Chan Gary Ka Wai, Chow Tsz Kit, Hui Yan Ho, Ho Wai Yin
Nuclear Medicine Unit, Department of Radiology, Queen Mary Hospital, Hong Kong.
Nuclear Medicine Unit, Department of Radiology and Nuclear Medicine, Tuen Mun Hospital, Hong Kong.
Radiol Case Rep. 2025 Jul 22;20(10):5061-5064. doi: 10.1016/j.radcr.2025.06.096. eCollection 2025 Oct.
Bone scintigraphy with technetium-labelled diphosphonates is widely used for evaluating skeletal pathology. However, extra-osseous uptake may also be encountered and can indicate underlying neoplastic processes. We report 2 cases of incidental intra-abdominal uptake on bone scans, later confirmed as gastrointestinal stromal tumors. In both cases, planar bone scintigraphy revealed focal tracer uptake in the abdomen, which SPECT/CT localized to exophytic gastric masses with intralesional calcification. Histopathological confirmation was obtained via endoscopic biopsy and surgical resection. These cases highlight the diagnostic value of hybrid SPECT/CT imaging in evaluating unexpected soft tissue uptake, enabling accurate anatomical localization and differentiation from physiological or benign causes. Although the mechanisms of diphosphonate accumulation in extra-osseous neoplasms are not fully understood, contributing factors may include calcification, vascularity, and altered tissue microenvironment. Recognition of such findings can facilitate timely diagnosis and management. Awareness of neoplastic causes of extra-osseous uptake is essential for interpreting physicians to guide appropriate clinical follow-up.
用锝标记的二膦酸盐进行骨闪烁扫描术被广泛用于评估骨骼病变。然而，也可能会遇到骨外摄取情况，这可能提示潜在的肿瘤性病变。我们报告2例骨扫描时偶然发现的腹腔内摄取病例，后来证实为胃肠道间质瘤。在这两例病例中，平面骨闪烁扫描显示腹部有局灶性示踪剂摄取，SPECT/CT将其定位到胃外生性肿块伴病灶内钙化。通过内镜活检和手术切除获得了组织病理学确诊。这些病例突出了SPECT/CT融合成像在评估意外软组织摄取方面的诊断价值，能够实现准确的解剖定位并与生理性或良性原因相鉴别。虽然二膦酸盐在骨外肿瘤中蓄积的机制尚未完全明确，但促成因素可能包括钙化、血管形成以及组织微环境改变。认识到这些发现有助于及时诊断和处理。了解骨外摄取的肿瘤性原因对于解读医师指导适当的临床随访至关重要。
