Diffuse Increased Sodium Fluoride Gastric Activity in a Patient With Hypercalcemia

Area of Science:

• Nuclear medicine
• Radiology
• Oncology

Background:

• Sodium fluoride (NaF) Positron Emission Tomography/Computed Tomography (PET/CT) is utilized for various diagnostic purposes.
• Extraosseous uptake of NaF can occur due to diverse underlying conditions.

Observation:

• A 62-year-old male patient with a history of osteoporosis underwent NaF PET/CT for evaluation of accidental chest pain.
• The scan revealed multiple fractures, consistent with the patient's presentation.
• Additionally, diffuse increased radiotracer uptake was observed in the gastric wall.

Findings:

• The unexpected gastric wall activity on NaF PET/CT was highly suggestive of hypercalcemia.
• Subsequent laboratory testing confirmed elevated serum calcium levels in the patient.

Implications:

• This case highlights the potential for NaF PET/CT to incidentally detect systemic metabolic abnormalities like hypercalcemia.
• Clinicians should consider hypercalcemia in the differential diagnosis for diffuse gastric wall uptake on NaF PET/CT.
• Enhanced awareness can lead to earlier diagnosis and management of hypercalcemia, improving patient outcomes.