title: Focal hot spot induced by a central subclavian line on bone scan.
abstract: The diagnostic accuracy of nuclear medicine reporting can be improved by awareness of these instrument-related artifacts. Both awareness and experience are also important when it comes to detecting and identifying normal (and abnormal) variants. We present a case of hot spot on the upper right chest in the region of right subclavicular region resulting from injection of radiotracer from central subclavian line. A 52-year-old woman with a history of left breast cancer and recent bone pain was referred to our nuclear medicine department for skeletal survey. Anterior views of chest show a focus of increased radiotracer uptake corresponding to anterior arch of one of the right second rib. The nuclear physician reported it as a focal rib bony lesion and recommended radiological evaluation. As technician later explained, physicians realized that injection site was a central subclavian line on the right side and hot spot on that region is due to injection site. The appearance of both skeletal and soft-tissue uptake depends heavily on imaging technique (such as the route of radiotracer administration) and the interpreting physicians should be aware of the impact of technical factors on image quality.
authors.affiliation: Department of Medical Physics and Biomedical Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masood
authors.initials: M
authors.lastname: Moslehi
authors.affiliation: Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Cheki
authors.affiliation: Department of Medical Physics and Biomedical Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Tohid
authors.initials: T
authors.lastname: Dehghani
authors.affiliation: Department of Biology, Science and Research Branch, Islamic Azad University, Fars, Iran.
authors.forename: Mansoureh
authors.initials: M
authors.lastname: Eftekhari
keywords: Bone scan; central line; hot spot