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IMAGE INTERPRETATION · BONE IMAGING

Superscan on Bone Scintigraphy

Whole-body bone scintigraphy showing diffusely increased skeletal uptake
Whole-body bone scintigraphy showing diffusely increased skeletal uptake

CC BY-SA 3.0 · Wikimedia Commons · source file

Question

A 'superscan' pattern on bone scintigraphy is characterized by diffusely increased skeletal uptake with absent or very faint kidney visualization. Which of the following is a common cause of a superscan?

  1. AWidespread skeletal metastases (especially prostate cancer) or metabolic bone disease
  2. BOsteoporosis
  3. CRenal failure with absent urine excretion
  4. DTechnically inadequate scan due to low administered activity
Show the answer and explanation

A. Widespread skeletal metastases (especially prostate cancer) or metabolic bone disease

A superscan occurs when there is such diffuse, intense skeletal uptake that virtually all radiotracer is extracted by bone, leaving little circulating tracer for renal excretion. The kidneys appear faint or absent, and the skeleton appears very bright. Common causes: (1) widespread osteoblastic skeletal metastases (especially prostate cancer); (2) metabolic bone disease (hyperparathyroidism, osteomalacia, renal osteodystrophy, Paget's disease). A superscan can be confused with a normal scan but is identified by the abnormally absent kidneys.

More bone imaging images

Whole-body bone scan showing intense uptake in expanded bony segmentsPaget’s Disease of Bone on Bone Scan Whole-body bone scintigraphy — photopenic (cold) skeletal lesionPhotopenic Bone Lesions: Multiple Myeloma Three-phase bone scan showing increased flow/blood pool in soft tissues with normal delayed bone uptake — pattern of cellulitisCellulitis vs Osteomyelitis on Three-Phase Bone Scan Normal whole-body Tc-99m MDP bone scan — anterior and posterior projectionsNormal Physiologic Uptake on a Bone Scan Tc-99m MDP bone scan showing uptake in the tibial regionShin Splints on Bone Scan: Medial Tibial Stress Syndrome Tc-99m MDP bone scan — femoral head and neck regionAvascular Necrosis of the Femoral Head on Bone Scan
← Bone Metastases: Prostate and Breast PrimariesPaget’s Disease of Bone on Bone Scan →

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