Appearance of situs inversus totalis and polysplenia syndrome on FDG PET/CT

A 49-year-old woman with a history of breast cancer had undergone surgery, chemotherapy, and radiation therapy for local disease. The patient was referred to our PET/CT department to search for possible metastatic disease. After a 6-hour fast (serum glucose level 120 mg/dL), the patient was injected with 14.9 mCi (555 MBq) F-18 of FDG intravenously. After a I-hour waiting period, the patient was imaged using a dedicated Siemens Biograph LSO HI-REZ integrated PET/CT camera. The CT scan without intravenous contrast was used for anatomic landmarking and attenuation correction. In addition to the metastatic disease on the anterior chest wall, there was situs inversus. Also CT images of the PET/CT study showed multiple spleens along the greater curvature of the stomach in the right side of the upper abdomen.