Rapid Verification of Unusual Tracer Uptake Patterns by Means of SPECT/CT A Case of Unexpected (111)Indium Pentetreotide Accumulation in a Splenic Variant

Abstract

A 45-year-old woman with gluteal mass and a histopathological diagnosis of malign small round cell sarcoma was investigated for metastatic spread. The patient was referred to nuclear medicine for further evaluation by means of somatostatin analogues. (111)Indium-pentetreotide whole body imaging revealed an intense and inverted arrow-shaped uptake in the left upper quadrant resembling cardiac activity. Although the location and posterior appearance of the tracer uptake was indicating somehow splenic activity, a SPECT/CT scan was performed for anatomic verification. The reconstructed SPECT/CT fusion images depicted clearly that the totality of the atypical activity originated from the spleen, which was defined as an anatomic variant. In this case, SPECT/CT easily clarified the unusual appearance of the spleen, suggesting a pathologic finding on conventional whole body imaging.