Thoracic and Abdominal Abnormalities Found on Raw Data Images of Cardiac SPECT

Received 3/25/2005; revised 4/2/2005; accepted 4/8/2005. For correspondence or reprints contact: Wei-Jen Shih, M.D., Nuclear Medicine Service, 1101 Veterans Drive, VA Medical Center, Lexington KY, USA. Tel: (606) 381-5928, Fax: (606) 323-2171, E-mail: [email protected] During acquisition of Tc labeled perfusion agents or Tl-thallous chloride (Tl) gated cardiac SPECT the field area covered includes the essential organs of the body, encompassing the organs or tissues of the thorax and the abdomen. Tl can be localized in benign and malignant lesion, and Tc-tetrofosmin is mostly excreted through hepatobiliary system, the raw data images at one hour may be considered as hepatobiliary scintigram using such as Tc-Choletec. Thus raw data images of dual isotope or 2-day Tc-tetrofosmin cardiac SPECT allow us to view the abnormality in the thorax and/or abdomen. Abnormalit ies above the diaphragm and chest wall include: (1) malignant or benign lesion(s) in the lungs; (2) pleural effusion; (3) pericardial effusion; (4) diffuse and bilateral pulmonary uptake; (5) sternal uptake in anemia and/or hypoxemia; (6) duodenogastroesophageal reflux; (7) hiatus hernia; (8) lucent lungs; (9) mediastinal tumor: atypical carcinoid tumor; and (10) breast cancer. Abnormalities of the diaphragm may include: (1) elevation of the right diaphragm and (2) displacement of the diaphragm on both sides. Abnormal findings below the diaphragm include: (1) hepatomegaly; (2) splenomegaly; (3) cirrhosis of the liver with ascites; (4) vertebral uptake in anemia and/or hypoxemia; and (5) a focal avascular lesion. It is emphasized that: (1) multiple abnormalities in the thorax and/or abdomen may exist as demonstrated by one patient’s raw data images; (2) viewing raw data images should be included as part of cardiac SPECT interpretation; and (3) abnormal findings should also be included in the report to alert clinicians to further investigation if clinically indicated.