Abnormal focal pulmonary tracer uptake on myocardial perfusion imaging studies

Recurrent 99mTc sestamibi emboli in the lungs revealed on consecutive rest and stress single-photon emission computed tomography/computed tomography myocardial perfusion images

“…Information collected from raw data images is very important for detecting extracardiac findings using myocardial perfusion scintigraphy. Although many causes of incidental focal uptake on raw data images in myocardial perfusion imaging, including malignant diseases, metastatic processes, benign pathologies, and physiological conditions, have been reported in the literature,[123456789101112] to the best of our knowledge, this report is the first to demonstrate iatrogenic 99m Tc-sestamibi embolization on rest and stress myocardial perfusion images at different locations. In our case, SPECT/CT helped to avoid additional diagnostic tests and radiation exposure and provided psychological comfort to the patient by identifying the false-positive result.…”

Importance of systematic review of rotating projection images from Tc99m-sestamibi cardiac perfusion imaging for noncardiac findings

“…Among these are focal liver photopenia representing colon cancer metastasis [2], diffuse appendicular skeleton uptake representing multiple myeloma [3,4], focal thyroid uptake representing Hurthle cell carcinoma [5], anterior mediastinal activity representing malignant thymoma [6], and focal lung uptakes representing bronchogenic carcinoma [7,8], ectopic parathyroid adenoma [9], and carcinoid [10]. In addition, there is a growing collection of reports describing non-neoplastic NCF, such as pleural effusions [11,12], pericardial effusions [13,14], large ovarian cyst [15], large liver cyst [16], large renal cysts [17], large hiatal hernia [17,18], cholecystitis [19,20], lactation [21], gastric wall uptake [22], benign lung nodules [23], acute pulmonary embolism [24], ascites [25,26], gastric reflux [27], and nonspecific dyspepsia [22]. Shih provides good reviews of many of these pathologies on myocardial perfusion imaging (MPI) studies using Tc99m-tetrofosmin [28] and Tl-201 [29].…”