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An Unusual Case of Extraosseous Accumulation of Bone Scan Tracer in a Renal Calculus - Demonstration by SPECT-CT.

Joshi PV, Lele V, Gandhi R - J Clin Imaging Sci (2012)

Bottom Line: Extraosseous localization of radioisotope, used in bone scan, in a variety of physiological and pathological conditions is a well-known phenomenon.The causes of extraosseous accumulation of bone-seeking radiotracers should be kept in mind when bone-imaging studies are reviewed to avoid incorrect interpretations.We report an extremely rare occurrence of extraosseous accumulation of bone scintigraphy tracer in a renal calculus, in a patient with adenocarcinoma of prostate, that was demonstrated by Single Photon Emission Computed Tomography and Computed Tomography (SPECT-CT) fusion imaging.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine and PET/CT, Jaslok Hospital and Research Center, Deshmukh Marg, Worli, Mumbai, India.

ABSTRACT
Extraosseous localization of radioisotope, used in bone scan, in a variety of physiological and pathological conditions is a well-known phenomenon. The causes of extraosseous accumulation of bone-seeking radiotracers should be kept in mind when bone-imaging studies are reviewed to avoid incorrect interpretations. We report an extremely rare occurrence of extraosseous accumulation of bone scintigraphy tracer in a renal calculus, in a patient with adenocarcinoma of prostate, that was demonstrated by Single Photon Emission Computed Tomography and Computed Tomography (SPECT-CT) fusion imaging.

No MeSH data available.


Related in: MedlinePlus

(a-b) Lateral and (c-d) oblique views clearly demonstrate the focal tracer uptake outside the skeletal structures in left kidney (arrows).
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Figure 2: (a-b) Lateral and (c-d) oblique views clearly demonstrate the focal tracer uptake outside the skeletal structures in left kidney (arrows).

Mentions: A 60-year-old man, who had difficulty in passing urine for the past 6 months and a complaint of lower back pain presented to our department. On ultrasound imaging, he was found to have an enlarged prostate. Transrectal ultrasound-guided biopsy revealed adenocarcinoma of prostate, Gleason's score 3+3=6. His PSA was normal (1.3 ng/ml) and serum Alkaline phosphatase was elevated 58 U/L (Normal range 30-50 U/L). A 99m Technitium methylene diphosphonate (99m Tc-MDP) bone scan was performed. The scan [Figures 1 and 2] showed mildly increased tracer uptake in lumbar vertebrae and focal accumulation of tracer in lower pole of the left kidney. Fusion imaging [Figure 3], using Single Photon Emission Computed Tomography along with X-ray Computed Tomography (SPECT-CT) of the lumbar spine was performed to characterize the vertebral tracer uptake. Lasix 40 mg was given 45 minutes prior to SPECT-CT to monitor the renal tracer accumulation. The scan demonstrated degenerative changes in lumbar vertebrae. The kidneys were included in the SPECT-CT imaging. High tracer uptake in a lower pole of the left kidney was found localized in a calculus in the lower calyx of kidney. The calculus measured 8 x 8 mm in size. The CT attenuation factor was 1060 Hounsfield unit, compatible with that of a renal calculus.


An Unusual Case of Extraosseous Accumulation of Bone Scan Tracer in a Renal Calculus - Demonstration by SPECT-CT.

Joshi PV, Lele V, Gandhi R - J Clin Imaging Sci (2012)

(a-b) Lateral and (c-d) oblique views clearly demonstrate the focal tracer uptake outside the skeletal structures in left kidney (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3307216&req=5

Figure 2: (a-b) Lateral and (c-d) oblique views clearly demonstrate the focal tracer uptake outside the skeletal structures in left kidney (arrows).
Mentions: A 60-year-old man, who had difficulty in passing urine for the past 6 months and a complaint of lower back pain presented to our department. On ultrasound imaging, he was found to have an enlarged prostate. Transrectal ultrasound-guided biopsy revealed adenocarcinoma of prostate, Gleason's score 3+3=6. His PSA was normal (1.3 ng/ml) and serum Alkaline phosphatase was elevated 58 U/L (Normal range 30-50 U/L). A 99m Technitium methylene diphosphonate (99m Tc-MDP) bone scan was performed. The scan [Figures 1 and 2] showed mildly increased tracer uptake in lumbar vertebrae and focal accumulation of tracer in lower pole of the left kidney. Fusion imaging [Figure 3], using Single Photon Emission Computed Tomography along with X-ray Computed Tomography (SPECT-CT) of the lumbar spine was performed to characterize the vertebral tracer uptake. Lasix 40 mg was given 45 minutes prior to SPECT-CT to monitor the renal tracer accumulation. The scan demonstrated degenerative changes in lumbar vertebrae. The kidneys were included in the SPECT-CT imaging. High tracer uptake in a lower pole of the left kidney was found localized in a calculus in the lower calyx of kidney. The calculus measured 8 x 8 mm in size. The CT attenuation factor was 1060 Hounsfield unit, compatible with that of a renal calculus.

Bottom Line: Extraosseous localization of radioisotope, used in bone scan, in a variety of physiological and pathological conditions is a well-known phenomenon.The causes of extraosseous accumulation of bone-seeking radiotracers should be kept in mind when bone-imaging studies are reviewed to avoid incorrect interpretations.We report an extremely rare occurrence of extraosseous accumulation of bone scintigraphy tracer in a renal calculus, in a patient with adenocarcinoma of prostate, that was demonstrated by Single Photon Emission Computed Tomography and Computed Tomography (SPECT-CT) fusion imaging.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine and PET/CT, Jaslok Hospital and Research Center, Deshmukh Marg, Worli, Mumbai, India.

ABSTRACT
Extraosseous localization of radioisotope, used in bone scan, in a variety of physiological and pathological conditions is a well-known phenomenon. The causes of extraosseous accumulation of bone-seeking radiotracers should be kept in mind when bone-imaging studies are reviewed to avoid incorrect interpretations. We report an extremely rare occurrence of extraosseous accumulation of bone scintigraphy tracer in a renal calculus, in a patient with adenocarcinoma of prostate, that was demonstrated by Single Photon Emission Computed Tomography and Computed Tomography (SPECT-CT) fusion imaging.

No MeSH data available.


Related in: MedlinePlus