Impact of patient motion on myocardial perfusion SPECT diagnostic integrity

Objective: Advances in ^99mTc-based radiopharmaceuticals and multiple-detector gantries have the potential to increase the significance of patient motion on the diagnostic integrity of myocardial perfusion SPECT acquisitions. Methods: An experimental study was used to evaluate the effect of various patient motions on the diagnostic integrity of myocardial perfusion SPECT data using 522 motion simulations generated from a technically and diagnostically normal dataset. Results: Of studies with induced motion, 21.7% of simulated motion demonstrated motion-induced artifacts. Abrupt motion resulted in artifacts for 52.6% of studies, whereas bounce motion resulted in artifacts in 6.8% of studies. The locations where motion resulted in the most studies with artifacts were at 45° (36.1%) and 75° (32.4%). No statistical difference was demonstrated between single, dual-, and triple-head configurations. Conclusion: Combining these results with those of the clinical evaluation of incidence indicates that patient motion during ^99mTc-based myocardial perfusion SPECT studies is a potential source of false-positive findings for coronary artery disease. There is a 7.1% probability that myocardial perfusion SPECT studies performed at the 3 sites investigated will contain a motion-induced artifact. Fully realized, this potential results in decreased test specificity and unfavorable cost and consequence outcomes.