technetium-tc-99m-medronate and Cerebral-Infarction

A 70-year-old man with lung cancer underwent whole-body MDP bone scintigraphy to evaluate bone metastases that showed marked tracer uptake in the right side of the head, suggestive of skull metastasis. SPECT/CT imaging was performed for further evaluation. The SPECT images demonstrated increased MDP activity in the region of the brain perfused by the right middle cerebral artery. On CT images, there was a large hypoattenuation area corresponding to elevated MDP accumulation. At the same day, magnetic resonance angiography of the brain revealed occlusion of the right middle cerebral artery.

Topics: Aged; Cerebral Infarction; Humans; Magnetic Resonance Imaging; Male; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

We recently experienced a case of cerebral infarction incidentally found by whole body bone scintigraphy for the detection of bone metastasis from renal cell carcinoma. Additional bone SPECT and brain MR fusion images clearly demonstrated the wedge-shaped uptake of tracer corresponded to the abnormal intensity reflecting subacute cerebral infarction. Follow-up bone scan and fused images with MRI showed complete resolution of the abnormal uptake in chronic phase. A breakdown in the normal blood-brain barrier results in abnormal ionic calcium flux into the cells following altered cell membrane integrity leading to precipitation of calcium salts which eventually binds to bone imaging tracer such as (99m)Tc-methylene diphosphonate. That is, increased accumulation of bone seeking agents represents lethal cell death. The recent development of software and hardware has enabled the fusion of functional and anatomic images. Image fusion between SPECT with various tracers and MRI is expected to provide clues as to the underlying cause of diseases and to decide our treatment planning in the near future.

Topics: Bone Neoplasms; Carcinoma, Renal Cell; Cerebral Infarction; Endocarditis; Humans; Image Processing, Computer-Assisted; Incidental Findings; Magnetic Resonance Imaging; Male; Middle Aged; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Intracerebral uptake of methylene diphosphonate (MDP) was unexpectedly found in metastatic work-up of lung cancer. The history of the 52-year-old patient revealed a sudden onset of weakness of right limbs 10 days ago. Technetium-99m diethylenetriamine pentaacetate (Tc-99m DTPA) brain scan and Tc-99m hexamethyl propylene amine oxime (HMPAO) brain single photon emission computed tomography (SPECT) were done, and both showed abnormality in the left temporoparietooccipital region corresponding to the territory of left middle cerebral artery. A repeated bone scan four months later showed complete resolution of the intracerebral Tc-99m MDP uptake. We present this case to emphasize the importance of complementary and enhanced radionuclide images.

Topics: Brain; Cerebral Infarction; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Oximes; Technetium Tc 99m Exametazime; Technetium Tc 99m Medronate; Technetium Tc 99m Pentetate; Tomography, Emission-Computed, Single-Photon

Topics: Aged; Bone and Bones; Cerebral Infarction; Humans; Male; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Aged; Brain; Cerebral Infarction; Dementia, Multi-Infarct; Humans; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Anemia, Sickle Cell; Bone and Bones; Cerebral Infarction; Child, Preschool; Gallium Radioisotopes; Humans; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

In the metastatic work-up of a patient with a malignant lung tumor and cerebrovascular disease, bone imaging was performed which showed abnormal uptake in the right parietal region. Emission computed tomography indicated that this was due to intracranial disease and revealed a wedge-shaped pattern indicative of cerebral infarction. A later follow-up study showed complete clearance of the abnormal uptake.

Topics: Cerebral Infarction; Female; Humans; Middle Aged; Technetium Tc 99m Medronate; Tomography, Emission-Computed

Topics: Brain Edema; Cerebral Infarction; Child Abuse; Hematoma, Subdural; Humans; Infant; Radionuclide Imaging; Technetium Tc 99m Medronate