Incidence and characterisation of patient motion in myocardial perfusion SEPCT: part 1

Despite advances in 99mTc-based radiopharmaceuticals and multiple-detector gantries, patient motion in myocardial perfusion SPECT acquisitions is still problematic and may produce artifacts that mimic coronary artery disease. Methods: A prospective cross-sectional study of 800 myocardial perfusion SPECT studies performed with 99mTc-based radiopharmaceuticals at 3 private nuclear medicine sites was used to determine the incidence, type, and location of visually detectable motion. The rotating cinematic display and sinograms of the ungated datasets were visually assessed by 2 experienced technologists unaware of the other observer's responses and the clinical outcome. Results: Among the 800 studies analyzed, 36% contained visually detectable motion. Motion was seen on 31.5% of rest studies, compared with 40.5% of stress studies (P = 0.004). The most common type of motion detected was multiple bounce, which represented 47.6% of motion. Left anterior oblique and anterior were the most common specific locations in which patient motion was detected in the raw data. Conclusion: This investigation established the significant incidence of patient motion during 99mTc-based myocardial perfusion SPECT studies that, fully realized, has the potential to introduce artifacts leading to false-positive findings. Further investigation of the impact of various types and degrees of patient motion is recommended.