Extra cardiac activity detected on myocardial perfusion scintigraphy after intra-arterial injection of 99mTc-MIBI.
OBJECTIVE
We present an unusual case of extra cardiac activity of 99mTc-MIBI in the left part of thorax and left upper extremity in a patient admitted for myocardial perfusion scintigraphy.


METHODS
A standard 2-day protocol of 99mTc-MIBI perfusion scintigraphies starting day 1 with stress (dipyridamol) imaging and followed by rest imaging day 2 was performed.


RESULTS
On day 2, when rest perfusion scintigraphy was carried out, extra cardiac activity was present in the left part of thorax and in the left upper extremity resulting in reduced accumulation of 99mTc-MIBI in cardiac tissue, prolongation of the study and interference of the extra cardiac activity with the cardiac image reconstructions. Whole-body scintigraphy disclosed an arterial flow distribution of activity to skeletal muscles in left shoulder and upper limb.


CONCLUSIONS
Accidentally injected radiotracer retrogradely into the arterial system resulted in an unusual extra cardiac activity interfering with later image processing.
Afzelius
Pia
P
Department of Clinical Physiology and Nuclear Medicine, Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, Denmark. pia.afzelius@dadlnet.dk
Henriksen
Jens H
JH
D001132:Arm / Q000000981:diagnostic imaging; D005080:Exercise Test / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D012782:Shoulder / Q000000981:diagnostic imaging*; D017256:Technetium Tc 99m Sestamibi; D013909:Thorax / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi