Covid-19 manifestation on Tl-201 myocardial perfusion SPECT/CT

A 67 years old woman was referred to nuclear medicine center for myocardial perfusion imaging (MPI) for assessment of ischemic heart dieses (IHD).She had a history of atypical chest pain and dyspnea since about 10 days before admission. The MPI SPECT/CT was performed by stress/redistribution Tl-201 protocol. MPI was interpreted as relatively good coronary flow with no appreciable stress induced ischemia. SPECT-CT images revealed multifocal, bilateral and peripheral ground-glass opacities in lungs with subtle background uptake of Tl-201. Considering Covid-19 outbreak, the first diagnosis based on chest CT was Covid-19. This case emphasizing importance of attention to non-cardiac findings in patients undergoing myocardial perfusion imaging, especially review of lung window images in SPECT/CT protocols in the era of covid-19.