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"Cold" lesions on bone imaging.

W M Sy, D W Westring, G Weinberger

    Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
    |November 1, 1975
    PubMed
    Summary
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    Bone imaging can reveal "cold" lesions not visible on X-rays, particularly in dense bones. Recognizing these photon-deficient areas is crucial for accurate interpretation of bone scans in patients with cancer or sickle cell disease.

    Area of Science:

    • Nuclear Medicine
    • Radiology
    • Oncology

    Background:

    • Bone scintigraphy using technetium-99m-polyphosphate is a common imaging modality.
    • Photon-deficient (
    • cold
    • ) lesions on bone scans can represent various pathologies, sometimes without radiographic correlation.

    Purpose of the Study:

    • To investigate the occurrence and characteristics of photon-deficient lesions on bone imaging.
    • To highlight the clinical significance of these "cold" lesions in the context of malignancies and sickle cell crisis.

    Main Methods:

    • Retrospective analysis of bone imaging studies in patients with malignancies and sickle cell crisis.
    • Correlation of bone scintigraphy findings with radiographic bone imaging.

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    Main Results:

    • Nine cases demonstrated photon-deficient "cold" lesions on 99mTc-polyphosphate bone imaging.
    • In five cases, corresponding radiographic bone changes were absent at the time of imaging.
    • The majority of "cold" lesions were located in dense and tubular bones.

    Conclusions:

    • Photon-deficient lesions on bone scans can occur in the absence of radiographic evidence of bony abnormality.
    • Understanding the factors influencing "cold" lesion appearance is important for accurate interpretation.
    • Recognition of "cold" areas in bone imaging is essential for comprehensive patient assessment.