Soft Tissue Attenuation Patterns Associated with Upright Acquisition SPECT Myocardial Perfusion Imaging: A Descriptive Study

Rami Doukky 1 , *, Mouyyad Rahaby 2, Dave Chawla 1, Raj Vashistha 2, Tareq Alyousef 2, Amit P Amin 2
1 Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
2 Division of Adult Cardiology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 2801
Abstract HTML Views: 617
PDF Downloads: 1014
Total Views/Downloads: 4432
Unique Statistics:

Full-Text HTML Views: 1354
Abstract HTML Views: 349
PDF Downloads: 412
Total Views/Downloads: 2115

Creative Commons License
© Doukky et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Rush University Medical Center, Section of Cardiology, 1653 W. Congress Pkwy, Chicago, IL 60612, USA; Tel: 312-563-2534; Fax: 312-942-6334; E-mail:



Little is known about soft tissue attenuation artifacts when an upright patient-position SPECTmyocardial perfusion imaging (MPI) system is used. In this investigation we sought to describe the patterns and frequency of attenuation artifacts associated with this type of instruments and we explored the impact of gender and body habitus on these artifacts.


In a cross-sectional study, we described the prevalence of various soft-tissue attenuation patterns in 212 normal SPECT-MPI studies acquired with an upright patient-position imaging system.


In these 212 normal, clinically-indicated, upright-acquisition SPECT-MPIs the attenuation patterns observed were: anterior (6.1%), inferior (63.7%) and lateral (24.1%). Though uncommon, anterior attenuation trended to being more prevalent among women [9.5% vs. 3.4%, P=0.07] and was independently associated with chest circumference. Lateral attenuation was more common among women [34.7% vs. 15.4%, p=0.001] and was strongly associated with obesity (p<0.001). Inferior attenuation was more prevalent among men than women (75.2% vs. 49.5% respectively, P<0.001).


Soft-tissue attenuation artifacts are common in upright-acquisition SPECT-MPI. Recognizing the frequency of these attenuation patterns and their interaction with gender and body habitus is critical for the accurate interpretation of SPECT-MPI.

Keywords: SPECT, Myocardial Perfusion Imaging, soft tissue attenuation, artifacts, upright, interpretation..