University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Clinic of Nuclear Medicine, Ankara, Turkey
The appearance of a hot kidney on bone scintigraphy is rare and can be seen due to various factors. In our clinic, we observed hot kidney appearance in two patients to whom technetium-99m methylene diphosphonate (Tc-99m MDP) whole body scan has been performed: a young male adult at the age of 18 who was diagnosed with acute lymphocytic leukemia with a presumptive diagnosis of avascular necrosis, and a 9-year-old girl with cystitis for a pre-diagnosis of osteomyelitis. The first patient had a history of cyclosporine usage and the second patient was being treated with amikacin + vancomycin. To the best of our knowledge, we present the first cases where hot-kidney appearance on Tc-99m MDP whole body scan due to the use of cyclosporin and amikacin + vancomycin is demonstrated.
Informed Consent: Consent form was filled out by all participants.
Peer-review: Internally peer-reviewed.
Surgical and Medical Practices: D.Ç., M.A., Concept: D.Ç., Design: D.Ç., Data Collection or Processing: D.Ç., M.E., Analysis or Interpretation: M.F., Literature Search: M.E., Writing: D.Ç., M.A.
Conflict of Interest: No conflict of interest was declared by the authors.
Financial Disclosure: The authors declared that this study received no financial support.
1. Langsteger W, Rezaee A, Pirich C, Beheshti M. 18F-NaF-PET/CT and 99mTc MDP Bone Scintigraphy in the Detection of Bone Metastases in Prostate Cancer. Semin Nucl Med 2016;46:491-501.
2. Koizumi K, Tonami N, Hisada K. Diffusely increased Tc-99m-MDP uptake in both kidneys. Clin Nucl Med 1981;6:362-365.
3. Ting A, Freund J. Nonsteroidal antiinflammatory-induced acute renal failure detected on bone scintigraphy. Clin Nucl Med 2004;29:318-319.
4. Gentili A, Miron SD, Adler LP, Bellon EM. Incidental detection of urinary tract abnormalities with skeletal scintigraphy. Radiographics 1991;11:571-579.
5. Choy D, Murray IP, Hoschl R. The effect of iron on the biodistribution of bone scanning agents in humans. Radiology 1981;140:197-202.
6. Ozdoğan O, Karahan NP, Sarıoğlu S, Durak H. Acute Kidney Injury Secondary to NSAID Diagnosed on 99mTc MDP Bone Scan. Mol Imaging Radionucl Ther 2013;22:66-69.
7. Siddiqui AR. Increased uptake of technetium-99m-labeled bone imaging agents in the kidneys. Semin Nucl Med 1982;12:101-102.
8. Buxton-Thomas MS, Wraight EP. High renal activity on bone scintigrams. A sign of hypercalcaemia? Br J Radiol 1983;56:911-914.
9. Arbona GL, Antonmattei S, Tetalman MR, Scheu JD. Tc-99m-diphosphonate distribution in a patient with hypercalcemia and metastatic calcifications. Clin Nucl Med 1980;5:422.
10. Datz F. Bone imaging: increased renal uptake-diffuse. In: Gamuts in Nuclear Medicine. St Louis, Mosby, 1995;160-161.
11. Lantieri RL, Lin MS, Martin W, Goodwin DA. Increased renal accumulation of Tc-99m-MDP in renal artery stenosis. Clin Nucl Med 1980;5:305-309.
12. Lamki LM, Wyatt JK. Renal vein thrombosis as a cause of excess renal accumulation of bone seeking agents. Clin Nucl Med 1983;8:267-268.
13. Lutrin CL, Goris ML. Pyrophosphate retention by previously irradiated renal tissue. Radiology 1979;133:207-209.
14. Sheth KJ, Sty JR, Johnson F, Tisdale P. Myoglobinuria with acute renal failure and hot kidneys seen on bone imaging. Clin Nucl Med 1984;9:498-501.
15. Schicha H, Rumpf KW, Kaiser H, Emrich D. Scintigraphy with 99mTc-methylene diphosphonate for the detection and localization of rhabdomyolysis. Nuklearmedizin 1984;23:287-291.
16. Watanabe N, Shimizu M, Kageyama M, Kamei T, Seto H, Kakishita M. Diffuse increased renal uptake on bone scintigraphy in acute tubular necrosis. Clin Nucl Med 1994;19:19-21.
17. Maza A, Montaudié H, Sbidian E, Gallini A, Aractingi S, Aubin F, Bachelez H, Cribier B, Joly P, Jullien D, Le Maître M, Misery L, Richard MA, Ortonne JP, Paul C. Oral cyclosporin in psoriasis: a systemic review on treatment modalities, risk of kidney toxicity and evidence for use in non-plaque psoriasis. J EurAcad Dermatol Venereol 2011;25(Suppl 2):19-27.
18. Feutren G, Abeywickrama K, Friend D, von Graffenried B. Renal function and blood pressure in psoriasis patients treated with cyclosporine. Br J Dermatol 1990;122(Suppl 36):57-69.