Juweid Malik E, Alsyouf Baraa, Kasasbeh Nour, Mahafza Waleed, Moghrabi Serin, Al-Makhamreh Hanna, Saleh Akram
Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan.
Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan.
Asia Ocean J Nucl Med Biol. 2025;13(2):198-202. doi: 10.22038/aojnmb.2025.85251.1609.
This case report presents a case of unusual diffuse cardiac uptake (Peruguni 3: uptake greater than rib uptake) on a Tc-methylene diphosphonate bone scan in an 83-year-old patient with metastatic prostate cancer which is almost resolved (Peruguni 1: uptake less than rib uptake) on a follow up bone scan about 4.4 months later. Laboratory values and imaging were negative for cardiac amyloidosis and a thorough review of the patient's medical chart did not reveal any other possible causes, pharmacologic or otherwise, thus deeming the uptake non-specific. While increased non-specific cardiac Tc-diphosphanate uptake has been previously reported in elderly prostate cancer patients, possibly attributable to asymptomatic atherosclerosis, this explanation is unlikely considering that the uptake almost resolved within a relatively short period of time. It is clinically important to rule out amyloidosis in patients with increased cardiac uptake on bone scans. However, we believe that clinicians should also consider the possibility of non-specific uptake as a cause for cardiac uptake on bone scan, which would only require follow-up rather than medical intervention.
本病例报告介绍了一名83岁转移性前列腺癌患者，其在锝-亚甲基二膦酸盐骨扫描中出现不寻常的弥漫性心脏摄取（佩鲁古尼3级：摄取大于肋骨摄取），而在约4.4个月后的随访骨扫描中几乎消失（佩鲁古尼1级：摄取小于肋骨摄取）。心脏淀粉样变的实验室检查值和影像学检查均为阴性，对患者病历的全面审查未发现任何其他可能原因，无论是药物性还是其他原因，因此认为该摄取是非特异性的。虽然先前已有报道老年前列腺癌患者心脏锝-二膦酸盐摄取增加，可能归因于无症状动脉粥样硬化，但考虑到摄取在相对较短时间内几乎消失，这种解释不太可能。在骨扫描中出现心脏摄取增加的患者中排除淀粉样变在临床上很重要。然而，我们认为临床医生也应考虑非特异性摄取作为骨扫描中心脏摄取原因的可能性，这种情况仅需随访而非医学干预。
