Interesting Image

Incidental Tc-99m MDP Uptake in Cortical-subcortical Parietotemporal Cerebral Area in a Patient with a History of Recent Ischemic Cerebrovascular Event who Underwent Whole-body Bone Scan


  • Demet Nak
  • Sibel Göksel

Received Date: 09.07.2021 Accepted Date: 18.01.2022 Mol Imaging Radionucl Ther 2023;32(1):65-67 PMID: 36820007

The authors present Tc-99m methylene diphosphonate (MDP) uptake in the right parietotemporal area at whole-body bone scan (WBBS) in 75 years male patient with prostate adenocarcinoma Gleason score 3+4 (pT2N0Mx). No residual or metastatic disease was detected in the patient’s Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography four months before WBBS. The patient had undetectable prostate-specific antigen levels and underwent WBBS to restage prostate cancer due to equivocal findings in previous WBBS. Current WBBS planar views revealed heterogeneous Tc-99m MDP uptake in the right parietotemporal area and the sphenoid bone in addition to equivocal uptake on the lower lumbar vertebrae. Single-photon emission computed tomography study to identify the MDP-avid lesion on the right cranial area revealed heterogeneous Tc-99m MDP uptake in the right parietotemporal area and sphenoid bone. The patient had a history of transsphenoidal surgery for a hypophyseal tumor two years ago and a recent cerebrovascular event (CVE). Diffusion-weighted magnetic resonance imaging revealed a cortical-subcortical patchy area of restricted diffusion in the parietotemporal region compatible with acute ischemia. Heterogeneous Tc-99m MDP uptake in the right parietotemporal area was attributed to recent CVE and secondary vascular-tissue change-related dystrophic calcification.

Keywords: Bone scan, cortical- subcortical, cerebral, MDP uptake


Informed Consent: Oral and written informed consent of the patient was obtained.

Peer-review: Externally peer-reviewed.

Authorship Contributions

Concept: D.N., Design: D.N., Data Collection or Processing: D.N., S.G., Analysis, or Interpretation: D.N., S.G., Literature Search: D.N., Writing: D.N.

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. Lionel Zuckier LS, Martineau P. Altered biodistribution of radiopharmaceuticals used in bone scintigraphy. Semin Nucl Med 2015;45:81-96.
  2. Hung GU, Lee JD, Lee JK. Bilateral cranial Tc-99m MDP uptake due to hypoxic-ischemic encephalopathy. Clin Nucl Med 2007;32:328-329.
  3. Kannivelu A, Padhy AK, Srinivasan S, Ali SZ. Extraosseous uptake of technetium-99m methylene diphosphonate by an acute territorial cerebral infarct in a classical biodistribution pattern. Indian J Nucl Med 2013;28:240-242.
  4. Das J, Ray S. Incidental finding of technetium-99m methylene diphosphonate uptake in acute cerebral infarct. Indian J Nucl Med 2016;31:313-315.
  5. Mackie GC. Tc-99m MDP uptake resulting from acute middle cerebral artery territory infarction. Clin Nucl Med 2003;28:851-852.