Delayed imaging and additional methods to reduce subdiaphragmatic activity in myocardial perfusion SPECT imaging.

Compton scatter from radiotracer in structures close to the heart may partially or completely mask myocardial perfusion defects on SPECT imaging. Previous reports have discussed benefits of additional delayed imaging. We present a case in which additional delayed stress imaging reduced Compton scatter and unveiled clinically significant, stress-induced ischemia.

Bladder diverticulitis on PET/CT.

Diverticula are commonly seen in hollow viscous organs. One common complication of diverticula is infection, known as diverticulitis. Although diverticulitis has been extensively described with respect to the colon, not many cases describe diverticulitis of the urinary bladder.

Decreased myocardial perfusion SPECT lung-to-heart ratio: Lucent lungs.

We present a case of a patient with chronic obstructive pulmonary disease whose myocardial perfusion SPECT imaging demonstrated diffusely decreased Tc-99m sestamibi lung uptake ("lucent lungs"); our results indicate that there may be a lower limit of normal for lung-to-heart ratio, below which pathology can be inferred.

Varices: A potential pitfall in gastrointestinal bleeding scan interpretation.

Gastrointestinal bleeding scans are extremely useful for localizing the source of gastrointestinal bleeding before interventional radiology procedures. It is essential that physicians understand the numerous possible pitfalls when interpreting these scans. Understanding the potential causes of false-positive scan interpretation eliminates unnecessary procedures for the patient and minimizes costs.

Silicone granulomas following free silicone gluteal augmentation.

Gallium-67 citrate has long been used for imaging of infection and inflammation. Although gallium-67 uptake due to silicone implants and silicone injections has been previously reported in the literature, very few cases are documented. We report a case of increased gallium-67 uptake in the buttocks in a patient who previously received silicone injections in the buttocks, to reemphasize silicone augmentation as a potential source of gallium-67 uptake.

Extraperitoneal urinary bladder perforation detected by FDG PET/CT.

Accurate localization of areas of increased metabolic activity on PET only imaging can be challenging. Fusion of PET with CT imaging provides anatomic detail which aids in localization of functional information. As a result, the overall sensitivity and specificity of information provided by PET or CT alone is improved with combined PET/CT resulting in improved diagnosis and patient management.

The role of nuclear imaging in multiple endocrine neoplasia 1 (MEN 1).

Multiple endocrine neoplasia 1 (MEN 1) is a rare genetic disorder classically characterized by a predisposition to tumors of the parathyroid glands, anterior pituitary gland, and pancreatic islet cells (1). In addition to exhibiting these characteristic tumors, MEN 1 patients also have an increased propensity for other tumors such as carcinoids, adrenal adenomas, angiofibromas, and lipomas (1, 2, 3). Although MEN 1 is rare, with a prevalence of approximately 2 per 100,000 people, recognition of this syndrome is extremely important for both patient treatment and evaluation of family members (1, 4).

Nonvisualization of sentinel node by lymphoscintigraphy in advanced breast cancer.

Previous studies have shown that an increased number of axillary lymph nodes with metastatic involvement is associated with nonvisualization of lymph nodes during lymphoscintigraphy. We report a case of nonvisualization of the sentinel node during lymphoscintigraphy in a female with advanced breast cancer to support this association. Although many factors can affect visualization of the sentinel node during lymphoscintigraphy, the presence of advanced metastatic disease involving the lymphatic system must always be considered.

Paradoxical response of prostate cancer skeletal metastases to androgen deprivation therapy.

We report a marked geographically inconsistent response of prostate cancer skeletal metastases to androgen deprivation therapy. Such inconsistent response to therapy has not been described previously in the literature and should be correlated with individual patient history. Further understanding of the mechanism of geographic responses to hormone deprivation therapy may have implications in the targeting of specific regions of disease for treatment in the future.