Extraosseous accumulation of (99m)Tc-HMDP to radiation nephropathy, mimicking recurrent neuroblastoma.
OBJECTIVE
The aim of this study is to clarify the period of extraosseous accumulation of (99m)Tc-hydroxymethylenediphosphonate (HMDP) to radiation nephropathy mimicking recurrent or remnant neuroblastoma in the pararenal region.


METHODS
We reviewed five neuroblastoma and one ganglioneuroblastoma patients (2 boys and 4 girls aged 1-9 years) who underwent (99m)Tc-HMDP bone scintigraphies periodically before and after radiation therapy.


RESULTS
Increased renal uptake coincident with the radiation port appeared in 5 of 6 patients from 0 to 3 months (mean 1.7 months), and persisted up to 7 months after the completion of radiotherapy. Renal uptake of (99m)Tc-HMDP was gradually decreased, and eventually became accumulation defects in 5 of 6 patients from 6 to 17 months (mean 8.9 months) after radiotherapy.


CONCLUSIONS
When extraosseous accumulation is found after radiation therapy in neuroblastoma patients, radiation nephropathy would be a candidate in the differential diagnosis besides recurrent or remnant tumor.
Abe
Koichiro
K
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan. k-abe@radiol.med.kyushu-u.ac.jp
Sasaki
Masayuki
M
Kuwabara
Yasuo
Y
Koga
Hirofumi
H
Baba
Shingo
S
Kaneko
Koichiro
K
Hayashi
Kazutaka
K
Shioyama
Yoshiyuki
Y
Tajiri
Tatsuro
T
Suita
Sachiyo
S
Honda
Hiroshi
H
D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000556:secondary; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000293:injuries / Q000378:metabolism / Q000528:radiation effects; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000378:metabolism; D009447:Neuroblastoma / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000556:secondary; D011832:Radiation Injuries / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D011878:Radiotherapy / Q000009:adverse effects; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives* / Q000493:pharmacokinetics*
D019275:Radiopharmaceuticals; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate