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Prone Myocardial Perfusion Imaging and Breast Attenuation: A Phantom Study

Author(s):

Susie Medeiros Oliveira Ramos*, Adriana Pereira Glavam, Adriana Soares Xavier de Brito, Tadeu Takao Almodovar Kubo, Gustavo Tukamoto, Debora da Cunha Pereira Sampaio and Lidia Vasconcellos de Sa   Pages 1 - 9 ( 9 )

Abstract:


Backgroud: Soft tissue attenuation artifacts are the most common cause of misinterpretation in myocardial perfusion Imaging (MPI). Few studies assessing the value of prone imaging in women have been published. Breast attenuation artifacts can be present in up to 40% of the MPI studies in women.

Objective: This study aimed at evaluating the potential impact of prone MPI on breast attenuation, with a critical analysis of activity optimization and breast size influence.

Methods: MPI of an Anthropomorphic Torso Phantom with silicone breast prostheses and an equivalent adipose tissue was compared to a standard MPI database.

Results: A medical qualitative and semiquantitative analysis demonstrated higher uptake in the LV anterior segments in the prone position for all injected activities. An artificial myocardium lesion was diagnosable in the right segment in all images, which shows that prone positioning would not mask a true lesion and it assists the cardiologist with a more accurate analysis. These results showed that it is possible to optimize the activity to be injected by up to 55.6% when using combined supine-prone images.

Conclusion: Prone position has a high impact on the interpretation of MPI in female patients since it reduces the breast attenuation artifacts, and optimizes de radiation protection of the patient and all staff involved in the procedure, making it more cost-effective.

Keywords:

Myocardial Perfusion Imaging, Prone Imaging, Breast Attenuation Artifacts, Activity Optimization, Breast Size Influence, Anthropomorphic Torso Phantom, Radiation Protection.

Affiliation:

Radiology Department, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Nuclear Medicine Department, CDPI – DASA, Rio de Janeiro, Nuclear Medicine Department, CDPI – DASA, Rio de Janeiro, Brazil; Nuclear Medicine Department, National Institute of Cardiology, Rio de Janeiro, Nuclear Medicine Department, CDPI-DASA, Rio de Janeiro, Brazil; Center for the Development of Nuclear Technology-CDTN, Belo Horizonte, Nuclear Medicine Department, CDPI-DASA, Rio de Janeiro, Brazil; Department of Medical Physics, PhysRAD, Rio de Janeiro, Medical Physics Department, Institute of Radiation Protection and Dosimetry-IRD, Brazilian Nuclear Energy Commission-CNEN, Rio de Janeiro, Medical Physics Department, Institute of Radiation Protection and Dosimetry - IRD. Brazilian Nuclear Energy Commission – CNEN, Rio de Janeiro



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