prone spect

            Male, 54 year old underwent a 201Tl spect perfusion study to rule out myocardial ischemia. Exercise and resting images of vertical axis are displayed and show decreased uptake in the inferior wall in supine position, which does not vary from stress to rest. The possibility of diaphragmatic attenuation was raised but a non transmural myocardial infarction was not discarded in this fixed defect. A prone spect depicted a normal uptake in the inferior wall and so necrosis was ruled out.

            This is also applicable to 99mTc-Mibi Spect perfusion study. Schoss  et al. confirmed a significant decrease in the false-positive results  in the inferior-posterior region of the left ventricle and a 81% accuracy of Spect (1).

References:

1   Schoss RM, Gorten RJ. Comparison of supine versus prone tomographic myocardial imaging. Effect on false-positive rate. Clin Nucl Med. 1996 Jun;21(6):445-51.

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