Review of Extraskeletal Activity on Tc-99m Methylene Diphosphonate Bone Scintigraphy and Value of Cross-Sectional and SPECT-CT Imaging Correlation

Bermo, Mohammed; Behnia, Fatemeh; Fair, Joanna; Miyaoka, Robert S.; Elojeimy, Saeed

doi:10.1067/j.cpradiol.2017.07.009

Cited by 8 publications

(7 citation statements)

References 44 publications

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“… 3 Extraosseous uptake must be carefully assessed and it may occur due to a wide variety of factors such as benign or malignant disease processes, artefactual causes (such as other recent nuclear medicine investigations) or technical errors in the preparation or administration of the radiopharmaceutical – although these are rare with modern quality control measures. 4,5 As extraosseous uptake is relatively rare and planar imaging is less familiar to current radiologists than in previous eras, an understanding of the patterns of extraosseous uptake on planar imaging and the associated causes is important for daily practice. 5 …”

Section: Introductionmentioning

confidence: 99%

“…Ischaemic or infarcted tissue may take up bone avid radiotracers, likely as a result of an increase in intracellular calcium, and radiotracer accumulation has been demonstrated at sites of infarction in the brain, heart and liver. 4,6 Irreversibly damaged cells at the infarct site require some residual blood flow to demonstrate increased uptake and often after 7–10 days sites of acute infarction no longer show radiotracer uptake. 6,8 …”

Section: Introductionmentioning

confidence: 99%

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Incidental cardiac uptake in bone scintigraphy: increased importance and association with cardiac amyloidosis

et al. 2021

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Extraosseous radiotracer uptake during bone scintigraphy must be carefully assessed and it offers the potential to detect previously undiagnosed disease processes. A range of neoplastic, metabolic, traumatic, ischaemic and inflammatory disorders can cause soft tissue accumulation of bone avid radiopharmaceuticals. Accordingly, cardiac uptake in bone scintigraphy has a broad differential diagnosis and is commonly attributed to ischaemia/infarction related to coronary artery disease. However, there has been renewed focus on incidental cardiac uptake in recent years in light of significant developments in the diagnosis and management of cardiac amyloidosis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidental cardiac uptake in bone scintigraphy: increased importance and association with cardiac amyloidosis

et al. 2021

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“…The diagnostic accuracy of planar bone scintigraphy (PBS) increases by adding SPECT/CT imaging for these lesions (6) . SPECT/CT is useful in characterization and anatomical localization of these uncertain lesions that might be misinterpreted as skeletal metastasis in planar bone scintigraphy leading to misdiagnosis with inaccurate management of patients and unnecessary treatment (7,8) .…”

Section: Introductionmentioning

confidence: 99%

Added Value of SPECT/CT in Characterization of Extra-Skeletal Uptake of Tc-99m MDP on Planar Bone Scintigraphy in Known Cancer Patients.

2021

Egyptian Journal Nuclear Medicine

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Introduction: Extra-skeletal Tc-99m MDP uptake is not uncommon. It could be a problematic when it mimics a metastatic osseous lesion. Due to lack of proper anatomical localization, Planar bone scintigraphy (PBS) alone can't resolve this problem. Adding single photon emission tomography / computed tomography (SPECT/CT) images increases the diagnostic accuracy of planar bone scintigraphy. SPECT/CT has great impact on patients' management by preventing misinterpretation through precise localization and proper characterization of these uncertain lesions. In this study, we compared the diagnostic accuracy of SPECT/CT versus PBS in characterization of extra-skeletal lesions detected on conventional PBS in known cancer patients. Materials and Methods: This is a retrospective study including 50 patients with known cancer referred for conventional (PBS) for metastatic work up. PBS was acquired followed by SPECT/CT images for the concerned area. Diagnostic performance indices from both modalities (PBS& SPECT/CT) were compared against the reference standard (clinical/imaging follow-up). Results: A total of 50 known cancer patients were included in this study (37 females, 13 males) with median age 64 years

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“…Eight months later, the follow-up bone scan showed no lung abnormality (Figure 2C,D), suggesting a non-pathological condition. Extraosseous uptake on bone scan with 99m Tc-HDP or 99m Tc-methylene diphosphonate ( 99m Tc-MDP) have been well described, with great improved diagnosis accuracy in the era of SPECT/CT [1][2][3]. In particular, focal lung uptake can be due to several causes such as sarcoidosis, amylosis, lung metastasis, lung abscess, or hypercalcemia [4][5][6].…”

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confidence: 99%

“…Figure 2. Subsequent scintigraphic investigations with ventilation/perfusion scintigraphy: ventilation axial SPECT slices (A), perfusion axial SPECT slices (B); and follow-up whole body bone scan: posterior view (C), anterior view (D).Extraosseous uptake on bone scan with 99m Tc-HDP or 99m Tc-methylene diphosphonate ( 99m Tc-MDP) have been well described, with great improved diagnosis accuracy in the era of SPECT/CT[1][2][3]. In particular, focal lung uptake can be due to several causes such as sarcoidosis, amylosis, lung metastasis, lung abscess, or hypercalcemia[4][5][6].…”

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confidence: 99%

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

et al. 2022

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A 48-year-old woman was referred for a bone scan as an assessment of bone metastasis from breast cancer. Surprisingly, two hot spots of lung uptake were present in the left lung without any abnormality on CT slices. No history of pulmonary disease was observed. An optimized CT scan with fine slices performed the same day was strictly normal (without any micronodule). A lung ventilation/perfusion scintigraphy showed no significant perfusion defect. A follow-up bone scan performed eight months later was normal and without any lung uptake. After exclusion of the main etiologies described in the literature, such as amylosis, sarcoidosis, abscess, or hypercalcemia, radiotracer microembolism seems to be the most likely hypothesis in this patient.

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Review of Extraskeletal Activity on Tc-99m Methylene Diphosphonate Bone Scintigraphy and Value of Cross-Sectional and SPECT-CT Imaging Correlation

Cited by 8 publications

References 44 publications

Incidental cardiac uptake in bone scintigraphy: increased importance and association with cardiac amyloidosis

Incidental cardiac uptake in bone scintigraphy: increased importance and association with cardiac amyloidosis

Added Value of SPECT/CT in Characterization of Extra-Skeletal Uptake of Tc-99m MDP on Planar Bone Scintigraphy in Known Cancer Patients.

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

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