Myocardial perfusion imaging (MPI) can be affected by physical artefacts, such as attenuation and Compton scatter, both related to patient's morphological characteristics and his/her position during acquisition. These positional artefacts have been largely studied with classical Anger cameras. Recently, a new generation of heart-dedicated cameras has emerged, using novel cadmium–zinc–telluride (CZT) semi-conductors, with different physical characteristics and geometrical distribution. Our study aimed to investigate, in this new generation camera, the relation between patient's positioning and the occurring of physical artefacts. Plus, we examined whether these artefacts were likely to affect the interpretation made with such images. Material and methodsIn this prospective study, we included 60 patients scheduled in our unit for MPI. All of them underwent both prone and supine acquisitions, after stress test as well as at rest. ResultsAt a global population level, we observed significantly more abnormalities in supine acquisitions in territories mainly vascularized by right coronary artery, and to a lesser extent, by circumflex artery, than observed in prone acquisitions. No scoring difference was observed, regardless of position, in Summed Stress Score, Summed Rest Score or Summed Difference Score. This observation remained the same whether on a global population level, or on a BMI- and perimeter-basis level. ConclusionPosition related physical artefacts, such as attenuation and Compton scattering, are similar to those previously described with Anger cameras. These artefacts do not affect the interpretation of myocardial scans significantly, provided that both images are acquired in the same anatomical position.