Excerpt

Autosomal dominant polycystic kidney disease (ADPKD) has an estimated prevalence of between 1 in 1,000 and 1 in 2,500 individuals worldwide, making it the most common inherited kidney disorder. Its clinical course is characterized by the development and inevitable expansion of numerous cysts in the renal parenchyma. Frequently, patients progress to end-stage renal disease by the sixth decade of life.1 Liver cysts are the most common extrarenal manifestation of ADPKD, but they rarely lead to a significant reduction in hepatic function.2 In this case, impaired liver function due to extensive cystic involvement of ADPKD is demonstrated on single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). The planar projection images are notable for markedly reduced tracer activity in the location of the liver—the major pathway for Tc-99m Sestamibi’s clearance and a site at which activity is normally quite prominent. …