A comparison between upright and supine myocardial perfusion imaging with attenuation correction
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Updated: May 1, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Deborah Tout1, Christine Tonge, Peter Austin
1Nuclear Medicine Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
Objective:
The Digirad Cardius XACT is an upright myocardial perfusion imaging (MPI) single photon emission computed tomography system offering low-dose computed tomography for attenuation correction (AC). This study compares patient acceptability and image appearance for both non-AC and AC images on the XACT with supine MPI performed on a GE Infinia Hawkeye.
Patients And Methods:
A total of 47 patients [29 male patients; mean (range) BMI, 29.1 (21.0-57.5) kg/m] referred for routine MPI underwent rest and stress MPI on the XACT and Infinia. Non-AC and AC bullseye plots were created and uptake scores were recorded in each of five segments. All studies were reported by an experienced observer with clinical details available. A patient questionnaire was used to determine the relative comfort with the two systems.
Results:
Perfusion patterns on upright and supine non-AC images were significantly different and displayed a notable distinction between sexes. Perfusion patterns on upright and supine AC images were similar for both male and female patients, although some discrepancies between diagnostic reports still existed. A strong preference for upright imaging was demonstrated by the patient questionnaire.
Conclusion:
Changes in soft-tissue and diaphragmatic attenuation between upright and supine MPI can be overcome with the addition of AC. However, clinicians should still ensure that they are aware of typical artefacts produced by upright and supine imaging.
