Noncardiac findings on dual-isotope myocardial perfusion SPECT
Section snippets
Study population
We retrospectively reviewed 12,526 computer-generated text reports of patients who had undergone dual-isotope imaging with Tl-201 at rest and Tc-99m MIBI or TET stress perfusion SPECT over a 6-year period (1993 through 1999). Each report was inspected for a description of an “additional scintigraphic finding” that was noncardiac-related but seen on planar projection images viewed in cine format. Comments about attenuation artifacts (eg, breast shadowing, diaphragmatic attenuation, or
Results
Of the 12,526 reports, a total of 207 NCFs were identified in 180 reports (1.7% of total). The incidence of reporting NCFs varied among interpreters, ranging from 0% to 2.8% of reports, with the highest frequency occurring in the nuclear medicine/cardiology physician who read scans most frequently (56% of all studies) in the laboratory. The overall results are tabulated in Table 1. .
Of the 207 NCFs, 45 (24%) were considered to have a high probability for malignancy (eg, focal breast or lung
Discussion
SPECT myocardial perfusion imaging is a rapidly growing diagnostic technique that plays a pivotal role in the detection and management of patients with ischemic heart disease.1, 2, 3, 4, 5, 6 It is most often performed in older patients, obese subjects, and smokers, all of whom may be at increased risk for development of malignancy or other noncardiac abnormalities that could be detected by nuclear imaging techniques. A widely and increasingly performed SPECT technique, dual-isotope imaging
Acknowledgements
Dr. Williams is a researcher and lecturer for Amersham Healthcare, Inc (manufacturer of thallium 201 and technetium 99m tetrofosmin) and a researcher for Bristol Meyers Squibb, Inc (manufacturer of Tc-99m sestamibi).
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2015, Seminars in Nuclear MedicineCitation Excerpt :99mTc-sestamibi is taken up by various noncardiac tissues, sometimes indicative of severe pathology, especially malignancy.95 In a review of 12,526 MPI studies over a 6-year period, Williams et al reported a 1.7% incidence of such incidental findings, with 24% of these considered high probability of malignancy.96 In Figure 19, SPECT perfusion image findings are seen to be normal, but in the unprocessed SPECT images, extracardiac uptake is seen that was a breast malignancy.
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