Abstract
Fifteen months after right lobe lobectomy with adjunctive radiation therapy for squamous cell carcinoma, a patient 53-yr-old man underwent Tc-99m depreotide chest single photon emission tomography (SPECT). In addition to two focal areas of abnormally increased uptake in the right lung, the Tc-99m depreotide SPECT showed cold areas in the middle thoracic vertebrae. Photopenic areas in the 6th and 7th thoracic vertebrae were shown on a bone scintigraphy. T1 weighted magnetic resonance imaging (MRI) of the spine showed fatty replacement of the marrow and Schmorl’s nodes involving the 5th to 11th thoracic vertebrae. The vertebrae are normally visualized in Tc-99m depreotide SPECT imaging study, and lung tumor is usually somatostatin receptor positive with demonstrable activity in the lung. Absent uptake in the vertebrae in the fatty replacement of the marrow and multiple and giant vertebral Schmorl’s nodes in the correspondent vertebrae in MRI may reflect visualization of vertebrae due to Tc-99m depreotide localizing in the bone marrow. Of the three imaging modalities, MRI showed the widest areas of thoracic vertebral involvement. One should be aware that a cold lesion in the vertebrae on Tc-99m depreotide imaging study may result from irradiation and may indicate the presence of a benign lesion in the bone marrow.
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Morehead RS, Shih WJ. Tc-99m labeled somatostatin receptor binding peptide imaging for a pulmonary nodule.Clin Nucl Med 2001; 26: 910–912.
Blum J, Handmaker H, Lister-James J, Rinne NA. S multicenter trial with a somatostatin analog Tc-99m depreotide in the evaluation of solitary pulmonary nodules.Chest 2000; 117: 1232–1238.
Blum J, Handmaker H, Rinne NA. The utility of a somatostatin-type receptor binding peptide radiopharmaceutical (P829) in the evaluation of solitary pulmonary nodules.Chest 1999; 115: 224–232.
Shih WJ, Hirschowitz E, Bensadoun ES, Woodring J, Ryo YU, Kraman S. Biodistribution on Tc-99m Labeled Somatostatin Receptor-binding Peptide (Depreotide, NeoTec) Planar and SPECT Images.Ann Nucl Med 2002; 16: 213–219.
Bostaph A, Miliziano J, Bradley Y. Qualitative Analysis of Solitary Pulmonary Nodule Using Tc-99m Depreotide.J Nucl Med 2002; 43: 113p.
Schmorl G, Junghanns H. In:The Human Spine in Health and Disease. New York; Gune and Stratton, 1971.
Pfirrmann CW, Resnick D. Schmorl Nodes of the Thoracic and Lumbar spine: Radiographic-Pathologic Study of Prevalence, Characterization, and Correlation with Degenerative changes of 1650 Spinal Levels in 100 Cadavers.Radiology 2001; 219: 368–374.
Hauger O, Cotton A, Chateil JF, Borg O, Moinard M, Diard F. Giant Cystic Schmorl’s Nodes: Imaging Finding in Six Patients.AJR 2001; 176: 969–972.
Kirkwood ID, Quint DI, Haig A, Wahl RL. Painful Schmorl’s node: another cause of vertebral photopenia on In-111 labeled leukocyte scintigraphy.Clin Nucl Med 1999; 24: 206–208.
Walters G, Coumas JM, Akins CM, Ragland RL. Magnetic resonance imaging of acute symptomatic Schmorl’s node formation.Pediatric Emergency Care 1991; 7: 294–296.
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Shih, WJ., Van Wyk, C. Tc-99m depreotide SPECT demonstrates photon-deficiency in the thoracic vertebrae after adjunct radiation therapy of lung cancer: Correlation with MRI and bone scintigraphy. Ann Nucl Med 17, 245–248 (2003). https://doi.org/10.1007/BF02990029
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DOI: https://doi.org/10.1007/BF02990029