Ancillary Finding on Myocardial Perfusion Imaging Due to Urinary Bladder Displacement

When patients are referred for SPECT myocardial perfusion imaging with Tc-99m agents, attention focuses on the tracer activity in the myocardium. Apart from myocardial activity, normal biodistribution of Tc-99m-sestamibi and Tc-99m-tetrofosmin is seen in the thyroid, liver, gastrointestinal tract, kidneys, and urinary bladder. These structures may be visualized when a gamma-camera with a large field of view is used for SPECT imaging. This case report presents a serendipitous finding of a pelvic mass, which was identified because of the extended field of view afforded by the conventional gamma-camera used for SPECT myocardial perfusion imaging and detected because of a review of the raw images by the nuclear medicine technologist. This case emphasizes the importance of training the nuclear medicine technologist to review the raw data in the entire field of view before study completion.