[99mTc]Tc-MDP uptake in the prostate gland confirmed by SPECT/CT

Articles in Press

Document Type : Case Report

Authors

Department of Nuclear Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

10.22034/irjnm.2025.130020.1680

Abstract

Prostate cancer remains a leading cause of cancer-related mortality among men worldwide. Technetium-99m methylene diphosphonate ([99mTc]Tc-MDP) bone scintigraphy is commonly employed to detect skeletal metastases due to its high sensitivity in identifying osteoblastic activity. However, [99mTc]Tc-MDP uptake in soft tissues, particularly in the prostate gland, is exceedingly rare. Here, we present a case of a 70-year-old male with acinar prostate adenocarcinoma (Gleason score 7/10) and persistent lower back pain. [99mTc]Tc-MDP scintigraphy demonstrated abnormal radiotracer uptake in the prostate gland without any evidence of bone metastases. Further evaluation through performing SPECT/CT confirmed the radiotracer uptake in the prostate gland without evidence of calcification. This rare finding emphasizes recognizing atypical imaging patterns and accurately interpreting them, which are important for clinical decision-making. We evaluate the patient regarding the potential mechanisms for such uptake, including dystrophic calcification and localized osteoblastic activity, and discuss the diagnostic implications and future research directions in prostate cancer imaging.

Keywords

Main Subjects

References

  1. Rawla P. Epidemiology of prostate cancer. World J Oncol. 2019 Apr;10(2):63-89.
  2. De Visschere PJL, Standaert C, Fütterer JJ, Villeirs GM, Panebianco V, Walz J, Maurer T, Hadaschik BA, Lecouvet FE, Giannarini G, Fanti S. A systematic review on the role of imaging in early recurrent prostate cancer. Eur Urol Oncol. 2019 Feb;2(1):47-76.
  3. Conte M, De Feo MS, Frantellizzi V, Marampon F, Filippi L, Schillaci O, De Vincentis G. Extraosseous distribution of 99mTc-diphosphonates during bone scintigraphy: review of the literature with case series presentation. Int J Radiat Biol. 2024;100(1):18-27.
  4. Zhang L, He Q, Zhou T, Zhang B, Li W, Peng H, Zhong X, Ma L, Zhang R. Accurate characterization of 99mTc-MDP uptake in extraosseous neoplasm mimicking bone metastasis on whole-body bone scan: contribution of SPECT/CT. BMC Med Imaging. 2019 May 30;19(1):44.
  5. Peller PJ, Ho VB, Kransdorf MJ. Extraosseous Tc-99m MDP uptake: a pathophysiologic approach. Radiographics. 1993 Jul;13(4):715-34.
  6. Zucker I, Charkes ND, Seidmon EJ, Maurer AH. Soft-tissue uptake of technetium-99m-MDP after prostate cryoablation. J Nucl Med. 1997 Apr;38(4):525-8.
  7. Campeau NG, Howarth DM, Collins DA. Prostatic calcifications detected on Tc-99m MDP bone scan mimicking bone metastasis. Clin Nucl Med. 1996 Jan;21(1):24-6.
  8. Erfani S, Raeisi N, Shakeri S, Askari E. Prostatic bed calcification with [99mTc]Tc-MDP uptake: easy to miss on planar images. Nucl Med Rev Cent East Eur. 2023;26(0):42-3.
  9. Zaman MU, Fatima N, Sajjad Z, Hashmi I, Khan K. Higher scrotal uptake ratio of (99m)Tc-MDP on bone scans in newly diagnosed prostate cancer: a reliable indicator of pelvic node metastasis. Ann Nucl Med. 2012 Oct;26(8):676-80.
  10. Chakraborty D, Manohar K, Kamleshwaran KK, Bhattacharya A, Singh B, Mittal BR. Tc99m-MDP uptake in ascitic fluid in a patient with prostate carcinoma: a clue to detect metastases. Indian J Nucl Med. 2011 Jul;26(3):161-2.
  11. Wale DJ, Wong KK, Savas H, Kandathil A, Piert M, Brown RK. Extraosseous findings on bone scintigraphy using fusion SPECT/CT and correlative imaging. AJR Am J Roentgenol. 2015 Jul;205(1):160-72.
Iranian Journal of Nuclear Medicine

Articles in Press, Accepted Manuscript
Available Online from 27 December 2026

Files

Share

How to cite

Statistics