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Introduction: Myocardial perfusion imaging (MPI) faces a challenge in diagnostic accuracy due to gastric wall uptake (GWU). Previous studies have linked GWU to proton pump inhibitors (PPIs) intake, but only a minority of patients on PPIs show activity accumulation. Our study aimed to investigate the influence of PPIs on GWU in MPI by single photon emission computed tomography (SPECT) and assess the necessity or benefits of discontinuing PPIs before the procedure. Methods: The 368 patients who underwent a two-day stress/rest [99mTc]Tc-MIBI SPECT/CT MPI were divided into three groups: (i) Control group (n=114, without the consumption of any gastroprotective medication), (ii) continued medication(n=48, on PPI treatment) and (iii) discontinued medication (n=206, PPI discontinued for one day or more before MPI). Rest SPECT images were analysed for clinically relevant GWU. Results: Based on our study, out of 114 patients in group (i),16 individuals (14%), and 10 patients from 48 patients in group (ii) (20.8%) demonstrated radioactivity accumulation in the gastric wall. In group (iii), despite discontinuing PPIs use, 20.3% of patients showed GWU. Statistical analysis of these three groups and their subgroups did not show any significant difference in terms of gastric wall uptake of [99mTc]Tc-MIBI in MPI. Conclusion: Concisely, our study found no significant link between PPI use and gastric wall activity in MPI. Further data is needed before adjusting drug guidelines in nuclear medicine centers. Multicenter studies with larger patient cohorts must explore the PPI-GWU relationship, utilizing SPECT/CT scans for precise interference location determination. [ABSTRACT FROM AUTHOR]

The diagnosis of patients with fever of unknown origin (FUO) in pediatric heart transplantation is a challenging medical problem. The physician should differentiate between rejections, infections, malignancy, adrenal insufficiency, and drug fever. Immunosuppressive therapy in these patients exposes them to a high risk of developing a post-transplantation fungal infection. In this case, we discuss the diagnostic contribution of the 99mTc-UBI scan and 18F-FDG PET scan for diagnosis of fungal infection causing FUO in these patients. [ABSTRACT FROM AUTHOR]

Background and Aim: It have been shown that changes in organization of high stimulation related to tinnitus in special areas in brain can be eliminated using protocols based on transcranial magnetic stimulation (TMS). The current study aims to assess the pattern of brain perfusion and effects of TMS on brain activity in tinnitus participants as measured by single-photon emission computed tomography (SPECT) as well as evaluate the efficacy of TMS on severity of tinnitus. Methods: This was a cross-sectional randomized clinical trial, which was performed in 15 patients that referred to tinnitus clinic of Rasoul Akram Hospital during March 2017 to April 2018. These participant were randomly divided into two groups of active treatment with TMS and placebo. In each studied group, the variables of the brain perfusion, tinnitus handicap index (THI), pitch-matching test, loudness match of tinnitus, minimum masking level, and residual inhibition were investigated for all included tinnitus participants before and after TMS. Results: In all tinnitus participants, we had increased uptake in temporal lobes (unilateral or bilateral). In active treatment group, SPECT variables in hotspots were significantly decreased in comparison with placebo group (P < 0.05). Visual analog scale of tinnitus was significantly decreased in active group rather than placebo group (P = 0.023). Conclusion: Our findings showed that tinnitus patients have abnormal brain perfusion increased uptake in temporal lobes that decreased with treatment with TMS and therefore this modality could be an appropriate therapeutic option for the improvement of tinnitus in these patients and efficacy of therapy could assessed by brain perfusion scan as well. [ABSTRACT FROM AUTHOR]

Moreover, the reconstructed SPECT images demonstrated abnormal multifocal areas of extracardiac pulmonary uptake of SP 99m sp Tc-sestamibi in both lungs, corresponding to the ground glass opacities in concurrent CT image, which was taken for non-uniform CT-based attenuation correction (Figures 3, 4). Incidental abnormal non-cardiac findings are not uncommon in single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).[1] Thorough inspection of rotating raw and reconstructed images may not only lead to discovery of important non-cardiac disorder but also provide a hint of coronavirus disease 2019 (COVID-19) during its outbreak.[2] We report a challenging finding of multifocal pulmonary uptake in an asymptomatic patient with typical features of pulmonary involvement with COVID-19 infection, incidentally noticed in SPECT MPI. (A) Stress phase; (B) rest phase Graph: Figure 3 SPECT/CT fusion (upper row), CT (middle row), and SPECT (lower row) images in transverse plane. [Extracted from the article]