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| Investigation and reason analysis of domestic knowledge on relatively higher tracer uptake inneck in anterior image of 99mTc-MDP bone scanning |
| LI Wei, ZHANG Ru-sen, LIU Feng, LU Bin-gui, REN Zhi-gang |
| Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou 510095, China |
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Abstract Objective: To investigate the reasons for domestic knowledge about neck’s relatively higher tracer uptake(RHTUN) in anterior image of 99mTc-MDP whole body scanning by SPECT/CT. Methods: After investigating the domestic nuclear medicine professional books and papers for understanding RHTUN and its reasons, analyzing 20 nuclear medicine professional books published after 2000, searching VIP Chinese database with conditions of “bone imaging” and “neck”, and sending questionnaire survey to the Tencent QQ group “happy nuclear medicine” with 203 members, 100 cases of whole body bone imaging and neck SPECT/CT in one day were enrolled in the study. SPECT/CT findings were taken as the qualitative standard to analyse the causes for RHTUN. Results: All 20 books mentioned RHTUN. On the cause of formation, 18 books(90%) referred to “abnormal thyroid uptake of 99mTcO4-”, 13 books(65%) referred to “cervical bone hyperplasia and excessive intake of radioactive drugs”, 8 books(40%) referred to “throat cartilage calcification and abnormal uptake of radioactive drugs”. Only 4 of 14 papers in VIP Chinese database were correlated but not directly related with RHTUN. A total of 105 copies of effective response were got from “happy nuclear medicine”, and 105(100%) all knew RHTUN. About the primary cause of RHTUN, 72(68.6%) supported “thyroid uptake of 99mTcO4-”, 28(26.7%) supported “cervical bone hyperplasia and excessive intake of radioactive drugs”, and 5(4.8%) supported the “throat cartilage calcification and abnormal uptake of radioactive drugs”. In the 100 cases, 88 cases showed RHTUN. 88 cases(100%) showed cervical radioactive concentration in SPECT/CT image with higher radioactive level near intervertebral disc and the posterior side of vertebral body. In 88 cases(100%) of radioactivity distribution in the laryngeal cartilage, the radioactive level was not more than the background level in the cervical vertebra. All 88 cases(100%) showed no abnormal radioactivity distribution in the thyroid. In 88 cases of RHTUN, 63 cases were along with cervical vertebra hyperplasia(clear in 41 cases, suspicious in 7 cases, none in 15 cases) and intervertebral disc anomalies(clear in 27 cases, suspicious in 8 cases, none in 28 cases), and 25 cases were focal with cervical vertebra hyperplasia(clear in 14 cases, suspicious in 4 cases, none in 7 cases) and intervertebral disc anomalies(clear in 17 cases, suspicious in 5 cases, none in 3 cases). There was no significant difference in cervical vertebral hyperplasia or in intervertebral disc anomalies between 2 types. Conclusion: Domestic nuclear medicine profession showed no big concerns or even some misunderstandings on RHTUN. Degeneration of cervical vertebra and cervical physiological uptake were the main reasons of RHTUN. Focal type of RHTUN suggested the possibility of intervertebral disc degeneration.
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Received: 19 September 2014
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2015, Vol. 26 
