Intense and Diffuse Liver Uptake and Mild (Subtle) Multiple Skeletal Metastases on Bone Scintigraphy in a Patient with End-stage of Multiple Myeloma: Correlation with CT and MRI Findings

Received 10/17/2005; revised 11/29/2005; accepted 12/1/2005. For correspondence or reprints contact: Ching-Yuan Chen, M.D., Department of Nuclear Medicine, Tri-Service General Hospital. 325 Section 2, Cheng-Kung Road, Nei-Hu, Taipei 114, Taiwan, ROC. Tel: (886)2-87927374, Fax: (886)287927217, E-mail: [email protected] Diffuse hepatic uptake of bone-imaging agent can be due to a variety of causes including radiopharmaceutical fault of elevation of serum albumin level and hypoxemia secondary to respiratory failure. We present the case of a patient with end-stage of multiple myeloma whose Tc-HMDP bone images at 2and 21-h showed diffusely and intensely increased activity in the liver in addition to subtle skeletal metastases. Concurrent CT, MRI, and subsequent bone radiography survey demonstrated multiple osteolytic lesions in the vertebrae, ribs, scapulae, and pelvic bones without abnormality of the liver.