Three Cases of Rare Systematic Errors Due To Unstable PM Tube Gain in Gated Myocardial Perfusion Imaging

Document Type : Technical Notes

Authors

1 Firoozabadi Hospital, department of nuclear medicine, Iran University of Medical Sciences, school of medicine, Tehran, Iran.

2 Hazrate Rasool Akram Hospital, department of nuclear medicine, Iran University of Medical Sciences, school of medicine, Tehran, Iran.

3 Department of Medical Physics, Faculty of Medicine, Semnan University of Medical Science, Semnan, Iran

Abstract

Introduction: Myocardial perfusion imaging (MPI) is a valuable diagnostic tool for the diagnosis of coronary artery disease (CAD) and is susceptible to a variety of artifacts, which degrade image quality and decrease diagnostic accuracy. Pitfalls and Artifacts in nuclear medicine imaging are not rare and could be classified into issues related to patients, equipment, and technologist. One of these artifacts is unstable PMT gain, which is rare and related to equipment. It is crucial for nuclear physicians to be aware of potential artifacts and their potential effect on image quality. This knowledge helps them to prevent or correct these artifacts if possible and if not, consider the potential effect of these artifacts on image pattern and quality. Some of these artifacts are preventable by routine quality control procedures, but some other artifacts may occur regarding quality control procedures.
Material and Methods: Three different female subjects 55, 57, and 61 years old with a history of atypical chest pain were referred to our department for myocardial perfusion imaging. MPI was performed according to standard protocols and stress, and rest phases were done.
Results: These three cases had different patterns of perfusion abnormalities due to interruption of count detection for a few seconds in some frames during acquisition that was due to voltage drop that leads to unstable PM tube gain.
Conclusion: Systematic errors due to voltage drops are not common, and they are not routinely sort of suspicion to artifactual perfusion abnormalities but they may cause misinterpretation of reports of MPI, and we should be aware of them.

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Main Subjects

References

  1. Malek H, Hedayati R, Yaghoobi N, Firoozabadi H, Rastgou F, Bitarafan Rajabi A. Association Between Blunted Heart Rate Response to Dipyridamole and Myocardial Ischemia in Diabetic Patients as Compared With Nondiabetic Patients. Iranian Heart Journal. 2020 Jan 1;21(1):67-74.
  2. Malek H, Hedayati R, Yaghoobi N, Behnia M, Rastgou F, Bitarafan Rajabi A, et al. The relationship between retinopathy in diabetes mellitus type 2 and severity and extent of myocardial ischemia in myocardial perfusion imaging. Iranian Heart Journal. 2013;13(4):6-14.
  3. Malek H, Hedayati R, Yaghoobi N, Firoozabadi H, Rastgou F, Bitarafan Rajabi A. Association Between Blunted Heart Rate Response to Dipyridamole and Myocardial Ischemia in Diabetic Patients as Compared With Nondiabetic Patients. Iranian Heart Journal. 2020 Jan 1;21(1):67-74.
  4. Burrell S, MacDonald A. Artifacts and pitfalls in myocardial perfusion imaging. Journal of nuclear medicine technology. 2006 Dec 1;34(4):193-211.
  5. Verberne HJ, Acampa W, Anagnostopoulos C, Ballinger J, Bengel F, De Bondt P, et al. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision. European journal of nuclear medicine and molecular imaging. 2015 Nov;42(12):1929-40.
  6. Kheruka SC, Naithani UC, Aggarwal LM, Painuly NK, Maurya AK, Gambhir S. An Investigation of a Sinogram Discontinuity Artifact on Myocardial Perfusion Imaging. Journal of Nuclear Medicine Technology. 2012 Mar 1;40(1):25-8.
  7. Schofield R, Menezes L, Underwood SR. Nuclear cardiology: state of the art. Heart. 2021 Jun 1;107(12):954-61.
  8. Singh B, Bateman TM, Case JA, Heller G. Attenuation artifact, attenuation correction, and the future of myocardial perfusion SPECT. Journal of Nuclear Cardiology. 2007 Mar;14(2):153-64.
  9. Dvorak RA, Brown RK, Corbett JR. Interpretation of SPECT/CT myocardial perfusion images: common artifacts and quality control techniques. Radiographics. 2011 Nov;31(7):2041-57.
  10. Malek H, Yaghoobi N, Hedayati R. Artifacts in Quantitative analysis of myocardial perfusion SPECT, using Cedars-Sinai QPS Software. Journal of Nuclear Cardiology. 2017 Apr;24(2):534-42.
  11. Dorbala S, Ananthasubramaniam K, Armstrong IS, Chareonthaitawee P, DePuey EG, Einstein AJ, et al. Single Photon Emission Computed Tomography (SPECT) Myocardial Perfusion Imaging Guidelines: Instrumentation, Acquisition, Processing, and Interpretation. J Nucl Cardiol. 2018 Oct;25(5):1784-846. DOI: 10.1007/s12350-018-1283-y

 

 

 

Iranian Journal of Medical Physics
Volume 20, Issue 1
January and February 2023
Pages 7-10

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History

  • Receive Date: 16 January 2022
  • Revise Date: 13 April 2022
  • Accept Date: 24 April 2022

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