RadteraBone Scan (Tc-99m MDP, Whole Body +/- SPECT)
NM+ ContrastWhole Body
Indications
- Metastatic disease screening (breast, prostate, lung)
- Occult or stress fracture
- Osteomyelitis
- Avascular necrosis
- Complex regional pain syndrome
- Evaluation of bone pain of unknown etiology
- Prosthesis loosening or infection
Patient prep
- No specific fasting required
- Encourage oral hydration after injection (~16 oz) to improve target-to-background
- Void immediately before imaging to clear bladder activity
- Remove metal objects from imaging field
Contrast
AgentTc-99m MDP (methylene diphosphonate) or Tc-99m HDP
RouteIV
Dose20-25 mCi (740-925 MBq); range 10-30 mCi
TimingDelayed imaging 2-4 hours after injection (allows soft-tissue clearance)
Technique
- Large field-of-view gamma camera, low-energy high-resolution (LEHR) collimator, 140 keV photopeak with 15-20% window
- Whole-body anterior/posterior sweep at 10-15 cm/min, or multiple spot views
- SPECT or SPECT/CT for problem-solving (e.g., spine, pelvis, joints)
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | Whole-body anterior | Coronal sweep | Patient supine, arms at side |
| 2 | Whole-body posterior | Coronal sweep | Simultaneous with anterior on dual-head |
| 3 | SPECT/CT (optional) | Axial/multiplanar | Localization of equivocal lesions |
Key points
- Ensure adequate hydration and voiding to reduce bladder artifact and improve image quality
- Recent bisphosphonate or chemotherapy may alter uptake; flare phenomenon can mimic progression
- Superscan (diffuse intense uptake with faint kidneys) suggests widespread metastases
- Contamination from urine can mimic lesions; have patient void and re-image if suspicious
Source: Researched — verify against your institution
‹ PreviousCT Whole-Body Trauma (Pan-Scan)Next ›Lymphoscintigraphy / Sentinel Lymph Node Mapping (Tc-99m Sulfur Colloid)
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.