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^99mTc-MDP Scintigraphic Findings in Children with Leukemia: Value of Early and Delayed Whole-Body Imaging

Department of Diagnostic Imaging and Radiology, Children’s National Medical Center, Washington; and The George Washington University Medical Center, Washington, DC

View larger version (100K): [in a new window]   FIGURE 1. Patient 8 (11.3-y-old girl) who presented with fever and back pain. (A) Early whole-body images show multifocal areas of abnormal uptake, including metaphysis/diaphysis of bilateral distal femurs, bilateral proximal tibiae, and right distal ulna; left distal radius diaphysis, right first rib, pelvis, and spine show diffuse uptake. (B) Delayed whole-body images reveal uptake in right first rib, skull, right distal ulnar metaphysis/diaphysis, and left distal radius diaphysis, shown to be healing fracture on radiograph, lateral view (arrow) (C). Spine, site of patient’s pain, is normal. SPECT imaging of spine was also normal (not shown).

View larger version (82K): [in a new window]   FIGURE 2. Patient 1 (7.4-y-old girl) who presented with bilateral hip pain. (A) Early whole-body images show intense diffuse abnormal uptake in pelvis, thoracic and lumbar spine, bilateral anterior ribs, and metaphysis/diaphysis of bilateral distal femurs, bilateral proximal tibiae, left proximal fibula, and left proximal humerus. Note symmetric involvement of knees. (B) Normal early whole-body images show minimal tracer uptake in skeleton. Note minimal tracer accumulation in bladder attributed to early phase of scanning (A and B). (C) Delayed whole-body images reveal heterogeneous abnormal uptake in bilateral ribs. Remainder of bone scan is normal, including hips, where patient was symptomatic.