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

Rami Doukky 1, *, Mouyyad Rahaby 2, Tareq Alyousef 2, Raj Vashistha 2, Dave Chawla 3, Amit P Amin 4
1 Section of Cardiology, Nuclear Cardiology and Stress Testing Laboratories, Rush University Medical Center, Chicago, IL, USA
2 Division of Adult Cardiology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA
3 Section of Cardiology, Rush University Medical Center, Chicago, IL, USA
4 Division of Cardiology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA

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© 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:



Soft-tissue attenuation patterns in SPECT-myocardial perfusion imaging (MPI) of supine acquisition systems are well recognized. Their prevalence and interaction with body-habitus and gender are ill-defined, which we sought to describe in this study.


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


In 263 normal, clinically-indicated, supine-acquisition SPECT-MPIs the attenuation patterns observed were: anterior (35.4%), inferior (41.8%) and lateral (13.3%). Anterior attenuation was more prevalent among women (50.7% vs. 15.7%, P<0.001) and was associated with chest circumference among men. Conversely, inferior attenuation was more prevalent among men (78.3% vs. 13.5%, P<0.001) and was not affected by body-habitus. Lateral attenuation was more common among women (19.6% vs. 5.2%, p=0.001) and was associated with obesity (p=0.015).


Soft-tissue attenuation artifacts are common in supine-acquisition SPECT-MPI. The recognition of their prevalence and association with body-habitus and gender is critical for the accurate interpretation of SPECT-MPI.

Keywords: SPECT, myocardial perfusion imaging, soft tissue attenuation, artifacts, supine, SPECT acquisition, interpretation..