PMC6357710_01
Selected axial low-dose computed tomography (a) image acquired for attenuation correction during myocardial perfusion scintigraphy (acquired in prone position). An incidental 10 mm opacity is seen within the right lower lobe. Further evaluation with full-dose diagnostic-quality computed tomography was recommended. Anatomical equivalent (b) shown on single-photon emission computed tomography
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F1
However, a subpleural opacity in the posterior aspect of the right lower lobe was seen on review of the CTAC images [Figure 1a]. The corresponding slice on single-photon emission CT (SPECT) fused with CT is also shown [Figure 1b].
Selected axial (a) and coronal (b) computed tomography images from a CT aorta study Performed 2 months following myocardial perfusion scintigraphy. An incidental right lower lobe opacity, now measuring 12 mm is seen. Urgent further investigation was advised due to suspicion for malignancy
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F2
A further CT aorta took place 2 months following MPS which reported that the nodule now measured 12 mm and was suspicious for malignancy [Figure 2a and b].
Selected axial (a) and coronal (b) computed tomography images from a CT chest performed 14 months after the initial myocardial perfusion scintigraphy occurred. A 23 mm opacity was now present within the right lower lobe with associated hilar lymphadenopathy and multiple smaller opacities within the lung fields. Subsequent computed tomography-guided biopsy revealed lung squamous cell carcinoma
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F3
This revealed that the pleural based opacity in the right lower lobe had grown to 23 mm and was now associated with multiple smaller opacities within the left lung and hilar lymphadenopathy [Figure 3a and b].
Selected axial computed tomography images from (a) low-dose attenuation correction CT acquired during myocardial perfusion scintigraphy (acquired in prone position) and (b) staging computed tomography performed following lung cancer diagnosis 14 months later. Within the limits of the lower dose scan, no hepatic lesions are seen at the time of myocardial perfusion scintigraphy compared with multiple metastatic lesions on staging computed tomography
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F4
Staging CT showed diffuse hepatic metastasis [Figure 4a and b].