Abstract
Technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) is a radiopharmaceutical routinely used in conjunction with exercise or pharmacologic stress for myocardial perfusion scintigraphy. This procedure provides information for the diagnosis and prognosis in patients with suspected coronary artery disease.
Interpretation of these studies includes systematic review of unprocessed rotating projectional images for evaluation of cardiac size as well as the presence of motion or attenuation artifacts. Inspection of raw data for the purpose of quality control may occasionally yield up incidental extracardiac findings that suggest the presence of another primary noncardiac disease.
We present a case of 58 year old woman who underwent 99mTc-MIBI myocardial perfusion scintigraphy due to atypical left-sided chest pain. The raw data in cine mode showed an incidental large photopenic area in the right upper abdominal quadrant.
The photopenic area corresponded to the location of a large intrahepatic cyst on consequential abdominal SPECT/LDCT and was consistent with hepatic cyst found on performed ultrasonography. We review the differential diagnosis of non-physiological accumulation of extra-cardiac activity identified on myocardial perfusion scintigraphy raw data and the importance of routinely analyzing these images for incidental non-cardiac findings.