Extracardiac findings with increased perfusion during clinical O-15-H2O PET/CT myocardial perfusion imaging: A case series

Coincidental extracardiac findings with increased perfusion were reported during myocardial perfusion imaging (MPI) with various retention radiotracers. Clinical parametric O-15-H2O PET MPI yielding quantitative measures of myocardial blood flow (MBF) was recently implemented at our facility. We aim...

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Bibliographic Details
Published in:Journal of nuclear cardiology 2023-08, Vol.30 (4), p.1458-1468
Main Authors: Jochumsen, Mads Ryø, Overgaard, David Lyse, Vendelbo, Mikkel Holm, Madsen, Michael Alle, Tolbod, Lars Poulsen, Gormsen, Lars Christian, Barkholt, Trine Ørhøj
Format: Article
Language:English
Subjects:
cardiac PET
Cardiology
coincidental findings
extra cardiac
Imaging
Kidney cancer
Medicine
Medicine & Public Health
myocardial perfusion
Nuclear Medicine
O-15-H2O PET
Original
Original Article
positron emission tomography
Radiology
splenic switch off
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Summary:Coincidental extracardiac findings with increased perfusion were reported during myocardial perfusion imaging (MPI) with various retention radiotracers. Clinical parametric O-15-H2O PET MPI yielding quantitative measures of myocardial blood flow (MBF) was recently implemented at our facility. We aim to explore whether similar extracardiac findings are observed using O-15-H2O. All patients (2963) were scanned with O-15-H2O PET MPI according to international guidelines and extracardiac findings were collected. In contrast to parametric O-15-H2O MBF images, extracardiac perfusion was assessed using summed images. Biopsy histopathology and other imaging modalities served as reference standards. Various malignant lesions with increased perfusion were detected, including lymphomas, large-celled neuroendocrine tumour, breast, and lung cancer plus metastases from colonic and renal cell carcinomas. Furthermore, inflammatory and hyperplastic benign conditions with increased perfusion were observed: rib fractures, gynecomastia, atelectasis, sarcoidosis, pneumonia, chronic lung inflammation and fibrosis, benign lung nodule, chronic diffuse lung infiltrates, pleural plaques and COVID-19 infiltrates. Malignant and benign extracardiac coincidental findings with increased perfusion are readily visible and frequently seen on O-15-H2O PET MPI. We recommend evaluating the summed O-15-H2O PET images in addition to the low-dose CT attenuation images.
ISSN:1071-3581
1532-6551
DOI:10.1007/s12350-022-03156-5