Case Study # 2

Correction of Significant Inferior Wall Defect




Patient History

Patient is a 64 year old male with multiple risk factors for CAD, including family history of cardiac events, elevated blood pressure, and elevated cholesterol.




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 Sestamibi13.8 mCi45 minutes post-injection
StressGated SPECT20 seconds99mTc Sestamibi40.2 mCi30 minutes post-injection


Patient exercised 8+ minutes on the Bruce protocol to a heart rate of 158 (101% of maximum heart rate) and 9.7 METS. Patient did not have any chest pain, chest pressure, or unusual shortness of breath. At peak exercise, EKG showed upsloping J-point depression.

Significant Inferior Wall Defect




Clinical Findings:

Non-attenuation corrected images show a significant defect in the posterior and inferior walls on both rest and stress. Attenuation corrected images do not show this defect. The appearance of the inferior wall has substantially improved on both the attenuation corrected slices and polar plots. These images, plus the fact that the wall motion analysis showed normal contractility throughout the myocardium, determined that the study was normal.


Images Courtesy of:
Lakeside Cardiology,
Milwaukee, Wisconsin