Clinical value of supine and upright myocardial perfusion imaging in obese patients using the D-SPECT camera
Simona Ben‐Haima b c✉, Omar Almukhailedd e, Johanne Neillf g, Piotr J. Slomkah i, Rayjanah Allied e, Dalia Shitij k, Daniel S. Bermanh i, Jamshed B Bomanjie
- aInstitute of Nuclear Medicine, University College London Hospitals, NHS Trust, London, UK, simona.ben-haim@sheba.health.gov.il
- bChaim Sheba Medical Center
- cUniversity College London Hospitals, NHS Trust
- dInstitute of Nuclear Medicine, University College London Hospitals, NHS Trust, London, UK
- eUniversity College London Hospitals NHS trust
- fCardiology Department, Royal Victoria Hospital, Belfast, Ireland
- gRoyal Victoria Hospital
- hCedars Sinai Medical Center, Los Angeles, CA, USA
- iCedars–Sinai Medical Center
- jSpectrum-Dynamics, Caesarea, Israel
- kSpectrum-Dynamics
- ✉Corresponding author
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Abstract
Purpose: We have assessed whether additional upright imaging increases the confidence of interpretation of stress only supine myocardial perfusion imaging (MPI) in obese patients. Methods and results: Tc-MIBI stress MPI of 101 consecutive patients (M = 49, 62 ± 12 years) with BMI ≥30 scanned on the D-SPECT cardiac camera were assessed. Images were interpreted as diagnostic or equivocal and the need for a rest study was recorded. Stress supine MPI was interpreted first, then gated and finally upright data were added. Defects on supine but not on upright were defined as artefacts and defects seen on both as abnormal. The total perfusion deficit (TPD) was also quantified. There were 27 normal, 22 abnormal, and 52 equivocal supine scans. The median EF was 52%, unaffecting the need for rest imaging. Upright imaging reclassified 32/52 (62%) equivocal studies as normal and 6/52 (11%) as abnormal (P < 0.001). Rest scan was deemed needed in 74/101 patients on supine vs 42/101 on supine/upright (P < 0.001). Supine TPD was normal in 53 and supine/upright TPD was normal in 70 patients (P < 0.001). Conclusion: Supine stress MPI is inadequate in obese patients. The addition of upright imaging significantly increases the ability to interpret scans as diagnostic and may reduce considerably the need for rest imaging.
TL;DRThe addition of upright imaging significantly increases the ability to interpret scans as diagnostic and may reduce considerably the need for rest imaging. (Semantic Scholar)