Extracardiac mediastinal uptake incidentally seen during myocardial SPECT studies; are all neoplastic?

Incidentally seen non-cardiac findings during myocardial single photon emission computed tomography (SPECT) imaging are not uncommon. These findings may be an indirect but important indication for a variety of non-cardiac disorders that may occasionally mimic cardiac symptoms. Some of these disorders are gastric diseases, liver and gallbladder diseases, spleen disorders, sternal and vertebral pathologies, and pulmonary diseases. Many reports emphasized the value of reviewing raw data in the process of reporting SPECT studies, a rule that is easily forgotten by nuclear medicine specialists. This systematic way of reviewing raw data is not only used for quality control purposes, but also for better detection of non-cardiac incidental findings.