Different software tools for quantification of MYOCARDIAL perfusion SPECT (MPS) studies are routinely used. Several perfusion parameters can be computed automatically. Interpretation of the MPS should start with visual inSPECTion of the rotating planar images, visual analysis of reconstructed SPECT slices and then quantitative analysis to confirm the visual impression. Quantification should be used routinely as complementary to visual analysis. Advantages of quantification are: greater confidence in interpretation, better reproducibility, diagnostic accuracy and measuring the degree of abnormality even subtle changes for serial comparisons. In this review, we look at the common features of such quantitative tools: 17- segment scoring system, polar maps including: raw, severity and extent polar maps, lung-to-heart ratio, transient ischemic dilation ratio, total perfusion deficit and spherecity index.

Background: In MYOCARDIAL perfusion SPECT imaging, images are degraded by photon attenuation, the distance-dependent collimator, detector response and photons scatter. Filters greatly affect quality of nuclear medicine images Materials and Methods: A phantom simulating heart left ventricle was built. About 1mCi of 99mTc was injected into the phantom. Images were taken from this phantom. Some filters including Parzen, Hamming, Hanning, Butterworth and Gaussian were exerted on the phantom images. By defining some criteria such as contrast, signal to noise ratio, and defect size detectability, the best filter can be determined. Results : 0.325 Nyquist frequency and 0.5 Nq was obtained as the optimum cut off frequencies reSPECTively for hamming and hanning filters. Order 11 ,cut off 0.45 Nq and order 20 cut off 0.5 Nq obtained optimum reSPECTively for Butterworth and Gaussian filters. Conclusion : The optimum member of every filter’s family was obtained

A 67 years old woman was referred to nuclear medicine center for MYOCARDIAL perfusion imaging (MPI) for assessment of ischemic heart dieses (IHD). She had a history of atypical chest pain and dyspnea since about 10 days before admission. The MPI SPECT/CT was performed by stress/redistribution Tl-201 protocol. MPI was interpreted as relatively good coronary flow with no appreciable stress induced ischemia. SPECT-CT images revealed multifocal, bilateral and peripheral ground-glass opacities in lungs with subtle background uptake of Tl-201. Considering Covid-19 outbreak, the first diagnosis based on chest CT was Covid-19. This case emphasizing importance of attention to non-cardiac findings in patients undergoing MYOCARDIAL perfusion imaging, especially review of lung window images in SPECT/CT protocols in the era of covid-19.

Introduction: MYOCARDIAL SPECT imaging is usually performed acquiring 32 views in 180 degree with equal steps of 5.625 degrees. Acquiring more images requires spending more time or injection of more activity to the patients. An idea to improve the quality reconstructed images without acquiring extra images is producing the extra images interpolating the data between adjacent projections. The aim of present study was investigation the feasibility of this idea.Methods: Obviously such investigation cannot be performed on real patient's data. Therefore, data were simulated using NCAT digital phantom and SimSET Monte Carlo code. The imaging was performed as usual, acquiring 32 views from right anterior oblique to left posterior oblique. The data were interpolated to construct 5 images between adjacent projections convert it into 187 projections. The simulation was performed again acquiring 187 images as the reference. The conventional, interpolated and reference data set were reconstructed and compared for improvement and degradation in quality of final images. The above procedure was repeated for phantoms representing different types of heart disease, different cardiac size and different count densities.Results: The results showed that Hermit interpolation technique produces better quality images comparing to other interpolation methods tested. Results also confirmed that streak artifacts decreases, signal to noise ratio and contrast increased due to increasing the number of samples.Conclusion: These results indicate that the physical properties of reconstructed images improve significantly.This directly must improve the lesions delectability of images. However the matter is still under investigation.

Background: Coronary heart disease (CHD) is a major cause of mortality and morbidity and its management consumes a large proportion of national healthcare budgets. A normal MYOCARDIAL perfusion scintigraphy (MPS) study is associated with a very low rate of future cardiac events. The objective was to determine the risk of future cardiac events after a normal MYOCARDIAL perfusion scan (MPS), and whether clinical risk factors alter the risk of future cardiac events after normal MPS in our local population.Materials and Methods: The data were collected from the nuclear medicine database identifying all the reported normal MYOCARDIAL perfusion scans between January 2008 and December 2011. There were 290 patients identified with normal cardiac nuclear scans in the pre‐specified time frame.103 of these patients were male accounting for 35% of the total population. Average age at the time of examination was 60.6±11.8 years and the highest age group were between 66 and 70 years.Results: There were 2 patients that were admitted with NSTEMI and went on to have diagnostic angiograms. One of those two patients underwent percutaneous coronary intervention with stenting. The other patient had non‐obstructive CAD and was advised for medical management only. These findings are consistent with a 0.7% risk of cardiac events after a negative scan Conclusion: The above findings demonstrate that the risk of major cardiac events after a negative nuclear cardiac scan is low irreSPECTive of the clinical risk factors and is in keeping with the international statistics available.

MYOCARDIAL perfusion SPECT is one of the most common imaging techniques performed in nuclear medicine departments. To avoid misleading interpretation, it is necessary to address the quality control and technical problems. The truncation artifact occurs when the patient size is large relative to the field of view of the camera, causing false perfusion defects in the LV myocardium, misinterpreted as MYOCARDIAL perfusion abnormality. It usually happens in obese patients, who may deviate from the detector field. Here, we present a skinny patient showing MYOCARDIAL truncation artifact, proved to be because of technical issues.