The value and practice of attenuation correction for myocardial perfusion SPECT imaging: a joint position statement from the American Society of Nuclear Cardiology and the Society of Nuclear Medicine.

Despite advancements in technologies, non-uniform soft tissue attenuation still affects the diagnostic accuracy of single photon emission computed tomography (SPECT) myocardial perfusion imaging. A variety of indirect measures have been used to reduce the impact of attenuation, most notably electrocardiography-gated SPECT imaging. However, all available techniques have limitations, making interpretation in the presence of attenuation difficult. The ultimate solution, similar to positron emission tomography imaging, is to use hardware/ software algorithms to eliminate attenuation and provide images that are more uniform and easier to interpret. Several attenuation correction solutions are currently available and more will be available soon. The value of these solutions has been varied, particularly with clinical applications. Guidelines and standards clearly are necessary. In recognition of the importance of this issue, the American Society of Nuclear Cardiology and the Society of Nuclear Medicine convened a joint task force to develop a position statement on attenuation correction. It is being published concurrently in the Journal of Nuclear Cardiology and The Journal of Nuclear Medicine, a first for these societies. The purpose of this position statement is to clarify the role of attenuation correction in SPECT procedures, to provide guidelines for its clinical use, and to provide a basis for the evaluation of published validation. It is hoped that this position statement will provide an important and useful road map to the widespread adoption of attenuation correction into clinical practice.