Technical aspects of myocardial SPECT imaging

Myocardial perfusion SPECT imaging accounts for well over 90% of all myocardial perfusion imaging performed in the United States today. Although clearly superior to the traditional planar technique in terms of image contrast and consequent diagnostic and prognostic yield, the SPECT approach also involves additional acquisition and processing steps. This article concisely describes the entire technical sequence of myocardial SPECT imaging, from the acquisition of projection images to their filtration and tomographic reconstruction and concluding with reorientation of the tomographic transaxial images. A simplified explanation of the frequency, or Fourier, domain and the operation of digital filters is also presented to help the reader intuitively understand these important concepts.