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99mTc Sestamibi Uptake by Acute Pulmonary Embolism

Conrad Wittram1, Stephen E. Jones1 and James A. Scott2

1 Division of Thoracic Radiology, Department of Radiology, FND 202, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114.
2 Division of Thoracic Radiology, Department of Nuclear Medicine, Massachusetts General Hospital, Boston, MA.


Figure 1
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  		Fig. 1A —Acute pulmonary embolism in 37-year-old woman. Axial 99mTc sestamibi scan shows abnormal radiopharmaceutical uptake within right lower lung (arrow). Normal cardiac uptake is on right of image.

 

Figure 2
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  		Fig. 1B —Acute pulmonary embolism in 37-year-old woman. Coronal (B) and sagittal (C) 99mTc sestamibi scans show abnormal radiopharmaceutical uptake within right lower lung (arrow).

 

Figure 3
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  		Fig. 1C —Acute pulmonary embolism in 37-year-old woman. Coronal (B) and sagittal (C) 99mTc sestamibi scans show abnormal radiopharmaceutical uptake within right lower lung (arrow).

 

Figure 4
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  		Fig. 1D —Acute pulmonary embolism in 37-year-old woman. Axial contrast-enhanced chest CT scan shows well-defined filling defect (arrow) within right lower lobe pulmonary artery at level of posterior and lateral basal segment bifurcation.

 

Figure 5
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  		Fig. 1E —Acute pulmonary embolism in 37-year-old woman. Axial image, inferior to D, shows filling defects (arrows) within posterior and lateral basal segment pulmonary arteries.

 

Figure 6
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  		Fig. 1F —Acute pulmonary embolism in 37-year-old woman. Technetium-99m sestamibi and CT fusion image confirms that right lower lobe 99mTc sestamibi abnormality overlies acute pulmonary emboli (arrow) in posterior and lateral basal segmental arteries. On fusion image, abnormal radiopharmaceutical uptake area on scintigram is larger than identified emboli on CT. Explanation for this observation is that resolution of 99mTc sestamibi perfusion scintigraphy is poor in comparison to that of CT.

 

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