Tc-99m MDP uptake in cerebral infarction: comparison with Tc-99m DTPA brain scan and Tc-99m HMPAO brain SPECT.

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.