Intrathoracic and intra-abdominal Tl-201 abnormalities seen on rotating raw cine data on dual radionuclide myocardial perfusion and gated SPECT.
OBJECTIVE
The lower thorax and upper abdomen are visualized during cardiac acquisition of rest Tl-201 and stress Tc-99m tetrofosmin gated SPECT. Thus, abnormal Tl-201 localization in these areas and in organs such as parts of the lungs, liver, spleen, and kidneys can be observed, including rotating raw cine data.


METHODS
Other than cardiac images, the authors retrospectively reviewed Tl-201 rotating (raw data) images of 235 patients. Abnormal findings in the lungs, liver, spleen, and kidneys were identified that correlated with the patients' clinical information; radiographic findings, including computed tomography and ultrasonography of the abdomen; other scintigraphic studies; and laboratory findings.


RESULTS
In 53 patients, 54 abnormalities were detected. Intrathoracic abnormalities included focal areas of increased uptake, one in the right lower lung and another in the right upper lung that confirmed lung cancer, in 2 patients; diffuse uptake in both lungs in 11 patients; photopenia in the lung bases, which had resulted from pleural effusions, in 3 patients; and abnormal right liver configuration caused by elevation of the right hemidiaphragm in 1 patient. Of the intra-abdominal abnormalities, 12 patients with splenomegaly were identified. Six patients had focal areas of increased uptake in the gastric area. Nonvisualization of one kidney resulted from a congenitally absent right kidney in 1 patient, from right nephrectomy in 1 patient, from end-stage renal disease in another, and from a lower position of the left or right kidneys in 5 patients. Small and decreased uptake of both kidneys resulted from end-stage renal disease in 1 patient. Small and decreased uptake of one kidney was noted in 1 patient with renal scarring, in 1 patient with a renal stone, in 3 patients with chronic pyelonephritis, and in 5 patients with renal cyst(s).


CONCLUSIONS
Discernible intrathoracic and intra-abdominal abnormalities using rotating raw cine data from imaging in three-dimensional displays include diffuse or focal pulmonary uptake, pleural effusion, elevation of a hemidiaphragm, splenomegaly, increased uptake in the gastric area, renal abnormalities including absent or small kidneys, end-stage renal disease, renal scarring, renal cyst(s), and lower position of a kidney. The incidental finding of such abnormalities may prompt further clinical investigation.
Shih
Wei-jen
WJ
Nuclear Medicine Service, Lexington VA Medical Center, Kentucky 40511, USA. Weh-Jen.Shih@med.va.gov
Kiefer
Vickie
V
Gross
Kelly
K
Wierzbinski
Becky
B
Collins
Judy
J
Pulmano
Calixto
C
Ryo
Yun U
YU
D000005:Abdomen / Q000000981:diagnostic imaging* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000150:complications / Q000000981:diagnostic imaging; D004066:Digestive System Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D008171:Lung Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D009040:Motion Pictures; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013793:Thallium; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C027549:thallium chloride; C078700:technetium tc-99m tetrofosmin; D013793:Thallium