{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:05:54Z","timestamp":1779696354691,"version":"3.53.1"},"reference-count":10,"publisher":"Scientific Scholar","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>Extracardiac images are occasionally revealed on Tc-99m tetrofosmin single photon emission computed tomography-computed tomography (SPECT-CT) imaging due to the known oncotropic properties of the tracer. A large area of inhomogeneous tracer uptake was revealed on SPECT-myocardial perfusion imaging in a 59-year-old male patient referred to our department for suspected coronary artery disease. On subsequent SPECT-CT, the mass was located in the anterior mediastinum, characterized by regular margins not infiltrating the adjacent anatomical structures, and had diameters of 6 cm \u00d7 5.2 cm \u00d7 10.3 cm. A very high uptake ratio value, equal to 26, strengthened the suspicion of giant thymoma. However, an ultrasound (US)-guided transcutaneous core biopsy was deemed necessary before surgical removal of the lesion due to its extremely large size and the absence of associated paraneoplastic syndromes. In this aspect, the SPECT-CT imaging proved to be very useful in guiding the sampling procedure in an area rich in viable cells, due to the presence of multiple areas of necrosis of various sizes that could have affected the outcome of the US-guided core biopsy.<\/jats:p>","DOI":"10.4103\/ijnm.ijnm_48_25","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T14:00:29Z","timestamp":1758290429000},"page":"244-248","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Tc-99m Tetrofosmin SPECT-CT as a Guide to Core Needle Biopsy of a Giant Thymoma"],"prefix":"10.25259","volume":"40","author":[{"given":"Mirco","family":"Pultrone","sequence":"first","affiliation":[{"name":"Department of Medicine and Urgency, Nuclear Medicine Unit, Ospedale Degli Infermi, Ponderano (BI), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Calandri","sequence":"additional","affiliation":[{"name":"Department of Medicine and Urgency, Nuclear Medicine Unit, Ospedale Degli Infermi, Ponderano (BI), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Meli","sequence":"additional","affiliation":[{"name":"Department of Medicine and Urgency, Radiology Unit, Ospedale Degli Infermi, Ponderano (BI), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Maria","family":"Pisacane","sequence":"additional","affiliation":[{"name":"Department of Oncology, Pathology Unit, Ospedale Degli Infermi, Ponderano (BI), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rognoni","sequence":"additional","affiliation":[{"name":"Department of Medicine and Urgency, Cardiology Unit, Ospedale Degli Infermi, Ponderano (BI), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Filippi","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"R1-20250922","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1097\/MNM.0b013e32830b0c45","article-title":"Unexpected 99mTc-tetrofosmin findings during myocardial perfusion scintigraphy: Intraindividual comparison with PET\/computed tomography","volume":"29","author":"Gratz","year":"2008","journal-title":"Nucl Med Commun"},{"key":"R2-20250922","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jtho.2021.10.010","article-title":"The 2021 WHO classification of tumors of the thymus and mediastinum: What is new in thymic epithelial, germ cell, and mesenchymal tumors?","volume":"17","author":"Marx","year":"2022","journal-title":"J Thorac Oncol"},{"key":"R3-20250922","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1378\/chest.118.2.550","article-title":"Detection of occult thymoma during exercise thallium 201, technetium 99m tetrofosmin imaging for coronary artery disease","volume":"118","author":"Paull","year":"2000","journal-title":"Chest"},{"key":"R4-20250922","doi-asserted-by":"crossref","first-page":"57","DOI":"10.4103\/0972-3919.198484","article-title":"Detection of thymoma on 99mTc MIBI scintigraphy: Revisiting the past","volume":"32","author":"Parida","year":"2017","journal-title":"Indian J Nucl Med"},{"key":"R5-20250922","doi-asserted-by":"crossref","first-page":"S102","DOI":"10.1097\/JTO.0000000000000294","article-title":"Approaching the patient with an anterior mediastinal mass: A guide for clinician","volume":"9","author":"Carter","year":"2014","journal-title":"J Thorac Oncol"},{"key":"R6-20250922","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1007\/s12350-020-02371-2","article-title":"Incidental thymoma detection during myocardial perfusion imaging by CZT camera","volume":"29","author":"Bellini","year":"2022","journal-title":"J Nucl Cardiol"},{"key":"R7-20250922","first-page":"260","article-title":"Evaluation by SPECT-CT of an incidental finding of a thymoma and breast cancer in a myocardial perfusion SPECT with 99mTc-MIBI","volume":"32","author":"Garc\u00eda-Talavera","year":"2013","journal-title":"Rev Esp Med Nucl Imagen Mol"},{"key":"R8-20250922","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S1071-3581(05)80076-5","article-title":"Mechanism of uptake of technetium-tetrofosmin. 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