Diagnosis

1. Myocardial Perfusion Defects

There are inferolateral and anterior myocardial perfusion defects which show partial reversibility of rest images.
 
Persantine Myocardial Perfusion Scintigraphy
Tomographic Slices
SA = short axis; VLA = vertical long axis; HLA = horizontal long axis

2. Padget's Disease

In addition, on the raw sestamibi data there is increase uptake in the skull, particularly in the occipital region.

Bone scan shows findings typical of Padget's disease in the skull.
 

Bone Scan
Whole Body Skull

Another Interesting Image

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J. Anthony Parker, MD PhD, Tony_Parker@bidmc.harvard.edu