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

Journal Article · Sun Oct 01 04:00:00 EDT 1989 · Journal of Nuclear Medicine; (USA)

OSTI ID:5158914

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

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

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.

• OSTI ID: 5158914
• Journal Information: Journal of Nuclear Medicine; (USA), Journal Name: Journal of Nuclear Medicine; (USA) Vol. 30:10; ISSN 0161-5505; ISSN JNMEA
• Country of Publication: United States
• Language: English

Related Subjects

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