Single Photon Emission Computed Tomography (SPECT) has the unique
ability to evaluate myocardial perfusion, at the cellular level, under peak stress
conditions. In that sense, by evaluating viability, SPECT myocardial perfusion imaging
(MPI) can establish prognosis and assess the effectiveness of therapy, thus becoming a
valuable modality in diagnosing and managing cardiac patients. Nevertheless, SPECT
MPI can be exposed to various pitfalls and artifacts that may affect negatively the
reliability of the technique, arising from a number of sources at any stage of this
complex imaging process that includes patient-related, software- and equipment-related
and user-related factors. By understanding and recognizing the sources of these pitfalls
and artifacts, the reader should be able to make all the necessary steps to limit the
sources of error, and more importantly to interpret the results of a study by taking into
account their relative influence.
Keywords: Artifacts, Attenuation artifacts, Breast attenuation, Cardiac imaging,
Diaphragmatic attenuation, Myocardial perfusion imaging, Pitfalls, Single photon
emission computed tomography.