Detection of Cerebral Ischemia in Bone Scan

The current case involves a 68-year-old woman who was referred to the nuclear medicine department for a bone scan for suspected cardiac amyloidosis. Bone scan did not show any evidence of cardiac amyloidosis, but extraosseous cerebral 99m Tc-labeled diphosphonate analogs uptake was detected. Further questioning revealed that the patient has had left lower limb hemiparesis for the past 24 hours. Thus, she was admitted for an MRI the same day, which showed signs of a recent ischemic stroke. This case exhibits that cerebral uptake in bone scan may reflect acute ischemia and, thus, an MRI scan should be performed quickly.