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J Nucl Med. 2006 Aug;47(8):1312-8.

Clinically significant abnormal findings on the "nondiagnostic" CT portion of low-amperage-CT attenuation-corrected myocardial perfusion SPECT/CT studies.

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  • 1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland, USA.


Attenuation correction is recommended to optimize the performance of cardiac SPECT. The 2.5-mA CT commonly used for this purpose in myocardial perfusion SPECT is generally considered "nondiagnostic" in quality. In other areas of cardiac and hybrid imaging, diagnostically relevant abnormal findings on higher-quality CT studies have been described. The purpose of this study was to establish the frequency and significance of abnormal findings on low-amperage-CT cardiac SPECT/CT scans and to assess whether a systematic review of the nondiagnostic CT findings should be recommended.


Two hundred consecutive patients who underwent clinical low-amperage-CT attenuation-corrected myocardial perfusion studies acquired on a SPECT/CT system were included in the study. The cardiac CT images were reviewed in consensus by both an experienced CT reader and a nuclear medicine resident less experienced in CT. Abnormal CT findings of varying significance were recorded.


Eighty-one patients had no abnormal CT findings. In the remaining 119 patients, 234 abnormalities were detected. Twenty-five major findings (in 21 patients) were seen, and 16 of these had been previously unrecognized. Sixty-four minor and 131 minimal findings were noted. Fourteen findings were labeled as equivocal (i.e., the CT findings were not definite).


Potentially significant abnormal findings on the nondiagnostic-CT portion of the cardiac SPECT/CT examination were detected in 10.5% of our patients. These data suggest that, in addition to the review of the emission image dataset, low-amperage-CT findings should routinely be assessed for major diagnostic abnormalities.

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