Nucl Med Mol Imaging.  2013 Sep;47(3):208-211.

Diffuse Myocardial Uptake of 99mTc-HDP in Multiple Myeloma

• Demirel K
• Sadic M
• Korkmaz M
• Comak A
• Atilgan HI
• Koca G

Abstract

Soft tissue uptake is a rare finding in bone scintigraphy, with an incidence of 2%. Although the mechanism has not yet been fully clarified, several causes have been reported for this unusual uptake pattern. This paper presents a case of diffuse myocardial accumulation of technetium-99m hydroxymethylene diphosphonate (99mTc-HDP) without either solid/visceral organ or soft tissue with multiple myeloma (MM) in skeletal scintigraphy. A 93-year-old man with hypertension and chronic heart failure for 14 years underwent bone scanning due to a 2-month history of back pain within a 1-year period of MM. Three hours later, 99mTc-HDP late static images showed diffuse myocardial radiotracer accumulation and there were no other sites of abnormal soft tissue or visceral uptake. Myocardial accumulation had disappeared on 24-h delayed static images. This accumulation was thought to be related with AL-type amyloidosis associated with MM.

Keyword

Technetium-99m hydroxymethylene diphosphonate (99mTc-HDP); Technetium-99m bone agents; Myocardial uptake; Multiple myeloma

MeSH Terms

Amyloidosis
Back Pain
Heart Failure
History
Hypertension
Incidence
Multiple Myeloma*
Radionuclide Imaging