"Window on the heart" technique for diagnosis of recent myocardial infarction using Tc-99m pyrophosphate SPECT subtraction imaging

Detection of acute myocardial infarction by SPECT with Tc-99m pyrophosphate is complicated by overlying bony structures, such as the ribs and sternum. The authors report a technique using volume rendered rotating SPECT images with digital subtraction of overlying ribs. The technique is described and illustrated by case reports in which the diagnostic accuracy was improved with its use. This technique has diagnostic use in difficult clinical cases, and where avid radiotracer uptake in the ribs or sternum obscures the underlying myocardium.