusions
Despite numerous investigated techniques to reduce interfering gastrointestinal activity, results have been inconsistent, and current MPI guidelines provide scant information on effective procedures to mitigate this issue. Based on our experience, some possible approaches to reducing artifacts include choosing stress testing with an exercise stress test, when possible, late imaging, fluid intake, and consuming carbonated water immediately before imaging.