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The correct energy window setting and a stable photopeak position are crucial for good data acquisition. We report a patient whose myocardial perfusion SPECT images showed mildly irregular radiotracer uptake when the patient was prone but not when the patient was supine. Review of the sinogram showed clear interruptions in the sinusoidal shape of the raw data when the patient was prone. Detailed technical evaluation revealed that the artifact was caused by an unstable photopeak position due to malfunction of a power supply board of the gamma-camera. This case emphasizes the importance of reviewing the sinogram display and raw data to assess the integrity of data acquisition and to reveal any potential technical problems such as a spontaneous shift of the photopeak.

Review of the Linogram and Sinogram: An Easy Way to Detect Off-Peak Artifacts in Myocardial Perfusion SPECT