A Monte Carlo investigation of artifacts caused by liver uptake in single-photon emission computed tomography perfusion imaging with technetium 99m-labeled agents

Background Significant hepatobiliary accumulation of technetium 99m-labeled cardiac perfusion agents has been shown to cause alterations in the apparent localization of the agents in the cardiac walls. A Monte Carlo study was conducted to investigate the hypothesis that the cardiac count changes are due to the inconsistencies in the projection data input to reconstruction, and that correction of the causes of these inconsistencies before reconstruction, or including knowledge of the physics underlying them in the reconstruction algorithm, would virtually eliminate these artifacts.