Case Study #1

Correction of Mild Inferior Wall Defect




Patient History

Patient is a 46 year old male who has a family history of heart disease and slightly elevated cholesterol level.




Imaging Procedure

The One Day Cardiolite Protocol was followed, and rest imaging was performed first. Imaging was done on a GE Millennium MG Dual Head Camera with 36 stops/detector, 180 degrees. Images were acquired with ACuscan™ attenuation correction methodology using two movable gadolinium-153 transmission line sources.

Acquisition Parameters:

 Type of AcquisitionTime per stopAgentDoseInjection-Image Interval
RestUngated SPECT25 seconds99mTc Sestamibi10.5 mCi45 minutes post-injection
StressGated SPECT20 seconds99mTc Sestamibi30.8 mCi30 minutes post-injection


Patient exercised 15 minutes on the Bruce protocol to a heart rate of 174 (92% of maximum heart rate) and 16.9 METS. Patient had no symptoms of chest pain and blood pressure response was normal.

Mild Inferior Wall Defect




Clinical Findings:

Non-attenuation corrected images show a mild inferior wall defect, corresponding to a possible RCA lesion. However, with the attenuation corrected images, this inferior wall defect is no longer present, and it can be said with a high degree of certainty that this defect represents diaphragmatic attenuation. Note the filling in of the inferior wall on both the slices and the polar plots.


Images Courtesy of:
Lakeside Cardiology,
Milwaukee, Wisconsin