Wei-Jen Shih MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: Tc-99m tetrofosmin is mainly excreted by hepatobiliary clearance and its image similar to the chelescintigraphy. Yet the radiopharmaceutical may be localized in the bone/bone marrow; spleen and/or kidneys can be visualized. During acquisition of Tc-99m tetrofosmin gated cardiac single photon emission computed tomography (SPECT), the field areas covered include the essential organs of the body, encompassing the organs or tissues of the thorax and upper abdomen. In the thorax, the heart, part of the lungs, diaphragm and the thoracic vertebrae are included. The liver, gallbladder, spleen, kidneys, part of the bowel, and lumbar vertebrae are covered by the abdominal cavity. We illustrate abnormal findings in the thoracic and abdominal region. Methods and Materials: Sixty minutes after iv injection 25 mCi Tc-99m tetrofosmin, the patients (pts) were placed in 3-head camera (Prism, Picker) acquired 360 degrees ECG gated SPECT data or 2-head camera (Phillips) acquired 180 degrees data.In addition to viewing the stress and rest SPECT iamges including quantitative perusion SPECT, quantitative gated SPECT, and wall motion, we routinely reviewed 280 pts'raw data images. The cine images presented by 180- or 360-degrees rotation viewed abdominal and thoracic organs or tissues including ribs, sternum, and spine. These abnormalities were correlated with radiography, laboratory, and clinical follow-up. Results: Fivty-five pts had abnormal findings: 15 pts with non-visualization of the gallbladder, 12 with enterogastric reflux, 12 with bone/marrow uptake of the thoracic and lumbar spine due to anemia, 6 high position of the liver resulting in elevation of the right diaphragm, 5 splnomegaly, 2 hepatomegaly, 1 with pleural effusion, 1 with pericardial and pleural effusions, and ascites, and 1 with massive ascites due to hepatic cirrhosis. Among 15 non-visualization of the gallbladder, 9 had cholecystectomies, 6 had chronic cholelithiasis and/chronic cholecystitis. The 12 pts with enterogastric reflux including 4 pts having Billiroth I or II operations, the extracardiac activity of the group pts not only difficulty to process SPECT but also may interfere interpretation of the inferior wall of the LV. Conclusion: a) Enterogastric reflux may complicate the interpretation of the inferior wall of LV; b) Non-visualization of the gallbladder may signify the clinical relevance; and c) Hepatomegaly, splenomegaly, ascites, plural and/or pericardial effusion maybe detected; and d) A bone/bone marrow uptake may predict anemia.       Questions about this event email: wei-jen.shih@med.va.gov

Shih MD, W, Illustration of Intra-abdominal Abnormalities Found during Tc-99m Tetrofosmin Gated Cardiac SPECT.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3102369.html