Intense gallbladder uptake associated with chemotherapy. An unusual finding in pediatric skeletal scintigraphy

Focal and diffuse hepatic uptake of bone-seeking radiopharmaceuticals may be due to a variety of conditions including tumors and radiopharmaceutical impurity. However, uptake in the gallbladder is unusual with currently used skeletal agents. Three patients (aged 10, 15, and 16 years) underwent routine whole-body bone scans during a course of intensive chemotherapy with VP-16 and ifosphamide. Images showed intense gallbladder and faint liver uptake. No patient had symptoms of cholecystitis. Radiopharmaceutical quality control revealed no impurities. Repeat bone scans after completion of chemotherapy showed no liver or gallbladder uptake. The authors conclude that this finding represents altered distribution induced by the chemotherapy regimen, and should not be misinterpreted as intrinsic liver or gallbladder disease.