A phantom assessment of cold stomach-related artifacts in myocardial perfusion imaging

AIM: To study the effect of a 'cold stomach', caused by either air or water, on Tl-201 and Tc-99m myocardial perfusion single-photon emission computed tomography (MPS). MATERIALS AND METHODS: A stomach insert was created in a thorax phantom. MPS was performed with Tl-201 or Tc-99m. MPS was recorded with an empty stomach, a stomach filled with 0.5 or 1 l of water, or with 0.5 or 1 l of air. For Tc-99m, transmission scans for attenuation correction (AC) were also obtained. RESULTS: In Tl-201 MPS, filling the stomach with air caused an increase of activity in the infero-lateral wall, whereas filling the stomach with 1 l of water resulted in a slight decrease of activity in the infero-lateral wall. In Tc-99m MPS, filling the stomach with air also resulted in a higher activity in the infero-lateral wall, which normalized when AC was applied. Filling the stomach with water caused no marked differences in Tc-99m MPS with or without AC. CONCLUSION: A stomach filled with large amounts of water causes (mild) infero-lateral wall defects in Tl-201 MPS; a stomach filled with air causes a strong scintigraphic overexpression of the infero-lateral wall in both Tl-201 and Tc-99m MPS which can be compensated with AC.