Iatrogenic Lung Microembolism Resulted in Extraosseous Uptake of 99mTc-MDP

Abstract

A 61-year-old woman diagnosed with left breast cancer underwent a bone scan for the evaluation of possible bone metastases. Multiple foci of elevated activity were noticed in the spine and pelvis. In addition, a focus of intense activity was observed in the right lung on the SPECT/CT images without corresponding anatomic abnormality.

68Ga-DOTA–Ibandronic Acid PET/CT in a Patient With Chemotherapy-Induced Salivary Gland Hypofunction

“…68 Ga-DOTA-IBA is a new bisphosphonate radiopharmaceutical, which can be used for diagnosis and response evaluation for bone metastasis 1–3 . Previous studies have reported the uptake of bisphosphonate radiopharmaceuticals in extraosseous tissues, including splenic composite hemangioendothelioma, 9 lung microembolism, 10 multiple arterial thromboses, 11 and so on. There is a gap in the study of extraosseous uptake of 68 Ga-DOTA-IBA.…”

Unusual Focal Lung Uptake without CT Abnormality on a Bone Scan: What Might It Mean?

“…Furthermore, unusual lung focal uptake with no morphological abnormality on CT scan were described with several radiotracers such as 99m Tc-dimercaptosuccinic acid ( 99m Tc-DMSA) [7], 99m Tc-sestamibi [8,9], 68 Ga-DOTANOC [10], more recently 68 Ga-PSMA-11 [11] and above all 18 F-fluorodesoxiglucose ( 18 FDG) with which lung hot spots could be present in up to 1.5/1000 exams [12,13]. Despite the great number of bone scan practiced worldwide since decades, this pattern seems extremely rare with bone-seeking tracers, described once with 99m Tc-MDP [14]. A paravenous radiotracer injection due to extravasation has been incriminated in a few cases [15].…”