How to evaluate incidental extracardiac findings on hybrid PET and SPECT/CT imaging?

Cardiac SPECT-CT and PET-CT studies often have clinically actionable non-cardiac pathologies, making thorough interpretation critical. The American Society of Nuclear Cardiology (ASNC) emphasizes importance of reviewing both cardiac and extracardiac regions to ensure that significant incidental findings are not overlooked. Although CT images used for attenuation correction are often low in resolution and lack diagnostic detail, they can still reveal incidental findings that warrant further evaluation with dedicated imaging. In this manuscript, we highlight clinically relevant extracardiac and limited upper abdominal findings that may be of value to the interpreting physicians.