False perfusion defect on myocardial perfusion spect induced by sternal tumoral uptake

Sahar Mirpour, Ali Gholamrezanezhad, Kianoush Ansari-Gilani

Research output: Contribution to journalArticle

Abstract

A 61-year-old man with chronic chest pain was referred for a myocardial perfusion scan. Following dipyridamole infusion, 99m Tc-MIBI was injected and the reconstructed images showed decreased activity in the anteroseptal wall, which prompted the supervising physician to review the cinematic data. Reviewing the cinematic images revealed abnormal 99m Tc-MIBI uptake by the ribs, clavicles, and more intensely in the sternum. The next morning, whole-body planar imaging was performed 20 minutes after injection of 99m Tc-MIBI at rest, which again revealed widespread abnormal 99m Tc-MIBI uptake. Subsequently, a skull X-ray showed multiple areas of osteolysis, typical of punched-out lesions. In view of this evidence, the patient underwent bone marrow aspiration, which revealed marked plasmocytosis and confirmed the diagnosis of multiple myeloma. Our case indicates a false positive perfusion defect induced by sternal sestamibi uptake secondary to sternal tumoral involvement. As the sternum is in close proximity to the myocardium, the effects of its unusual radiotracer uptake on the pattern of myocardial perfusion can be significant. The interpretation of a myocardial perfusion scan should not be limited to the heart and, as the ultimate goal is the patient's well-being, any available information should be interpreted.

Original languageEnglish (US)
Pages (from-to)163-167
Number of pages5
JournalHellenic Journal of Cardiology
Volume52
Issue number2
StatePublished - Mar 1 2011
Externally publishedYes

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Keywords

  • Multiple myeloma
  • Myocardial perfusion scintigraphy
  • Sestamibi
  • Sternum

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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