Traditionally, patients undergoing SPECT Myocardial Perfusion Imaging (MPI) were imaged in the supine position. Although convenient from a procedural standpoint, patient experience and satisfaction may be significantly enhanced through upright imaging. As the technology, image quality, and clinical confidence have continued to improve, upright imaging is gaining more attention and consideration among physicians and technologists.

Supine vs. Upright Imaging

With supine imaging, patients must climb up to, and position themselves on, a roughly 15-24” imaging table. Face-up, they lie still with their arms raised above their heads, which can be difficult or uncomfortable for some, especially those patients with COPD, arthritis or other shoulder or arm impediments. The size and the location of the camera detectors also have the potential to exacerbate any feelings of claustrophobia since they rotate so closely around the patient’s face or chin.

The general consensus among patients is that if you can comfortably get in and out of your car, you can get up and down from an upright imaging scan. Across several formal and informal surveys, the overwhelming majority of patients preferred upright, seated imaging. The patient’s arms rest easily on the device’s armrest, which alleviates the need for the patient to stabilize that overhead weight. The seated position is easy to navigate, and the more compact detectors are much less imposing, which offers a significant improvement in comfort and patient anxiety.

Which is a better choice?

Clinically, choosing one position over the other does not impact the imaging results or the physician’s diagnostic confidence. The preference revolves around comfort and ease of use from both the patient and the technologist’s perspective. In today’s healthcare marketplace, where quality of service can be directly correlated with patient satisfaction, retention, and referrals, upright Myocardial Perfusion Imaging is gaining support in the broader imaging community.