Upward creep of the heart: A frequent source of false-positive reversible defects during thallium-201 stress-redistribution SPECT

Friedman, J; Van Train, K; Maddahi, J; Rozanski, A; Prigent, F; Bietendorf, J; Waxman, A; Berman, D S

Title: Upward creep of the heart: A frequent source of false-positive reversible defects during thallium-201 stress-redistribution SPECT

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Abstract

A new cause of artifactual {sup 201}Tl defects on single photon emission computed tomography (SPECT) termed upward creep of the heart is described. In 102 consecutive patients undergoing {sup 201}Tl SPECT, 30 (29%) demonstrated upward creep defined by an upward movement of the heart of greater than or equal to 2 pixels during acquisition. In 45 consecutive patients with a less than 5% likelihood of coronary artery disease, 17 (38%) had upward creep. Of these nine had reversible {sup 201}Tl defects localized to the inferior and basal inferoseptal walls, while none of the 28 without upward creep had defects. The 17 low likelihood patients with upward creep had longer exercise duration and higher peak heart rate than those without upward creep. In five additional low likelihood patients with upward creep in whom imaging was immediately repeated, the upward creep pattern disappeared on the repeated images. After we changed our test protocol to begin imaging 15 min postexercise, only five (14%) of 36 low likelihood patients tested demonstrated upward creep. Upward creep is probably related to a transient increase in mean total lung volume early following exhaustive exercise, resulting in a mean lower position of the diaphragm (and thus the heart)more »« less

Authors:

Friedman, J; Van Train, K; Maddahi, J; Rozanski, A; Prigent, F; Bietendorf, J; Waxman, A; Berman, D S ^[1]

Cedars-Sinai Medical Center, Los Angeles, CA (USA)

Publication Date:: Sun Oct 01 00:00:00 EDT 1989

OSTI Identifier:: 5158914

Resource Type:: Journal Article

Journal Name:: Journal of Nuclear Medicine; (USA)

Additional Journal Information:: Journal Volume: 30:10; Journal ID: ISSN 0161-5505

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; CARDIOVASCULAR DISEASES; DIAGNOSIS; HEART; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY; EXERCISE; PATIENTS; THALLIUM 201; BETA DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR SYSTEM; COMPUTERIZED TOMOGRAPHY; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; EMISSION COMPUTED TOMOGRAPHY; HEAVY NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPES; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES; TOMOGRAPHY; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats


                    Friedman, J, Van Train, K, Maddahi, J, Rozanski, A, Prigent, F, Bietendorf, J, Waxman, A, and Berman, D S. Upward creep of the heart: A frequent source of false-positive reversible defects during thallium-201 stress-redistribution SPECT.  United States: N. p., 1989. 
        Web.

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                    Friedman, J, Van Train, K, Maddahi, J, Rozanski, A, Prigent, F, Bietendorf, J, Waxman, A, & Berman, D S. Upward creep of the heart: A frequent source of false-positive reversible defects during thallium-201 stress-redistribution SPECT.  United States.

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                    Friedman, J, Van Train, K, Maddahi, J, Rozanski, A, Prigent, F, Bietendorf, J, Waxman, A, and Berman, D S. 1989.  
        "Upward creep of the heart: A frequent source of false-positive reversible defects during thallium-201 stress-redistribution SPECT".  United States.

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@article{osti_5158914,

  title        = {Upward creep of the heart: A frequent source of false-positive reversible defects during thallium-201 stress-redistribution SPECT},

  author       = {Friedman, J and Van Train, K and Maddahi, J and Rozanski, A and Prigent, F and Bietendorf, J and Waxman, A and Berman, D S},

  abstractNote = {A new cause of artifactual {sup 201}Tl defects on single photon emission computed tomography (SPECT) termed upward creep of the heart is described. In 102 consecutive patients undergoing {sup 201}Tl SPECT, 30 (29%) demonstrated upward creep defined by an upward movement of the heart of greater than or equal to 2 pixels during acquisition. In 45 consecutive patients with a less than 5% likelihood of coronary artery disease, 17 (38%) had upward creep. Of these nine had reversible {sup 201}Tl defects localized to the inferior and basal inferoseptal walls, while none of the 28 without upward creep had defects. The 17 low likelihood patients with upward creep had longer exercise duration and higher peak heart rate than those without upward creep. In five additional low likelihood patients with upward creep in whom imaging was immediately repeated, the upward creep pattern disappeared on the repeated images. After we changed our test protocol to begin imaging 15 min postexercise, only five (14%) of 36 low likelihood patients tested demonstrated upward creep. Upward creep is probably related to a transient increase in mean total lung volume early following exhaustive exercise, resulting in a mean lower position of the diaphragm (and thus the heart) at the beginning of imaging. The frequency of this source of false-positive {sup 201}Tl studies can be reduced by delaying SPECT acquisition until 15 min postexercise.},

  doi          = {},

  url          = {https://www.osti.gov/biblio/5158914},
  journal      = {Journal of Nuclear Medicine; (USA)},

  issn         = {0161-5505},

  number       = ,

  volume       = 30:10,

  place        = {United States},

  year         = {Sun Oct 01 00:00:00 EDT 1989},

  month        = {Sun Oct 01 00:00:00 EDT 1989}

}

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