Diffuse liver uptake on (99m)Tc-MDP bone scan secondary to severe hepatic failure

Area of Science:

• Nuclear medicine
• Radiology
• Hepatology

Background:

• Hepatic uptake on Technetium-99m MDP bone scans is a non-specific finding requiring etiological investigation.
• Differential diagnosis for hepatic uptake varies based on the pattern observed (focal vs. diffuse).
• Known causes of diffuse hepatic uptake include hepatitis, amyloidosis, IV gadolinium, and aluminum breakthrough from molybdenum generators.

Observation:

• A patient presented with diffuse hepatic uptake on an MDP bone scan.
• The patient was diagnosed with acute hepatic failure.

Findings:

• The etiology of the acute hepatic failure was determined to be extensive thrombosis of the inferior vena cava (IVC).
• This case illustrates a rare cause of diffuse hepatic uptake on bone scintigraphy.

Implications:

• Clinicians should consider IVC thrombosis in the differential diagnosis of diffuse hepatic uptake, especially in cases of acute hepatic failure.
• Understanding the diverse causes of hepatic uptake on bone scans is crucial for accurate diagnosis and patient management.