• M. Elizabeth Oates
  • Vincent L. Sorrell


The most common mediastinal condition detected on MPI projection data is hiatal hernia. Hiatal hernias may be “hot” when containing refluxed bile or “cold” when containing nonradioactive fluid or food, and can be a source of SPECT MPI artifact given proximity to the heart. Malignant mediastinal masses (e.g., thymoma) typically appear “hot.”


Esophageal Cancer Hiatal Hernia Mediastinal Lymph Node Mediastinal Mass Refluxed Bile 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

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  1. Bhambhvani P, Dubovsky E, Nath H, Heo J, Iskandrian A. Unusual incidental findings by SPECT myocardial perfusion imaging and CT in the same patient. J Nucl Cardiol. 2010a;17(5):937–8. doi: 10.1007/s12350-010-9219-1.CrossRefPubMedGoogle Scholar
  2. Bhambhvani P, Dubovsky E, Heo J, Iskandrian A. Incidental detection of hepatocellular carcinoma by SPECT myocardial perfusion imaging. J Nucl Cardiol. 2010b;17(6):1116–7. doi: 10.1007/s12350-010-9267-6.CrossRefPubMedGoogle Scholar
  3. Burrell S, MacDonald A. Artifacts and pitfalls in myocardial perfusion imaging. J Nucl Med Technol. 2006;34:193–211.PubMedGoogle Scholar
  4. Chadika S, Kokkirala AR, Giedd KN, Johnson LL, Giardina EG, Bokhari S. Focal uptake of radioactive tracer in the mediastinum during SPECT myocardial perfusion imaging. J Nucl Cardiol. 2005;12(3):359–61.CrossRefPubMedGoogle Scholar
  5. Chamarthy M, Travin MI. Altered biodistribution and incidental findings on myocardial perfusion imaging. Semin Nucl Med. 2010;40:257–70.CrossRefPubMedGoogle Scholar
  6. García-Talavera P, Olmos R, Sainz-Esteban A, Ruiz MÁ, González ML, Gamazo C. Evaluation by SPECT-CT of an incidental finding of a thymoma and breast cancer in a myocardial perfusion SPECT with 99mTc-MIBI. Rev Esp Med Nucl Imagen Mol. 2013;32(4):260–2. doi: 10.1016/j.remn.2012.10.010. Epub 2012 Dec 23.PubMedGoogle Scholar
  7. Gedik GK, Ergun EL, Aslan M, Caner B. Unusual extracardiac findings detected on myocardial perfusion single photon emission computed tomography studies with Tc-99m sestamibi. Clin Nucl Med. 2007;32:920–6.CrossRefPubMedGoogle Scholar
  8. Hawkins M, Scarsbrook AF, Pavlitchouk S, Moore NR, Bradley KM. Detection of an occult thymoma on 99Tcm-tetrofosmin myocardial scintigraphy. Brit J Radiol. 2007;80:e72–4.CrossRefPubMedGoogle Scholar
  9. Niederkohr RD, Chiu E, Nielsen KRK, Maclean M. Extramedullary hematopoiesis within paravertebral masses demonstrating prominent sestamibi and thallium uptake. Clin Nucl Med. 2009;34:506–7.CrossRefPubMedGoogle Scholar
  10. Raza M, Meesala M, Jain D. Unusual radiotracer uptake in the lower mediastinum on sestamibi perfusion images. J Nucl Cardiol. 2005a;12:740–1.CrossRefPubMedGoogle Scholar
  11. Raza M, Meesala M, Panjrath GS, Ghanbarinia A, Jain D. Abnormal photopenic area on nuclear perfusion imaging. J Nucl Cardiol. 2005b;12:607–9.CrossRefPubMedGoogle Scholar
  12. Raza M, Panjrath GS, Haider A, Jain D. Extracardiac abnormalities on myocardial perfusion imaging. J Nucl Cardiol. 2005c;12(Suppl):S36 (abstr).CrossRefGoogle Scholar
  13. Raza M, Panjrath GS, Meesala M, Jain D. Prevalence of incidental non-cardiac findings on SPECT perfusion studies. J Nucl Cardiol. 2005d;12:S121–2 (abstr).Google Scholar
  14. Seo I, Del Priore E, Almonte A, Kappes R, Fedida A, Ong K. Extracardiac lesions: why more prominent on the rest SPECT? J Nucl Cardiol. 2005;12:S122 (abstr).CrossRefGoogle Scholar
  15. Slavin Jr JD, Engin IO, Spencer RP. Retrocardiac uptake of Tc-99m sestamibi: manifestation of a hiatal hernia. Clin Nucl Med. 1998;23(4):239–40.CrossRefPubMedGoogle Scholar
  16. Vijayakumar V, Gupta R, Rahman A. Pathologic extracardiac uptake of Tc-99m tetrofosmin identified in the chest during myocardial perfusion imaging. J Nucl Cardiol. 2005;12(4):473–5.CrossRefPubMedGoogle Scholar
  17. Watanabe N, Hirano T, Fukushima Y. Esophageal cancer detection with Tc-99m tetrofosmin SPECT. Clin Nucl Med. 1997;22:431–3.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • M. Elizabeth Oates
    • 1
  • Vincent L. Sorrell
    • 2
  1. 1.Division of Nuclear Medicine and Molecular Imaging Department of RadiologyUniversity of KentuckyLexingtonUSA
  2. 2.Division of Cardiovascular Medicine Department of Internal Medicine Gill Heart InstituteUniversity of KentuckyLexingtonUSA

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