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Axillary lymph node uptake of technetium-99m-MDP
F Ongseng1, C R Goldfarb, H Finestone
1Department of Radiology, Beth Israel Medical Center, New York, New York 10003, USA.
Summary
Axillary lymph node visualization on bone scans is often due to technetium-99m methylene diphosphonate (99mTc-MDP) extravasation, not adenopathy. Delayed imaging can improve bone detail in these cases.
Area of Science:
- Nuclear Medicine
- Radiology
- Oncology
Background:
- Bone scans using diphosphonates are common diagnostic tools.
- Axillary lymph node visualization can be a concerning finding, potentially indicating metastatic disease.
Purpose of the Study:
- To investigate the frequency and significance of axillary lymph node visualization on bone scans.
- To differentiate true lymphadenopathy from artifactual uptake.
Main Methods:
- Reviewed 2435 bone scans using 99mTc-MDP for axillary soft-tissue uptake.
- Correlated positive findings with physical exams, other imaging, and serial bone scans.
Main Results:
- 2% of scans showed axillary uptake ipsilateral to injection site, always associated with tracer extravasation.
- No correlation found with axillary adenopathy, mass, or calcification.
- Superimposed foci and reduced bone-to-background ratio were common; delayed imaging improved osseous detail.
Conclusions:
- Axillary visualization on 99mTc-MDP bone scans is frequently an artifact of extravasation, not true adenopathy.
- This artifact can mimic pathology and may require delayed imaging for clearer osseous detail.