J Nucl Med. 2007; 48 (Supplement 2):385P
Oncology: Clinical Diagnosis-Solid Tumors
Clinical Diagnosis-Solid Tumors Posters |
Utility of Technetium-99m hydroxydiphosphonate bone scintigraphy (HDP) in the evaluation of extraosseous cardiopulmonary uptake
Martin Zloty1 and
Dwight Achong1
1 Nuclear Medicine Service (115), James A. Haley Veterans' Affairs Medical Center, Tampa, Florida
1637
Objectives: Myocardial uptake of bone-seeking tracers has recently been associated with prostate cancer in the majority of patients studied. Technetium-99m hydroxydiphosphonate bone scintigraphy (HDP) is also reported to possess different radiotargeting properties during cardiopulmonary localization since HDP uptake is more intense and more uniform than that of MDP, making it a potentially a more sensitive tool to study the significance of incidentally observed extraosseous bone agent uptake in the heart and lungs. Methods: Bone scintigrams clinically ordered for evaluation of benign and malignant disorders collected between 2000 to 2006 were evaluated for the presence of cardiopulmonary uptake, selected and graded on the basis of cardiac uptake: equal to surrounding bone (3+); less than bone (2+); and greater than bone (4+). Scans with absent uptake and residual blood pool (1+) were excluded. Irregular or diffuse uptake was noted and findings correlated with clinical history, biochemical and hematological parameters. Results: The average age of patients noted to have abnormal cardiac HDP uptake was 80.3 years, and all were males. The percentage of patients with known neoplastic disease was 23/30 (77%), the majority of those patients, 17/30 (57% of the total) carried the diagnosis of prostate cancer. Intensity or pattern of cardiac uptake did not correlate with PSA, Gleason score, serum calcium, alkaline phosphatase, hematological indices, or other bone scan findings. No consistent clinical cardiac abnormality (dysrhythmia, ischemia, cardiomyopathy) correlated with intensity of cardiac uptake, and the majority of patients had no significant cardiac history. Only two patients had evidence of paraproteinemia. Pulmonary uptake, when present (13%), was always less intense than cardiac uptake and did not identify significant pulmonary disease. Conclusions: Technetium-99m hydroxydiphosphonate bone scintigraphy (HDP) is able to identify patients with varying degrees of cardiopulmonary uptake as an epi-phenemenon associated with the diagnosis of prostate cancer in elderly patients, the biochemical significance of which is not yet clear. Long term follow up of this patient population may be useful.
