Users Online: 1997
Home Print this page Email this page
Home About us Editorial board Search Browse articles Submit article Ahead of Print Instructions Subscribe Contacts Login 


 
Previous article Browse articles Next article 
CASE REPORT
Adv Biomed Res 2014,  3:230

Focal hot spot induced by a central subclavian line on bone scan


1 Department of Medical Physics and Biomedical Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Biology, Science and Research Branch, Islamic Azad University, Fars, Iran

Date of Submission12-Aug-2012
Date of Acceptance03-Dec-2012
Date of Web Publication29-Nov-2014

Correspondence Address:
Mohsen Cheki
Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran
Iran
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2277-9175.145723

Rights and Permissions
  Abstract 

The diagnostic accuracy of nuclear medicine reporting can be improved by awareness of these instrument-related artifacts. Both awareness and experience are also important when it comes to detecting and identifying normal (and abnormal) variants. We present a case of hot spot on the upper right chest in the region of right subclavicular region resulting from injection of radiotracer from central subclavian line. A 52-year-old woman with a history of left breast cancer and recent bone pain was referred to our nuclear medicine department for skeletal survey. Anterior views of chest show a focus of increased radiotracer uptake corresponding to anterior arch of one of the right second rib. The nuclear physician reported it as a focal rib bony lesion and recommended radiological evaluation. As technician later explained, physicians realized that injection site was a central subclavian line on the right side and hot spot on that region is due to injection site. The appearance of both skeletal and soft-tissue uptake depends heavily on imaging technique (such as the route of radiotracer administration) and the interpreting physicians should be aware of the impact of technical factors on image quality.

Keywords: Bone scan, central line, hot spot


How to cite this article:
Moslehi M, Cheki M, Dehghani T, Eftekhari M. Focal hot spot induced by a central subclavian line on bone scan. Adv Biomed Res 2014;3:230

How to cite this URL:
Moslehi M, Cheki M, Dehghani T, Eftekhari M. Focal hot spot induced by a central subclavian line on bone scan. Adv Biomed Res [serial online] 2014 [cited 2019 Nov 12];3:230. Available from: http://www.advbiores.net/text.asp?2014/3/1/230/145723


  Introduction Top


Bone scintigraphy is one of the most common studies performed in nuclear medicine and is used routinely in the evaluation of patients with cancers to detect suspected bone metastases and in various benign musculoskeletal conditions, such as traumatic or inflammatory disorders. Although it may seem self-evident, it is important to remain aware of those nonbiologic artifacts that are directly related to the patient's condition. Furthermore, at times the distinction between normal variants and artifacts can be difficult. Commonly encountered patient-related artifacts include artifacts caused by attenuation, contamination artifacts, and artifacts caused by intravenous lines, tubes, and catheters. The diagnostic accuracy of nuclear medicine reporting can be improved by awareness of these instrument-related artifacts. Both awareness and experience are also important when it comes to detecting and identifying normal (and abnormal) variants. [1],[2],[3],[4],[5],[6] We present a case of hot spot on the upper right chest in the region of right subclavicular region, resulting from injection of radiotracer from central subclavian line.


  Case report Top


A 52-year-old woman with a history of left breast cancer and recent bone pain was referred to our nuclear medicine department for skeletal survey. Anterior views of chest show a focus of increased radiotracer uptake corresponding to anterior arch of one of the right second rib [Figure 1]. The nuclear physician reported it as a focal rib bony lesion and recommended radiological evaluation. On reviewing the images, the second reader noticed a technical question. Where is the injection site? As technician later explained, physicians realized that injection site was a central subclavian line on the right side and hot spot on that region is due to injection site.
Figure 1: Right upper chest: Abnormal activity uptake in anterolateral

Click here to view



  Discussion Top


The appearance of both skeletal and soft-tissue uptake depends heavily on imaging technique (such as the route of radiotracer administration) and the interpreting physicians should be aware of the impact of technical factors on image quality. [2] The practitioners have to know the history, physical examination, technical issues before and during bone scanning for the most reliable interpretation. Oblique, lateral, and SPECT (Single Photon Emission Computed Tomography) views can also confirm the possible extraskeletal nature of suspicious radiotracer uptakes. [7],[8]

 
  References Top

1.
Howarth D. Patient-related pitfalls and artifacts in nuclear medicine imaging. Semin Nucl Med 1996;26:295-307.  Back to cited text no. 1
    
2.
Eftekhari M, Gholamrezanezhad A. Unusual misplacement of a subclavian vein catheter detected on a bone scan. Rev Esp Med Nucl 2006;25:117.  Back to cited text no. 2
    
3.
Loutfi I, Collier B, Mohammed A. Nonosseous abnormalities on bone scans. J Nucl Med Technol 2003;31:149-53. quiz 154-6.  Back to cited text no. 3
    
4.
Mirpour S, Fallahi B, Gholamrezanezhad A. Fecal impaction detection on a bone scan. Rev Esp Med Nucl 2006;25:327-8.  Back to cited text no. 4
    
5.
Andrews A, Theocheung L, Andrews E, Tyler K. Unintentional intra-arterial injection of a bone-imaging agent. Clin Nucl Med 1980;5:499-501.  Back to cited text no. 5
    
6.
Thrall J, Ghaed N, Geslien G, Pinsky S, Johnson M. Pitfalls in Tc-99m polyphosphate skeletal imaging. Am J Roentgenol Radium Ther Nucl Med 1974;121:739-47.  Back to cited text no. 6
    
7.
Kobayashi K. short-time SPECT images of bone scintigraphy improve the diagnostic value in the evaluation of solitary lesions in the thoracic spine in patients with extraskeletal malignancies? Ann Nucl Med 2005;19:557-66.  Back to cited text no. 7
    
8.
Yui N. Usefulness of bone SPECT of the cervical spine: With special reference to separate visualization of the trachea and thyroid cartilage. Ann Nucl Med 1993;7:223-30.  Back to cited text no. 8
    


    Figures

  [Figure 1]



 

Top
Previous article  Next article
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Case report
Discussion
References
Article Figures

 Article Access Statistics
    Viewed1199    
    Printed27    
    Emailed0    
    PDF Downloaded107    
    Comments [Add]    

Recommend this journal