Diffuse Cardiac Uptake Misdiagnosed as Cardiac Amyloidosis in Bone Scan

Yeongjoo Lee; Jaehyuk Jang; Sae Jung Na

doi:10.3390/diagnostics13213342

Diffuse Cardiac Uptake Misdiagnosed as Cardiac Amyloidosis in Bone Scan

Diagnostics (Basel). 2023 Oct 30;13(21):3342. doi: 10.3390/diagnostics13213342.

Authors

Yeongjoo Lee¹, Jaehyuk Jang², Sae Jung Na¹

Affiliations

¹ Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
² Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.

Abstract

In this presented case, a 77-year-old woman with an implanted prosthesis and ongoing knee pain underwent a bone scan using ^99mTc-hydroxydiphosphonate (HDP) in suspicion for bone infection. An incidental finding from this scan revealed diffuse cardiac uptake, necessitating further diagnostic procedures to exclude the possibility of cardiac amyloidosis. In the subsequent ^99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) scan and SPECT images, no perceptible cardiac uptake was observed at all. Upon retrospective review of the patient's medical records, she received 1000 mg of ferric carboxymaltose for iron-deficient anemia the day before the ^99mTc-HDP bone scan. Therefore, it was assumed that the diffuse and temporary cardiac activity was due to the transient iron overload. We present and share these bone scan images in order to avoid possible future misinterpretation of cardiac amyloidosis.

Keywords: 99mTc-HDP; bone scan; cardiac amyloidosis; iron overload.

Grants and funding

This research received no external funding.