Truncation in Myocardial Perfusion SPECT Imaging

Myocardial perfusion single photon emission computed tomography (SPECT) imaging (MPI) is commonly used to evaluate patients for myocardial ischemia. One confounding factor during scan interpretation is imaging artifacts. Physicians must be aware of the various imaging artifacts that may occur to avoid false positive results. Truncation of the heart during nuclear imaging has been previously described but has not been emphasized as much as other imaging artifacts. Truncation leads to artifacts in the reconstructed tomographic images, which may be misinterpreted as perfusion defects. We recently reported a case where truncation of the myocardium occurred in the planar stress and rest acquisition datasets. Currently, we report a case of truncation of the heart which was not present in the original planar stress acquisition dataset, but rather was introduced by shifting of the image sequences during the automated joining of the two separate detector datasets, an integral part of multidetector SPECT reconstruction.