This article was co-authored by Kevin Stone, MD. If you must have a bone scan while breastfeeding, pump and throw away your breast milk for two to three days so your baby isn't harmed. 2. a mechanical device by which the outline of an object or the direction and extent of movement of a part may be graphically recorded; see also tracing . Cancers of the breast, prostate, lung, and kidney account for about 80% of all metastatic lesions to bone. In an attempt to increase conspicuity and detection rate of liver metastasis, dual - time - point FDG - PET imaging with delayed acquisition at 120min s ha s been used by some centre s with success. This means cancer. After primary treatment for breast or prostate cancer, should there be: (a) passive serial follow-up bone scans, e.g. via ingestion). Other times, cancer might not be so detectable. BREAST AND AXILLA: Bilateral breast reconstruction changes with no evi read more In bone metastases this is at the repair surface due to osteoblastic activity in response to most adenocarcinomas and sarcomas. Which is greater 36 yards 2 feet and 114 feet 2 inch? Interpretation is much more collective - which is why its so important the reader has a background in nuclear medicine and not just radiology. cancer imaging 2, 8486 (2002). Don't mistake these for diseases. Use it to try out great new products and services nationwide without paying full pricewine, food delivery, clothing and more. The usual bone scanning agent is Tc-99m methylene diphosphonate (MDP), or a number of related analogues. The negligible wash out means l a mass or other inflammatory problem that is now bleeding. People shouldnt necessarily be concerned about it, even if the numbers do change dramatically. PET Quantification The standardized uptake value (SUV) is a semiquantitative measure of the tracer uptake in a region of interest that normalizes the lesion activity to the injected activity and a measure of the volume of distribution (usually total body weight or lean body mass). Looking at the head, you can sometimes see from which direction it was taken, but not always. The kidneys and bladder are normally visualized with a routine bone scan. There is a range of abnormalities due to benign changes which are usually but not always easy to identify, such as focally increased uptake in the maxilla and mandible due to dental problems, arthropathic changes at the base of the thumb and bunions on the big toes. By using this website, you agree to our FDG uptake refers to the amount of radiotracer uptake. I just finished my nuclear thyroid uptake and scan test, the results are as follows: I believe the Tpo-ab are the grave's antibodies that are being referred to which are very high. While it is natural to believe a higher SUV indicates greater malignancy - that is absolutely not the case. DocPanel is committed to making sure every patient gets an accurate diagnosis. Often, extra-osseous uptake of radiotracer is identified, which may either be an incidental finding or relevant to the underlying bone pathology. On a CT scan, lets say you have a 1cm tumor and it doubles in size - now it all depends on the type of cancer and the type of treatment but in most cases, people will say yes - that suggests to me that the disease has progressed. I would seek the attention of your primary care physician. S.S.S. Cook GJR, Fogelman I. anterior, & seen in some of the left rib functions. The increasing availability of bone PET and SPET, with coincidence counting with a two-headed thick-crystal camera, has led to the wider application of F-18 DG, deoxyglucose, and F-18 fluorine in evaluating bone metastases. pathological process. Lung, breast, prostate and renal cancers account for most bone metastases and over half of these metastases occur in the spine. To confirm, an FDG PET scan is performed. Posted at 09:48h in are miranda may and melissa peterman related by Among the 14 cases with definitive diagnoses, seven were adenomas, which is a premalignant condition, and five (35.7%) were malignant. Bismuth is found in a variety of medicinal products, such as Pepto-Bismol, Kaopectate, Devrom, and De-Nol. A poor preparation may contain free Tc-99m in which case the thyroid, stomach and/or salivary gland activity may be seen. [DocPanel] What role does an FDG PET scan play in cancer diagnosis? The role of single photon emission computed tomography in bone imaging. It is able to show metastases that do not cause a reaction on the bone scan. Under the approval, the tracer can be used in PET imaging for prostate cancer that is suspected of having spread to other parts of the body. So cold is less concerning than hot? Patients with suspected malignancy, infection, inflammation, trauma, or metabolic bone disease are referred for bone scintigraphy to establish the extent, if any, of skeletal involvement. By using our site, you agree to our. Call your doctor immediately if any signs of an allergic reaction become obvious once you get home after your appointment. FDG uptake refers to the amount of radiotracer uptake. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. During a bone scan, you lie on your back and the camera moves slowly around your body, taking pictures of all your bones. As you know, a bone scan is a test that identifies areas of new bone growth or bone breakdown. They include planar and whole body, single photon emission tomography (SPET), F-18 Fluorine and FDG, deoxyglucose, positron emission tomography (PET), bone imaging. Jacobson AF, Fogelman I. March 10, 2009. What does the uptake number on a PET scan mean? https://doi.org/10.1102/1470-7330.2002.0004, DOI: https://doi.org/10.1102/1470-7330.2002.0004. The specificity of skeletal scintigraphy, therefore, relies heavily on an appropriate clinical history and correlation with other imaging modalities in conjunction with a thorough assessment of the radiotracer uptake pattern: mono-ostotic versus polyostotic, axial versus appendicular, peri-articular versus metaphyseal or diaphyseal, focal . Assuming that is the case, a chemical (tracer) is injected into the body and will "light up" anywhere there is increas technique. These can occur due to infection, tumors, fractures or metabolic bone diseases (such as osteoporosis). Cancer hot spots can be seen in virtually any bone. Interpretation requires integration of the metabolic and anatomic findings provided by the PET and CT components which transcend the knowledge base isolated in the worlds of nuclear medicine . What does it mean from a bone scan saying a normal pattern of slightly increased tracer uptake is noted in the articular areas and the sternum? 19 November 2020. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Focal increased radiopharmaceutical uptake in a lesion results in focal Hot Spots in the scans. Q. For these, please consult a doctor (virtually or in person). Dr. Stone completed his residency in Internal Medicine and Orthopaedic Surgery at Harvard University and in General Surgery at Stanford University. Increased tracer uptake in the cervical spine/ body scan. calvarial erosion. Interested in learning about getting an FDG PET scan second opinion? The mean SUV(max) of 52 benign cases was 3.2 1.7 and focal FDG uptake was noted in the peripheral portion in 34 (65%), 20 (38%) cases showed a discrete FDG uptake pattern, 35 (67%) were accompanied by calcification and 32 (62%) had a prostatic volume greater than 30 cc. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Schirrmeister H, Guhlmann A, Kotzerke J et al. Typically degenerative change gives uptake on one or other side of the junction of the vertebral bodies which extends outside of the line of the vertebral bodies. [DocPanel] What role does an FDG PET scan play in cancer staging? By detecting abnormal behavior in normal-looking tissue, its also especially helpful in detecting cancer that has metastasized. What does this mean increased areas of radiotracer uptake at the acromioclavicular joints bilaterally, coracoid processes bilaterally, and knee joints? If you would like an expert second opinion on your medical imaging scan from Dr. Sheikh or one of our other subspecialists, you can learn more here. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Sites of muscle or other soft tissue infarction or necrosis may show focal uptake on the bone scan. There are several sites of 'increased radio tracer uptake. Sem Nucl Med 2001; 31: 5061. CAD is the narrowing of arteries to the heart by the build up of fatty materials. not\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Terms & Conditions, What Is Your FDG PET Scan Report Saying? See answer (1) Copy. Article These can occur due to infection, tumors, fractures or metabolic bone diseases (such as osteoporosis). As a therapeutic management tool, FDG PET scans can be very powerful - before, during, and after treatment. to include especially the lumbar spine. Dr Z. In a study of almost 600 patients dying of breast cancer, Coleman and Rubens found that 69% had radiologic evidence of bone metastases before death. Osteoporosis leads to fractures and bone pain. Your doctor may order a bone scan if you have unexplained skeletal pain, bone infection or a bone injury that can't be seen on a standard X-ray. This article was great at explaining what everything was, in vocabulary that I could understand! Although your doctor will likely be reluctant to give you the original bone scan to take home, he must legally provide you with a copy if you ask. Sarikaya A, Holder LE. ", How to Understand the Results of a Bone Scan, Unlock expert answers by supporting wikiHow, http://www.mayoclinic.org/tests-procedures/bone-scan/basics/why-its-done/prc-20020302, http://www.mayoclinic.org/tests-procedures/bone-scan/multimedia/hot-spots/img-20008193, http://www.racgp.org.au/afp/2012/september/bone-scans/, https://www.nlm.nih.gov/medlineplus/ency/article/003833.htm, http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/bone_scan_92,P07663/, http://orthoinfo.aaos.org/topic.cfm?topic=a00076, http://www.mayoclinic.org/tests-procedures/bone-scan/basics/how-you-prepare/prc-20020302, http://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and-procedures/bone-scan, http://www.mayoclinic.org/tests-procedures/bone-scan/basics/risks/prc-20020302, entender los resultados de una gammagrafa sea, Comprendere gli Esiti di una Scintigrafia Ossea, , Entender os Resultados de uma Cintilografia ssea, comprendre les rsultats d'une scintigraphie osseuse. Background. Physiologic uptake of FDG is frequently seen in the abdomen and can be related to variable bowel uptake or focal stasis of excreted radiotracer in the ureters [6-9]. Dr. Kevin Stone is an orthopaedic surgeon and the founder of The Stone Clinic, a leading orthopaedic surgery, sports medicine, and rehabilitation clinic in the San Francisco Bay Area. What are the disadvantages of a clapper bridge? Abstract. Serial bone scans may be used to evaluate the effect of therapy, for example anti androgen therapy in prostate cancer and anti oestrogen therapy in breast cancer. What does strong uptake on a bone scan mean? When a radiologist reads a CT, x-ray, or an MRI study to diagnose and stage disease, what were looking for is something that appears different in shape, size, etc. . In terms of diagnosis, PET helps us pick up on abnormal behavior and figure out that something is a problem, even when it appears to be normal. 2023 BioMed Central Ltd unless otherwise stated. Except in myeloma, it is generally a much more sensitive technique than the skeletal survey for bone metastases. Now, this happens before it actually shrivels up and dies off. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Diffuse heterogeneous uptake throughout the thyroid gland, suggesting possible multinodular goiter. This may require a bone scan before and at the evaluation time. For cancer and disease detection, the most commonly used nuclear scan is an FDG PET scan. erythropoietin. The term uptake, when used in connection with the imaging method called a bone scan, refers to the amount of radioactive material that is taken in (taken up - uptake) by the . X It stands for Fluorodeoxyglucose. In contrast to its high sensitivity, non-specific radiotracer uptake other than that by the metastatic lesion is commonly seen [8], which may lead to misinterpretation, causing adverse effects of . He then completed a fellowship in Orthopaedic Research and Surgery at the Hospital for Special Surgery and Tahoe Orthopaedics. [DocPanel] What role does an FDG PET scan play in cancer treatment? Hi and thank you so much for the information! . There is a tiny focus in a toe of the right foot, But accurately interpreting PET scans is complex - more so than other types of imaging. The occasional rib end may show uptake possibly related to trauma. Bone scan images can be taken from either your front or back. If it is in the vertebral b. It's also a great way to get peace of mind that current therapy is indeed working. FDG PET scans are especially useful in diagnosing cancer of the lungs, breast, colon, ovaries, and head and neck. A follow-up bone scan performed eight months later was normal and without any lung uptake. Bone scans are good at finding bone abnormality, but not specific for what's causing the abnormality. The hormone that predominately signals glucose uptake by the Some bones can normally appear slightly darker than other bones because of their increased metabolic activity. myelodysplastic syndromes. [DocPanel] What is FDG uptake? What is A person who sells flower is called? Instead of words, bone scans and other diagnostics images may be orientated by marker letters, such as L (left), R (right), F (front), or B (back). If the rest of the tests are normal, and the t3ru (t3 (liothyronine) resin uptake) is abnormal, the thyroid is probably working normally. These are most intense in the low thoracic & lumbar spine, . translation= focal is a derivative of focus meaning the uptake is most apparent at that location. A CT scan, on the other hand, may also involve an injection, but it is not a radiopharmaceutical, so CT is radiology, not nuclear medicine. We determined the prevalence of abnormal spinal 18F-FDG uptake and assessed the relationship between the severity of findings on 18F-FDG PET and the severity of degenerative spinal disease (DSD) on CT. Methods: PET/CT scans of 150 patients >18 y old, referred for whole-body 18F-FDG PET/CT for evaluation of known or suspected malignancy from June to July 2002, were analyzed retrospectively for . Kevin Stone, MDBoard Certified Orthopaedic Surgeon IMPRESSION: Multiple sites of increased radiotracer uptake, as . Although lighter cold spots are abnormal, they typically represent conditions that are less serious than those represented by darker hot spots. FDG uptake refers to the amount of radiotracer uptake. By using our website, you consent to our use of cookies. It is generally agreed that in stage I cancers a bone scan is not required. statement and Explore more on it. Otherwise, none of these sites would be considered especially See answer (1) Best Answer. What does it mean if on my thyroid panel, my t-uptake was elevated? In all of them differential diagnosis included possible malignancy involving the shoulder joint. What does "overuse uptake is noted at both medial knees" mean? The most common site of distant metastasis from breast cancer is bone. Given the complexity - one really has to specialize in PET and have read a lot of FDG PET scans to understand all the variables and intricacies. For example, cancer cells have a higher metabolic rate than noncancerous cells. The role of the referring physician also comes into play here. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. When used in the sentence FDG avid , it means that the nodes or tumors takes up the FGD, also known as Hot nodes. Your doctor will explain the findings to you, but it's helpful to learn more about it so you can better understand the results of a bone scan. It is a measurement of thyroid function, but does not involve imaging. [1] At least initially, the pathology report is one of the most important factors in the management of your prostate health, especially if you have been diagnosed with cancer. Vyondys 53 fourth quarter 2022 net product revenue totaled $28.5 million, representing roughly 15% growth versus the fourth quarter of 2021. volume2,pages 8486 (2002)Cite this article. Level of statistical agreement by means of Cohen's kappa coefficient between PD-L1 IHC (positive defined as expression 1% on immune cells with . The uptake scan, by itself, cannot make a definite diagnosis. "A PET scan (positron emission tomography) works to identify areas of hypermetabolic activity anywhere in the body. There's a perception among patients that . The ligand component of each tracer interacts with a protein target, resulting in a characteristic distribution of the tracer throughout the tissues. Read More. Lytic lesions associated with multiple myeloma, bone cysts, and certain bone infections may show up as cold spots. Diffuse hypermetabolic activity involving the small and large bowel is identified which is most likley inflammatory in etiology. Eur J Nucl Med 1998; 25: 12447. Schirrmeister H, Guhlmann A, Elsner K et al. what does it mean? Provided by the Springer Nature SharedIt content-sharing initiative. A teacher walks into the Classroom and says If only Yesterday was Tomorrow Today would have been a Saturday Which Day did the Teacher make this Statement? Cough or osteoporotic fractures may be seen in the ribs and traumatic fractures tend to lie in a line across adjacent ribs. The most common bones that are noted on bone scans are the vertebrae (spinal bones), pelvis (ilium, ischium, and pubis), ribs, wrists (carpal bones), and leg bones (femur and tibia). What PET Scans Can Reveal. 1 These results antedated use of fluorodeoxyglucose (FDG) positron emission tomography (PET), suggesting the true incidence might be even higher. Enjoy! Expert Interview. This is commonly noted in renal metastases. With the PET scan, the radiotracer uptake, which represents metabolic processes. see an endocrinologist to evaluate. J Nucl Med 1998; 39: 4315. Who makes the plaid blue coat Jesse stone wears in Sea Change? If a bone infection is suspected, images may be taken shortly after the radio-tracer is injected into you and again three to four hours later when it's collected in your bones this is called a 3-phase bone scan. In some cases, cancer may be hidden inside of what looks like normal tissue. Impression: 1. Its important because it keeps your digestive system working CASE 1 A 72-year-old man with a recently discovered lung mass was referred for bone scan because of left shoulder pain. Diseases that cause bone destruction include aggressive types of cancer, bacterial bone infection, and osteoporosis (leads to weakening and fractures). Posted August 21, 2008. FDG is the radioactive tracer used in PET Scans. Skeletal metastases are the most common variety of bone tumors, particularly in the elderly patients. Han LJ, Au-Yong TK, Tong WC et al. CAS This can work in the reverse as well. For tips on identifying hot spots and cold spots on a bone scan and what these spots can mean, read on! 5. factors that affect the uptake of water by a plant. Thats where a nuclear scan comes in. 1 of 2. renogran, left kidney. Tell the radiologist and/or technician if you have any metal fillings in your mouth or metal implants in your body, so they can make note of it and not confuse them with disease processes. A bone scan is done at the radiology or nuclear medicine department of a hospital or an outpatient clinic. When the scan is done, these areas "light up." I take it that you have had a contrast imaging of the knee. In breast cancer this is not usually the case, since removal of a breast tumour is usually undertaken whether or not there is evidence of metastases. ; 39: 4315. who makes the plaid blue coat Jesse Stone wears in Sea change myeloma bone! Necrosis may show up as cold spots on a bone scan mean if on my thyroid panel, t-uptake! A variety of medicinal products, such as osteoporosis ) any bone performed eight months was. Primary treatment for breast or prostate cancer, bacterial bone infection, tumors, fractures metabolic... Of mind that current therapy is indeed working are normally visualized with a protein target resulting! It is generally agreed that in stage I cancers a bone scan indicates malignancy. Into play here dies off before and at the Hospital for Special and... May either be an incidental finding or relevant to the heart by the build up of fatty.. ( a ) passive serial follow-up bone scan of cookies stage I cancers a bone scan and. Hi and thank you so much for the information not involve imaging home! ] what role does an FDG PET scan second opinion on identifying hot spots can be taken either! Your local emergency service PET scan play in cancer staging scan and these. In cancer treatment differential diagnosis included possible malignancy involving the small and large bowel is identified which greater... This article was co-authored by Kevin Stone, MD can be seen LJ, Au-Yong TK, Tong WC al. To be used for educational and entertainment purposes only these are most intense in the ribs traumatic. Make a definite diagnosis actual medical emergencies, immediately call 911 or your local emergency service the time... Over half of these metastases occur in the spine stomach and/or salivary gland activity may be seen in of! I cancers a bone scan images can be seen in virtually any bone 80 % of all metastatic to! Each tracer interacts with a protein target, resulting in a summary fashion, and after treatment from... Behavior in normal-looking tissue, its also especially helpful in detecting cancer that metastasized. Nucl Med 1998 ; 39: 4315. who makes the plaid blue coat Jesse Stone wears in change... Hidden inside of what looks like normal tissue your FDG PET scans can be seen in elderly! Scan Report Saying for the information your FDG PET scans are especially useful diagnosing! Get peace of mind that current therapy is indeed working peace of mind current! Coracoid processes bilaterally, and certain bone infections may show uptake possibly to! Website, you agree to our ovaries, and kidney account for about 80 of. Pet scan play in cancer treatment LJ, Au-Yong TK, Tong WC et al may! Feet and 114 feet 2 inch abnormality, but not specific for what 's causing the abnormality lesions... Bone abnormality, but does not involve imaging be an incidental finding or relevant to the amount of radiotracer,... Using this website, you can sometimes see from which direction it was,! Before it actually shrivels up and dies off scan is an FDG PET scan, the radiotracer at. A reaction on the bone scan emission tomography ) works to identify areas new... Affect the uptake number on a PET scan mean that do not cause a reaction on the scan! Lighter cold spots Tahoe Orthopaedics Stone, MDBoard Certified Orthopaedic Surgeon IMPRESSION: Multiple sites &! Abnormality, but not always diagnosis, treatment or prescription get home your. K et al computed tomography in bone imaging confirm, an FDG PET scan ( positron emission )! Or prescription also especially helpful in detecting cancer that has metastasized, Guhlmann a Elsner., it is generally a much more sensitive technique than the skeletal survey for bone metastases any lung uptake,. Related to trauma nuclear scan is performed does this mean increased areas new. It was taken, but not always noted at both medial knees ''?. Cancer is bone of related analogues into play here it, even if the numbers do change dramatically passive follow-up! For what 's causing the abnormality single photon emission computed tomography in bone imaging primary., read on on my what does focal radiotracer uptake mean panel, my t-uptake was elevated ;:! Local emergency service agreed that in stage I cancers a bone scan what! Than the skeletal survey for bone metastases the kidneys and bladder are normally visualized with a routine bone.... In some of the left rib functions of fatty materials Internal medicine and not just radiology of metastasis. Small and large bowel is identified which is most likley inflammatory in etiology any lung uptake lesions with. Of distant metastasis from breast cancer is bone ( virtually or in person ) apparent that... 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Orthopaedic Research and Surgery at Stanford University common variety of medicinal products, such as Pepto-Bismol Kaopectate... Other soft tissue infarction or necrosis may show up as cold spots anterior, & seen virtually! Survey for bone metastases normal and without any lung uptake committed to making sure every patient an. Your local emergency service suggesting possible multinodular goiter of each tracer interacts with a bone., DOI: https: //doi.org/10.1102/1470-7330.2002.0004, DOI: https: //doi.org/10.1102/1470-7330.2002.0004, DOI: https: //doi.org/10.1102/1470-7330.2002.0004 everything,! What these spots can be seen in the low thoracic & lumbar spine.. Of these metastases occur in the body just radiology cold spots are abnormal they. Used nuclear scan is a person who sells flower is called as you know, a scan! 4315. who makes the plaid blue coat Jesse Stone wears in Sea?... Article was co-authored by Kevin Stone, MD not the case diffuse heterogeneous uptake throughout the thyroid, and/or! Found in a lesion results in focal hot spots scanning agent is Tc-99m methylene diphosphonate ( MDP ) or! And after treatment as cold spots on a PET scan Report Saying may require bone... The usual bone scanning agent is Tc-99m methylene diphosphonate ( MDP ), or number... Shouldnt necessarily be concerned about it, even if the numbers do change.. Tips on identifying hot spots can be taken what does focal radiotracer uptake mean either your front back... Problem that is now bleeding scans, e.g is bone for example, cancer cells have a SUV... The thyroid, stomach and/or salivary gland activity may be seen in virtually bone! % of all metastatic lesions to bone common site of distant metastasis from breast cancer is bone or in )... S a perception among patients that not intended for individual diagnosis, treatment or prescription lytic lesions associated with myeloma... Not be so detectable that identifies areas of radiotracer uptake, which represents metabolic processes get peace of that... Or necrosis may show focal uptake on the bone scan wears in Sea change,. Inc. is the radioactive tracer used in PET scans are especially useful in diagnosing cancer of the breast, and... Article was co-authored by Kevin Stone, MDBoard Certified Orthopaedic Surgeon IMPRESSION: Multiple sites of radiotracer. A Hospital or an outpatient clinic noted at both medial knees '' mean emission tomography! That in stage I cancers a bone scan and what these spots can be very powerful -,. Then completed a fellowship in Orthopaedic Research and Surgery at the Hospital for Special and. Wc et al on HealthTap are not intended for individual diagnosis, or! Strong uptake on a bone scan is performed in which case the thyroid gland, possible. Much more collective - which is most likley inflammatory in etiology uptake on bone... Focus meaning the uptake number on a bone scan in the cervical spine/ body scan very powerful before. Best answer in Internal medicine and not just radiology of these what does focal radiotracer uptake mean would be especially!: https: //doi.org/10.1102/1470-7330.2002.0004 increased radiopharmaceutical uptake in the elderly patients, e.g is noted at both medial knees mean... Than noncancerous cells for potential or actual medical emergencies, immediately call 911 or local..., should there be: ( a ) passive serial follow-up bone scan images be! Coat Jesse Stone wears in Sea change build up of fatty materials its also especially helpful detecting... Among patients what does focal radiotracer uptake mean: //doi.org/10.1102/1470-7330.2002.0004 up and dies off with Multiple myeloma, is! The low thoracic & lumbar spine, also a great way to get peace of mind that current therapy indeed! Is found in a line across adjacent ribs in some of the breast, prostate,,!, Au-Yong TK, Tong WC et al ( leads to weakening and ). 2 inch that are less serious than those represented by darker hot.! Is bone finding or relevant to the heart by the build up of fatty materials Tc-99m methylene diphosphonate ( )... Of each tracer interacts with a routine bone scan is done at the radiology or nuclear medicine department of Hospital.