Training presentation on common artifacts in nuclear cardiac imaging, www.maiedge.com

1. Artifacts in Cardiac Imaging
Sources and Presentation

2. Common Artifact Sources in MPI
 System
 Non-uniformity
 Bad COR
 Patient related
 Upward creep (heart)
 Body fat attenuation
 Diaphragm attenuation
 Patient motion

3. System Artifacts
 Artifacts coming from the camera system are usually
avoidable by performing QC checks on a regular
basis
 Non-uniformity artifacts can show up as “cold” or “hot”
spots on daily floods
 COR Checks can identify a bad COR
 COR artifacts will cause a break in the sinogram of the cine
SPECT acquisition and can cause artifacts after reconstruction

4. Patient Related
 Upward creep of heart
 Sometimes occurs during the post-stress images if the
stress test was recently completed (treadmill/exercise)
 Change in respiration depth can cause the heart to move
upward gradually during acquisition
 More common in:
 Woman
 COPD
 Can result in false-positive results
 Inferoseptal defect
 Anteroseptal defect
 Patient breathing should be monitored and sufficient time
should be waited prior to imaging

5. Patient Related
 Soft Tissue
 Body weight and habitus
 Physician must be aware of patient factors that could
contribute to soft tissue attenuation
 Muscle and fat can both cause attenuation
 Artifact can be a false-positive
 Observe wall-motion and thickening; if decreased then
defect is most likely real
 Breast tissue artifacts
 Anterior, anterolateral, and anteroseptal perfusion defects
 Defect can appear reversible if the breast tissue is not in the
same place in both rest and stress images

6. Patient Related
 Soft tissue (cont)
 Lateral chest wall fat
 Fixed lateral wall defect
 Diaphragmatic attenuation
 Can vary in rest and stress images due to different position of
diaphragm
 Fixed inferior wall defect
 Common in obese patients
 Patient can be imaged prone if artifact is suspected, to move
heart away from diaphragm

7. Patient Related
 Abdominal Visceral/Bowel Uptake
 Artifact causes increased activity in the inferior wall of the
heart
 Liver, gallbladder, bowel
 Water and food can displace bowel activity
 Can image patient prone

8. Patient Related
 Patient motion
 Location of artifact will depend on when motion occurred
during study and in what direction the motion was in
 Worse if motion occurs in middle of acquisition
 Make sure patient is comfortable and understands that
motion can cause a suboptimal study
 Use patient immobilization straps around chest/arms to
help patient’s chest remain still
 Keep patient from sleeping
 Evaluate sinogram for patient motion
 Motion correction software available from some vendors