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The purpose is to compare percentages of myocardial segments showing attenuation in patients in forward tilted position (biker position) or 2 conventional positions (dorsal decubitus or semi sitting) at acquisition with D-SPECT camera in myocardial tomoscintigraphy.
The hypothesis is that the percentage of myocardial segments with attenuation is significantly lower when acquisitions are made in forward tilted position (biker position).
The secondary purpose is to restrict this analysis to 3 cardiac regions most subject to attenuation artifacts (anterior, apical and inferobasal regions).
Myocardial perfusion tomoscintigraphy is a very used technique for diagnosis and characterization of abnormalities of stress and rest myocardial perfusion (ischemia, infarction).
A common problem is attenuation artifacts that are due to tissue interposition attenuating radiation from some cardiac regions. These artifacts originate activity decreasing and thus perfusion abnormalities potentially in all walls of left ventricle, especially the inferior wall in men (attenuation by sub-diaphragmatic organs) and the anterior wall in women (attenuation by mammary glands). These artifacts are observed in rest and stress acquisitions and can lead to a wrong diagnosis of infarction.
Attenuation artifacts can be identified with analysis of contraction kinetics with "gated-SPECT" (normal kinetics and thus discordant with aspect of infarction). With D-SPECT camera some artifacts can be prevented with a 30-35° forward tilted position of acquisition. This position, also called biker position, can take cardiac area away from sub-diaphragmatic structures. It can also reduce the distance between heart and detection surface of camera and limit respiratory movements of thoracic wall.
In this study, patients with abnormal results at stress myocardial perfusion tomoscintigraphy will undergo a rest tomoscintigraphy. Acquisition will be done in forward tilted position and in one of 2 other positions: dorsal decubitus or semi sitting.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| forward tilted | Experimental | Patients with abnormal results at stress myocardial perfusion tomoscintigraphy will undergo a rest tomoscintigraphy. Acquisition will be done in forward tilted position |
|
| semi sitting | Other | Patients with abnormal results at stress myocardial perfusion tomoscintigraphy will undergo a rest tomoscintigraphy. Acquisition will be done in semi sitting |
|
| dorsal decubitus | Other | Patients with abnormal results at stress myocardial perfusion tomoscintigraphy will undergo a rest tomoscintigraphy. Acquisition will be done in dorsal decubitus |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rest tomoscintigraphy in forward tilted | Procedure | Rest tomoscintigraphy in forward tilted position |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of myocardial segments classified with attenuation artifact | With infarction aspect but normal contraction kinetics in Gated-SPECT analysis. Left ventricle is divided in 17 segments according to American Heart Association. | day 0 |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of myocardial segments classified with attenuation artifact in anterior region | day 0 | |
| Percentage of myocardial segments classified with attenuation artifact in apical region | day 0 | |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mathieu PERRIN, Dr | Contact | matperrin@yahoo.fr |
| Name | Affiliation | Role |
|---|---|---|
| Mathieu PERRIN, Dr | Service de Médecine Nucléaire - CHRU de Nancy-Brabois - Vandoeuvre Lès Nancy | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service de Médecine Nucléaire - CHRU de Nancy-Brabois | Recruiting | Vandœuvre-lès-Nancy | France |
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| Rest tomoscintigraphy in semi sitting position | Procedure | Rest tomoscintigraphy in forward tilted position, followed by a second rest tomoscintigraphy in semi sitting position, after max 30 min |
|
| Rest tomoscintigraphy in dorsal decubitus position | Procedure | Rest tomoscintigraphy in forward tilted position, followed by a second rest tomoscintigraphy in semi sitting position, after max 30 min |
|
| Percentage of myocardial segments classified with attenuation artifact in inferobasal region |
| day 0 |