Evaluation of adenosine-induced splenic switch-off in Tc-99m tetrofosmin (Myoview) myocardial perfusion studies as marker of stress adequacy by semiquantitative analysis of acquired single-photon emission computed tomography/computed tomography images
- 1Department of Nuclear Medicine, College of Medicine, Kuwait University, Kuwait
- 2Department of Nuclear Medicine, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
Abstract
Aim/Introduction: Adenosine pharmacological stress is commonly used for the detection of ischemia by myocardial perfusion imaging (MPI) using radiotracers and gated single-photon emission computed tomography/computed tomography (SPECT/CT) imaging. Recently, a phenomenon, splenic switch-off (SSO), has been observed where reduced perfusion to the spleen occurs after adenosine, suggesting an adequate effect of adenosine on the heart. The aim of the study is to evaluate the SSO effect in adenosine stress 99mTc tetrofosmin MPI studies using semiquantitative analysis of SPECT/CT data.
Materials and methods: Seventeen adenosine MPI studies were selected. Each study included stress and rest, which were reoriented in short, horizontal, and vertical long axes. Also, data were reconstructed in the body transaxial, coronal, and sagittal planes. In the resulting images, the spleen was identified on the CT component, and regions of interest were drawn on the spleen, thoracic vertebra, and myocardium. The ratios spleen/vertebra (S/VAd and S/VRst) and myocardium/vertebra (M and M/t) were calculated. Statistical analysis was done using a paired t test.
Results: Mean age was 60.35 years, with 9 males (53%). Mean S/VAd was 0.98 ± 0.38 and S/VRst 1.87 ± 0.87 (t = −3.707, P < 0.01). The mean M/VAd was 2.86 ± 1.65 and M/VRst 3.75 ± 2.41 (t = −1.323, P = 0.204).
Conclusion: Using the method outlined, especially the S/V ratio, evaluation of the SSO can be achieved from the acquired data, which shows promise as a marker for adequate effectiveness of adenosine stress in doubtful cases.
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BibTeX
@article{alkandari2026evaluation,
title = {{Evaluation of adenosine-induced splenic switch-off in Tc-99m tetrofosmin (Myoview) myocardial perfusion studies as marker of stress adequacy by semiquantitative analysis of acquired single-photon emission computed tomography/computed tomography images}},
author = {Noor F. AlKandari and Maryam M. Bouzabar and Danah A. AlDhafiri and Fatma R. AlShammari and Hawraa B. Humoud and Issa Loutfi},
journal = {Nuclear Medicine Communications},
year = {2026},
month = jul,
doi = {10.1097/mnm.0000000000002203},
url = {https://doi.org/10.1097/mnm.0000000000002203},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Evaluation of adenosine-induced splenic switch-off in Tc-99m tetrofosmin (Myoview) myocardial perfusion studies as marker of stress adequacy by semiquantitative analysis of acquired single-photon emission computed tomography/computed tomography images
AU - Noor F. AlKandari
AU - Maryam M. Bouzabar
AU - Danah A. AlDhafiri
AU - Fatma R. AlShammari
AU - Hawraa B. Humoud
AU - Issa Loutfi
PY - 2026
DA - 2026/07/07
JO - Nuclear Medicine Communications
DO - 10.1097/mnm.0000000000002203
UR - https://doi.org/10.1097/mnm.0000000000002203
AB - Aim/Introduction: Adenosine pharmacological stress is commonly used for the detection of ischemia by myocardial perfusion imaging (MPI) using radiotracers and gated single-photon emission computed tomography/computed tomography (SPECT/CT) imaging. Recently, a phenomenon, splenic switch-off (SSO), has been observed where reduced perfusion to the spleen occurs after adenosine, suggesting an adequate effect of adenosine on the heart. The aim of the study is to evaluate the SSO effect in adenosine stress 99mTc tetrofosmin MPI studies using semiquantitative analysis of SPECT/CT data. Materials and methods: Seventeen adenosine MPI studies were selected. Each study included stress and rest, which were reoriented in short, horizontal, and vertical long axes. Also, data were reconstructed in the body transaxial, coronal, and sagittal planes. In the resulting images, the spleen was identified on the CT component, and regions of interest were drawn on the spleen, thoracic vertebra, and myocardium. The ratios spleen/vertebra (S/VAd and S/VRst) and myocardium/vertebra (M and M/t) were calculated. Statistical analysis was done using a paired t test. Results: Mean age was 60.35 years, with 9 males (53%). Mean S/VAd was 0.98 ± 0.38 and S/VRst 1.87 ± 0.87 (t = −3.707, P < 0.01). The mean M/VAd was 2.86 ± 1.65 and M/VRst 3.75 ± 2.41 (t = −1.323, P = 0.204). Conclusion: Using the method outlined, especially the S/V ratio, evaluation of the SSO can be achieved from the acquired data, which shows promise as a marker for adequate effectiveness of adenosine stress in doubtful cases.
SN - 0143-3636
SN - 1473-5628
ER -