Supine myocardial 99mTc-sestamibi SPET is affected by artifactual inferior wall defects

In this study, the authors evaluate the clinical assessment of prone SPET. Supine and prone SPET studies were performed at stress and subsequently at rest in 36 male patients with inferior defect on supine images and without a history of inferior infarction. For the inferior wall, the specificities were 31 % and 67 % respectively on supine and prone imaging (p<0.05). The sensitivities were not significantly different, being 76% and 71 % on supine and prone imaging respectively. Among the nine patients with normal LAD and normal aspect of the anterior wall on supine images, three had a small anterior defect on prone images. In conclusion, with sestamibi, prone stress imaging is recommended to improve the inferior wall specificity and complementary supine imaging is possible in cases with abnormal anterior wall. At rest, the choice of patient's position depends on the aspect of the stress images. (authors). 7 refs., 2 figs