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Focal hot spot induced by a central subclavian line on bone scan
Masood Moslehi1, Mohsen Cheki2, Tohid Dehghani1, Mansoureh Eftekhari3
1 Department of Medical Physics and Biomedical Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Biology, Science and Research Branch, Islamic Azad University, Fars, Iran
| Date of Submission | 12-Aug-2012 |
| Date of Acceptance | 03-Dec-2012 |
| Date of Web Publication | 29-Nov-2014 |
Correspondence Address:
Mohsen Cheki
Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran
Iran
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2277-9175.145723
The diagnostic accuracy of nuclear medicine reporting can be improved by awareness of these instrument-related artifacts. Both awareness and experience are also important when it comes to detecting and identifying normal (and abnormal) variants. We present a case of hot spot on the upper right chest in the region of right subclavicular region resulting from injection of radiotracer from central subclavian line. A 52-year-old woman with a history of left breast cancer and recent bone pain was referred to our nuclear medicine department for skeletal survey. Anterior views of chest show a focus of increased radiotracer uptake corresponding to anterior arch of one of the right second rib. The nuclear physician reported it as a focal rib bony lesion and recommended radiological evaluation. As technician later explained, physicians realized that injection site was a central subclavian line on the right side and hot spot on that region is due to injection site. The appearance of both skeletal and soft-tissue uptake depends heavily on imaging technique (such as the route of radiotracer administration) and the interpreting physicians should be aware of the impact of technical factors on image quality. Keywords: Bone scan, central line, hot spot
How to cite this article:
Moslehi M, Cheki M, Dehghani T, Eftekhari M. Focal hot spot induced by a central subclavian line on bone scan. Adv Biomed Res 2014;3:230 |
| Introduction | |  |
Bone scintigraphy is one of the most common studies performed in nuclear medicine and is used routinely in the evaluation of patients with cancers to detect suspected bone metastases and in various benign musculoskeletal conditions, such as traumatic or inflammatory disorders. Although it may seem self-evident, it is important to remain aware of those nonbiologic artifacts that are directly related to the patient's condition. Furthermore, at times the distinction between normal variants and artifacts can be difficult. Commonly encountered patient-related artifacts include artifacts caused by attenuation, contamination artifacts, and artifacts caused by intravenous lines, tubes, and catheters. The diagnostic accuracy of nuclear medicine reporting can be improved by awareness of these instrument-related artifacts. Both awareness and experience are also important when it comes to detecting and identifying normal (and abnormal) variants. [1],[2],[3],[4],[5],[6] We present a case of hot spot on the upper right chest in the region of right subclavicular region, resulting from injection of radiotracer from central subclavian line.
| Case report | | |
A 52-year-old woman with a history of left breast cancer and recent bone pain was referred to our nuclear medicine department for skeletal survey. Anterior views of chest show a focus of increased radiotracer uptake corresponding to anterior arch of one of the right second rib [Figure 1]. The nuclear physician reported it as a focal rib bony lesion and recommended radiological evaluation. On reviewing the images, the second reader noticed a technical question. Where is the injection site? As technician later explained, physicians realized that injection site was a central subclavian line on the right side and hot spot on that region is due to injection site.
| Discussion | | |
The appearance of both skeletal and soft-tissue uptake depends heavily on imaging technique (such as the route of radiotracer administration) and the interpreting physicians should be aware of the impact of technical factors on image quality. [2] The practitioners have to know the history, physical examination, technical issues before and during bone scanning for the most reliable interpretation. Oblique, lateral, and SPECT (Single Photon Emission Computed Tomography) views can also confirm the possible extraskeletal nature of suspicious radiotracer uptakes. [7],[8]
| References | | |
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