title: Myocardial uptake of bone scintigraphic agents associated with increased pulmonary uptake.
abstract: OBJECTIVE
  Due to delivery problems with the most commonly used bone scintigraphic agent medronate-(99m)Tc-methylene diphosphonate (MDP) (medronate), several regional institutions changed, at various time points, to (99m)Tc-dicarboxypropane diphosphonate (DPD) (Teceos) from 2010. Extraosseous uptake, in particular, myocardial uptake, was observed in a number of patient examined with DPD, with reduced quality of the bone scans. Additionally, an increase in pulmonary uptake was apparent in many of these patients. The aim of this quality control was to assess pulmonary soft tissue uptake in the patients with high myocardial uptake.
  
  
  METHODS
  A retrospective analysis of the 2435 bone scintigraphies performed during a 3-year period revealed relatively intense myocardial uptake in 10 of the 1195 patients examined with DPD (Teceos). A comparison of pulmonary uptake in a control group of age- and gender-matched subjects and a control group of patients examined with the same preparation of DPD were assessed.
  
  
  RESULTS
  In patients with cardiac uptake of DPD, it could also be shown a relatively intense background uptake in the lungs with significantly higher uptake ratio over intercostals regions versus the abdomen, compared to the control groups. Furthermore, we found, as already well documented, a significantly lower bone to soft tissue uptake in these patients, as quantified by a femur to surrounding soft tissue ratio.
  
  
  CONCLUSIONS
  Cardiac uptake of bone scintigraphic agents is associated with high pulmonary uptake. This may be a sign of pulmonary involvement which may give extraosseous bone tracer uptake its own importance and DPD a new role.
authors.affiliation: Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Tore
authors.initials: T
authors.lastname: Bach-Gansmo
authors.affiliation: Department of Internal Medicine, Department of Nephrology, Oslo University Hospital, Oslo, Norway.
authors.forename: Tale N
authors.initials: TN
authors.lastname: Wien
authors.affiliation: Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Ayca
authors.initials: A
authors.lastname: Løndalen
authors.affiliation: Department of Radiology, Vestfold Hospital, Tønsberg, Norway.
authors.forename: Erling
authors.initials: E
authors.lastname: Halvorsen
mesh_terms: D000368:Aged; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000378:metabolism; D004164:Diphosphonates / Q000493:pharmacokinetics*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000378:metabolism*; D008297:Male; D008657:Metabolic Clearance Rate; D009206:Myocardium / Q000378:metabolism*; D009928:Organ Specificity; D015609:Organotechnetium Compounds / Q000493:pharmacokinetics*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D014018:Tissue Distribution
chemical_list: D004164:Diphosphonates; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C033905:technetium Tc 99m 1,1-diphosphonopropane-2,3-dicarboxylic acid
keywords: 99mTc-dicarboxypropane diphosphonate; amyloidosis; bone scintigraphy; myocardial uptake; pulmonary uptake