Main Effects of Obesity on Nuclear Medicine Imaging and Possible Remedies
| Obesity-related difficulty | Impact on imaging | Possible remedy |
| Body configuration | Attenuation | Proper preparation such as adequate hydration (higher amount) |
| Increase of injected activity | ||
| Delayed acquisition in some studies | ||
| Increased time of acquisition | ||
| Access to veins | Possible infiltration | Use of more experienced nuclear medicine technologist |
| Patient discomfort | Use of intravenous team | |
| Help from an anesthesiologist | ||
| Use of ultrasound-guided peripheral intravenous access injection method | ||
| Patient mobility | Possible fall injuries | Use of greater caution |
| Use of accessory gadgets | ||
| Imaging of patient on stretcher (mobile camera may be needed) | ||
| Adequate communication with patient | ||
| Positioning for acquisition | Difficulty in achieving proper positions | Attention to proper and secured positioning |
| Use of pillow, splints, or other means to ensure patient's comfort and thus minimize motion | ||
| Body contouring | Variable distances from camera at different parts of body | Manual adjustment of camera head to obtain adequate images |
| Patient girth | Compton scatter | Use of narrower or asymmetric energy window |
| Insufficient count statistics | Increase of acquisition time | |
| Beam-hardening artifact on CT. | Use of caution during reading and quantification | |
| Reduced sensitivity to peripheral lesions | Comparison with non–attenuation-corrected images | |
| Acquisition of additional spot image studies | ||
| Diaphragmatic attenuation (cardiac) | Masking of underlying organ activity (inferior wall artifact) | Use of prone acquisition in myocardial perfusion |
| Use of attenuation correction | ||
| Breast attenuation (cardiac) | Masking of underlying organ activity (anteroseptal-lateral wall defect) | Breast lifting and binding |
| Use of attenuation correction | ||
| Fat crease and steatopygia | Edge effect/attenuation | Manipulation of crease and reimaging, or addition of SPECT |
| Masking of bone details and creation of false findings | Addition of extra views or SPECT |