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Research ArticleImaging

Added Value of CT Attenuation Correction and Prone Positioning in Improving Breast and Subdiaphragmatic Attenuation in Myocardial Perfusion Imaging

Ahmed E. Tawakol, Hazem M. Tantawy, Rana E. Elashmawy, Yasser G. Abdelhafez and Yasser M. Elsayed
Journal of Nuclear Medicine Technology March 2021, 49 (1) 23-29; DOI: https://doi.org/10.2967/jnmt.120.255943
Ahmed E. Tawakol
1Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
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Hazem M. Tantawy
2Department of Nuclear Medicine Technology, Inaya Medical College, Riyadh, Saudi Arabia; and
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Rana E. Elashmawy
1Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
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Yasser G. Abdelhafez
3Nuclear Medicine Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
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Yasser M. Elsayed
1Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
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  • FIGURE 1.
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    FIGURE 1.

    Corrected and uncorrected artifacts using CT AC and prone imaging.

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    FIGURE 2.

    Matching between correction technique and final diagnosis.

  • FIGURE 3.
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    FIGURE 3.

    (A) No-AC images showing mild reversible inferior wall hypoperfusion defect. (B) Stress/rest CT AC images showing normalization of inferior wall hypoperfusion defect. (C) Stress/rest prone images showing normalization of inferior wall hypoperfusion defect.

  • FIGURE 4.
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    FIGURE 4.

    (A) No-AC images showing moderate reversible hypoperfusion defect in anteroseptal wall. (B) Stress/rest CT AC images showing partial improvement of anteroseptal wall defect. (C) Stress/rest prone images showing complete resolution of anteroseptal wall defect (C).

  • FIGURE 5.
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    FIGURE 5.

    (A) No-AC images showing hypoperfusion defect in inferior wall. (B) Stress/rest CT AC images showing partial improvement of inferior wall defect. (C) Stress/rest prone images showing complete resolution of inferior wall defect.

Tables

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    TABLE 1

    Presence or Absence of Myocardial Ischemia in the 14 Excluded Patients

    ParameternNon-ACCT ACProne imaging
    Negative for myocardial ischemia4No perfusion defectNo perfusion defectNo perfusion defect
    Multivessel disease10Perfusion defectPerfusion defectPerfusion defect
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    TABLE 2

    Age and Sex Distribution of the 30 Patients

    SexnPercentageAge (mean ± SD)
    Male2067%54.7 ± 12.5
    Female1033%49.8 ± 11
    Total30100%53 ± 12
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    TABLE 3

    Agreement Between Correction Technique and Uncorrected Images in All Wall Defects

    Final diagnosisCT AC*Prone imaging*
    True defect (n = 22)2222
    Attenuation artifact (n = 31)
     Corrected2826
     Uncorrected35
    Total (n = 53)53
    • ↵* P < 0.001.

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    TABLE 4

    Matching Between Correction Technique and Final Diagnosis

    Correction techniqueFinal diagnosisTotal
    MatchedMismatched
    CT AC50 (94%)3 (6%)53 (100%)
    Prone imaging48 (91%)5 (9%)53 (100%)
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    TABLE 5

    Correlation Between Wall Defects and Final Diagnosis

    ParameterWall defects in CT ACWall defects in prone imagingTrue defectsTotal
    Corrected28 (90.32%)26 (83.8%)None26 (49.1%)
    Uncorrected3 (9.68%)5 (16.2%)22 (100%)27 (50.9%)
    Total31 (100%)22 (100%)53 (100%)
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    TABLE 6

    Specificity and Sensitivity

    ParameterSpecificitySensitivity
    CT AC90.3%100%
    Prone imaging83.8%100%
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Journal of Nuclear Medicine Technology: 49 (1)
Journal of Nuclear Medicine Technology
Vol. 49, Issue 1
March 1, 2021
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Added Value of CT Attenuation Correction and Prone Positioning in Improving Breast and Subdiaphragmatic Attenuation in Myocardial Perfusion Imaging
Ahmed E. Tawakol, Hazem M. Tantawy, Rana E. Elashmawy, Yasser G. Abdelhafez, Yasser M. Elsayed
Journal of Nuclear Medicine Technology Mar 2021, 49 (1) 23-29; DOI: 10.2967/jnmt.120.255943

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Added Value of CT Attenuation Correction and Prone Positioning in Improving Breast and Subdiaphragmatic Attenuation in Myocardial Perfusion Imaging
Ahmed E. Tawakol, Hazem M. Tantawy, Rana E. Elashmawy, Yasser G. Abdelhafez, Yasser M. Elsayed
Journal of Nuclear Medicine Technology Mar 2021, 49 (1) 23-29; DOI: 10.2967/jnmt.120.255943
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