Case Study 1

Patient History

Patient is a 59-year-old female who presented with atypical chest pain and dyspnea. Patient’s medication chart included Lopressor, Amlodipine, Captopril, Lasix, Aspirin, Zocor, and Bupropion. Time between SPECT and PET exam was 12 days.

Body Habitus

Height: 5’5”
Weight: 140lbs
BMI: 23.3 Kg/m2

SPECT Images

PET Images

Protocol Characteristics
Protocol SPECT PET
Mode of Stress Adenosine (4 minutes) Dipyridamole (4 minutes)
Clinical Response Non-ischemic Non-ischemic
Blood Pressure Response Normal Normal
ECG Response Negative* Negative*
Radiopharmaceutical Tc-99m Sestamibi Rubidium-82
Rest/Stress Dose 12mCi/30mCi 36mCi/36mCi
Gated Yes Yes

* Patient had normal sinus rhythm and non-specific ST-T wave abnormalities on the resting ECG prior to the MPI studies



There was a small defect of moderate intensity in the mid to apical anterior wall that remained fixed on the rest images and most likely is due to breast attenuation artifact; however a non-transmural myocardial scar cannot be excluded.

PET MPI Report

There were no regional perfusion defects seen on the stress or rest images. The patient’s PET/CT test results are normal and suggest no evidence of flow-limiting CAD. The results suggest that the previously described fixed anterior wall defect (her prior SPECT study) is likely to represent an attenuation artifact.

Note: Cardiac catheterization was not performed because the PET MPI study was normal.

Reference: Case study courtesy of Medical Imaging & Technology Alliance ( The report was prepared by Dr. Marcelo DiCarli at Harvard/Brigham & Women’s Hospital in Boston, MA.

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