Superscan appearance. The term “superscan” usually refers to May 28, 2020 · Prostate cancer (46/80) was the most common cause of superscan appearance followed by breast cancer (10/80). Afterward, radiotherapy for bone lesions was arranged and the effects were evaluated. This case repor … The <sup>18</sup>F-fluorodeoxylucose (FDG) positron emission tomography (PET) is the gold standard imaging modality in the staging of lymphoma. A superscan is a rare imaging appearance characterized by a high ratio of skeletal to soft tissue radionucleotide uptake with minimal activity in the kidneys and bladder [[4], [5], [9]]. Apr 18, 2023 · BS with diffuse increased skeletal radioisotope uptake with absent or faint urinary tract and soft tissue activity is defined as a superscan. 88074. The present study was conducted to analyze the superscan appearance in skeletal metastatic disease and to find out its relationship with parameters such as cause, age, sex, duration of disease, serum ALP, and serum PSA. Radionuclide bone imaging is not specific, but its excellent sensitivity makes it useful in screening for many pathologic conditions. Apr 1, 2004 · Overall incidence of superscan in this study was 1. This case report presents lymphomatous blastic infiltration as a cause of superscan appearance in 18 F-FDG PET/CT. However, the extremities typically have a greater level of increased uptake with secondary hyperparathyroidism than is expected with metastatic disease. 7. Liu Y. Incidence of superscan in prostate cancer Feb 2, 2022 · The only case report of skeletal superscan appearance in the 68 Ga PSMA PET/CT was presented by Agarwal et al. , 2012; Love et al. 2 | METHODS 2. Hand radiograph with endosteal Feb 1, 2022 · The final images of the patient that demonstrated a superscan appearance in the Gallium-68 PSMA positron emission tomography/computed tomography, which is a rare phenomenon, are presented. Oct 1, 2017 · The term 'superscan' usually refers to a characteristic pattern on skeletal scintigraphy consisting of symmetrically intense and diffuse radiotracer uptake in the skeleton with absent or Dec 1, 2023 · In patients presenting with a markedly elevated PSA level and extensive bone metastases, a superscan pattern can be seen on BS. While a superscan is relatively uncommon, its recognition is important, as it is associated with a number of important underlying diseases. For the first time to our knowledge, a case of distal RTA is reported in association with a superscan on bone scintigraphy. (8). For the first time to our knowledge, a case of distal RTA is reported in association with a superscan on bone scintigraphy Dec 28, 2023 · The description of the superscan for conventional bone scintigraphy is widely documented, but this is not the case for 68 Ga PSMA PET/CT: at the date of writing this series of cases, and according to the literature review carried out, only four cases have been published [5-,8], so our study broadens this discussion and we propose for its as a superscan appearance can be seen in diffuse metastatic bone disease. Radionuclide bone scan shows multiple areas of increased activity in these regions as well as the ribs and scapula. Out of 6027 patients referred for bone scan, 307 patients had prostate cancer on The appearance of a superscan is frequently accompanied by an abnormal titer of serological markers IgG-VCA and IgA-VCA, liver metastases, and poor survival. 3% in different type of cancer patients, and the most common cause of Superscan appearance was prostate cancer. It is well known that superscans are associated with a poor prognosis among cancer patients, but there is a lack of information on whether superscans are associated with the prognosis among patients DOI: 10. We review reported cases of 18-F-FDG PET/CT superscans and propose criteria for differentiating pathologic superscans from physiologic causes. FB Corpus ID: 45106927; Multiple brown tumors with Tc-99m MDP superscan appearance and negative Tc-99m MIBI uptake. fb. Whole body planar scans were obtained at 3 h and 24 h after injection of 740 MBq 99 Tc m MDP and 5 days later at similar times after injection of 555 MBq . The multiple lytic lesions that were seen are brown tumors (osteoclastomas) without focal Tc-99m MDP or Tc-99m MIBI uptake. To the best of our knowledge, this is the only report of a case with lymph nodes Feb 21, 2023 · Bone scans may reveal diffuse skeletal uptake of radiopharmaceutical with a superscan appearance that can be confused with metastatic disease. Materials and methods: The search terms were 'bone' AND 'superscan' OR 'superscan' in the PubMed database from 1980 to November 2020. diseases causing superscan on BS and explore the reported frequency of superscan within different disease entities. We present an example of diffuse skeletal involvement on both F-FDG PET/CT and Ga DOTATATE PET/CT with a pattern similar to the superscan appearance described on skeletal scintig … This finding may be seen in extensive hepatic involvement by malignancy such as metastatic disease, lymphoma or hepatocellular carcinoma [5-7]. With metastatic disease (most commonly prostate or breast cancer), the uptake is heterogeneous or patchy and favors the axial skeleton. rlu. Apr 18, 2023 · In one study, Graves' disease was associated with the highest frequency of a superscan appearance among hyperthyroid patients (Kotb et al. Overall incidence of superscan in our study was 1. A superscan appearance may be caused by a prolonged delay before imaging. Jul 14, 2024 · The skeletal superscan-like appearance of 18 F-FDG PET/CT is a rare phenomenon in clinical practice. Note the lack of uptake in the kidneys and soft tissues, indicating a “superscan appearance ” (Courtesy of JS Wu, MD, Boston) (JPG 249 kb) Sep 29, 2020 · Superscan appearance in the liver in 18 F-FDG PET/CT is usually associated with malignancy, like massive liver metastases (breast primary), primary hepatic lymphoma, diffuse angiosarcoma of the liver, secondary lymphomatous or leukemic involvement of liver etc. 6. Aug 1, 2022 · 2686 Introduction: Superscan on Bone scintigraphy is characterized by diffusely increased tracer uptake throughout the skeleton accompanied by decreased renal visualization. This is a report of bone scintigraphy demonstrating superimposed metastatic and metabolic superscan in a patient with prostate cancer, … Mar 1, 2003 · Bone scintigraphy with technetium-99m–labeled diphosphonates is one of the most frequently performed of all radionuclide procedures. Superscan is often seen in metastatic setting to the bones, notably in Carcinoma Prostate. While the typical heterogeneous appearance of metastases normally is distinct from homogeneous uptake in metabolic bone disease, the appearance of confluent disease (a superscan) can be quite similar as seen in the present patient [4-7]. 1097/01. }, author={Adonios Zanglis and Demetrios Andreopoulos and Athanassios Zissimopoulos and Nikolaos Baziotis hosphatemia, whereas the biopsy of a lytic lesion (right humerus) showed only a few macrophages and multinuclear giant cells. Fig. References. The differential diagnosis pertaining to a superscan pattern on skeletal scintigraphy includes diffuse osteoblastic metastasis, renal osteodystrophy, osteomalacia, and severe primary hyperparathyroidism. In this review, we investigate the different etiologies causing superscan and the reported frequency of superscan among different disease entities. Herein, presented the final Sep 26, 2023 · A superscan is a rare imaging appearance char-acterized by a high ratio of skeletal to soft tissue radionu-cleotide uptake with minimal activity in the kidneys and blad-der [4,5,9]. Neck surgery verified the presence of a parathyroid adenoma. The appearance of a metastatic superscan differs from that of a metabolic superscan. Vargo-Gogola T, Rosen JM (2007) Modelling breast cancer: one size does not could be misinterpreted as a normal bone scan. Hepatic superscan appearance has also rarely been reported in non-malignant conditions including tuberculosis [8]. In metabolic bone dis-ease, the superscan appearance tends to show homogenous involvement of the axial and the Fig. . Tc99m is the most common radionuclide used in nuclear In metabolic bone disease, the superscan appearance tends to show homogenous involvement of the axial and the distal appendicular skeleton whereas in metastatic disease activity tends to be heterogenous and involves the axial and proximal appendicular skeletons. Typically, this has an appearance of multiple focal lesions. , 2007). @article{Zanglis2006MultipleBT, title={Multiple brown tumors with Tc-99m MDP superscan appearance and negative Tc-99m MIBI uptake. That appearance has been described as “too good” or beautiful scan and it include some This work reviews reported cases of 18-F-FDG PET/CT superscans and proposes criteria for differentiating pathologic superscan from physiologic causes and knowledge of the 18- F- FDG PET-CT superscan is important to the nuclear medicine physician or radiologist specializing in the interpretation of nuclear studies to avoid several diagnostic pitfalls. Caution should be exercised when interpreting a bone scintigraphy in May 1, 1991 · It is speculated that impaired hydrogen ion secretion in this patient with distal RTA subclinically increased bone turnover, contributing to the superscan appearance on bone scintigraphy. 99m Tc-MDP BS showed a superscan, especially because of the fact that the kidneys were not shown. However, it may also occur in metabolic bone diseases such as Hyperparathyroidism, Paget disease, Osteomalacia, and myelofibrosis The skeletal superscan-like appearance of 18 F-FDG PET/CT is a rare phenomenon in clinical practice. Here we present a case of colon carcinoma with metastatic superscan on 99m Tc-MDP bone scintigraphy, a very rare cause for metastatic superscan. Superscans and superscan-like appearances have also been described on fluorine-18-fludeoxyglucose positron emission tomography-computed Aug 14, 2023 · Skeletal scintigraphy, commonly referred to as a bone scan (BS), is a valuable and versatile nuclear medicine tool. There were two previously reported cases with diffuse Apr 1, 2004 · Skeletal metastases arising from a wide variety of malignancies including a few cases with superscan appearance were evaluated using 99 Tc m MDP bone scanning and 99 Tc m (V)DMSA scintigraphy. Two years after the first bone scintigraphy showing multiple metastases, the patient developed renal insufficiency, hyperphosphoremia, and hypocalcemia. Metastatic neureoendocrine tumor to bone is well recognized. This case also provides a clue to the cause of skeletal uptake: note that the left kidney has been displaced inferiorly by an enlarged spleen from marked Apart from prostate cancer, which is the most common condition associated with a superscan, other malignancies like breast cancer, lung cancer[1,2,3,4] can cause superscan appearance on bone scintigraphy. 2006 Oct;31(10):640-3. These malignancies have a predominance of spread Feb 2, 2022 · Herein, presented the final images of the patient that demonstrated a superscan appearance in the Gallium-68 PSMA positron emission tomography/computed tomography, which is a rare phenomenon. This case also provides a clue to the cause of skeletal uptake: note that the left kidney has been displaced inferiorly by an enlarged spleen from marked Jul 1, 2007 · The causes and variable features of a superscan are described and patterns which may aid in defining the underlying cause for the scan are depicted to help identify the underlying disease in such cases. Superscans on bone scintigraphy have been described mostly in metastatic and metabolic bone diseases, with different patterns and appearances of radiotracer uptake. Jan 19, 2022 · A superscan is an imaging appearance on a Tc-99m diphosphonate bone scan which occurs as a result of a high ratio of bone to soft tissue tracer accumulation. 1 | Search strategy and eligibility criteria The PubMed database was searched for relevant articles. Out of all patients with superscan, 71 patients (88. [1,2] Initially, by definition, this terminology applied to a pattern on bone scintigraphy that assumes a condition in which the 99 mTc-mthylene-diphosphonate is perfectly taken up in the skeletal system, and no background activity is noticed. To the best of our knowledge, this is the only report of a case with lymph nodes and skeletal superscan appearance in the 68 Ga PSMA imaging. doi: 10. Superscans and superscan-like appearances have also been described on fluorine-18-fludeoxyglucose positron emission tomography-computed tomography (18-F-FDG PET/CT). It has been reported in hematological diseases, solid tumors, and metabolic diseases and the specific imaging patterns may help us to find the cause of illness. RLU. Total of 6027 bone scans were examined in a 5 Aug 7, 2019 · 99m Tc Tc-99 m isotope HDP nuclear bone scan in a different patient demonstrates an appearance approaching a ‘superscan’ appearance due to intense skeletal tracer distribution. (A) “Pepper-pot” or “salt and pepper” skull in HPT on a skull radiograph and (B) on computed tomography. In the normal patient, both the osseous A superscan is defined as a bone scan which demonstrates markedly increased skeletal radioisotope uptake relative to soft tissues, in association with absent or faint genito-urinary tract activity. Feb 1, 2022 · The only case report of skeletal superscan appearance in the 68 Ga PSMA PET/CT was presented by Agarwal et al. Osteoblastic metastases. Distal renal tubular acidosis (RTA) is known to cause metabolic bone abnormalities. Incidence of superscan appearance in prostatic cancer patients was 14. Bone Superscan is defined as a special appearance of bone scan, characterized by homogeneous and symmetrical increased uptake of bone radiopharmaceuticals in the skeleton. A ‘Sub-superscan’ is a term used for scan findings in which the up-take is atypical of a superscan, but the patient has extensive bone metastases, as presented in our case report. Aug 7, 2019 · 99m Tc Tc-99 m isotope HDP nuclear bone scan in a different patient demonstrates an appearance approaching a ‘superscan’ appearance due to intense skeletal tracer distribution. MetastasisThe superscan appearance in patients with metastatic disease occurs most frequently in those patients with prostatic, breast or gastric cancers. Whole-body bone scintigraphy (bone scan) using a 99mTc-labelled pharmaceutical is one of the most commonly performed radionuclide examinations. 0000237968. This appearance may obscure recognition of osseous metastases. Feb 2, 2022 · The only case report of skeletal superscan appearance in the 68 Ga PSMA PET/CT was presented by Agarwal et al. Multiple brown tumors with Tc-99m MDP superscan appearance and negative Tc-99m MIBI uptake Clin Nucl Med . May 31, 2024 · Superscan appearance due to extensive skeletal metastases on bone scintigraphy. Out of 6027 patients referred for bone scan, 307 patients had prostate cancer on histopathological examination. A 64-year-old male patient with metastatic prostate carcinoma diagnosis received lutetium-177 prostate-specific membrane antigen (PSMA) treatment; however, his disease progressed. 2011 Mar;36(3):227-8. Super-superscan on a bone scintigraphy. Moreover, some conditions that are not clearly depicted on anatomic images can be diagnosed with bone scintigraphy. Apr 18, 2023 · In the prospective group, all the patients who were reported to have superscan appearance over the past 2 years of prospective period were included. PCa is the most common cause of diseases causing superscan on BS and explore the reported frequency of superscan within different disease entities. 7%) had elevated serum ALP levels. 3% in different type of cancer patients, and the most common cause of superscan appearance was prostate cancer. Apr 29, 2020 · The superscan appearance in the FDG PET/computerized tomography (CT) imaging might be because of benign diseases or malignant infiltrations. Data availability statement The superscan appearance obscures some findings and this causes false negative misinterpretation of some of the malignant lesions as well. Chapter 9: Skeletal System. Intense osteoblastic activity in the bones causes diminished renal and background soft tissue uptake. Eligibility criteria included the following: Peer-reviewed Apr 1, 1996 · The appearance of a superscan is frequently accompanied by an abnormal titer of serological markers IgG-VCA and IgA-VCA, liver metastases, and poor survival. Clin Nucl Med. Repeat bone scintigraphy demonstrates significantly different appearance from that of the first study. Although a superscan rarely occurs in nasopharyngeal carcinoma, its appearance may represent a poor prognosis in these patients. rostate cancer, who subsequently developed renal osteodystrophy. May 15, 2012 · Bone scan revealed diffuse skeletal metastases with superscan appearance. Mettler FA and Guiberteau MJ. 99m Tc MDP planar bone scan ( a ) whole-body and ( b ) spot view images show multiple areas of intense tracer uptake due to extensive skeletal metastases with relatively decreased soft tissue tracer uptake due to decreased bioavailability. Diffuse bone metastasis, which is common in NPC, were indeterminate on images showing superscan pattern or The term "superscan" usually refers to a characteristic pattern on skeletal scintigraphy consisting of symmetrically intense and diffuse radiotracer uptake in the skeleton with absent or diminished visualization of the genitourinary system and soft tissues. Usually infective etiologies like hepatic tuberculosis, 3 Q fever hepatitis will Superscans were also identified secondary to hyperparathyroidism, metabolic bone disease including osteomalacia and Pagets disease. 19 Superimposed on the diffuse uptake, brown tumors show focal areas of intense Prostate cancer (46/80) was the most common cause of superscan appearance followed by breast cancer (10/80). The examination is most commonly performed using the radiotracer Technetium-99m (Tc99m) complexed to a diphosphonate, either methylene diphosphonate (MDP) forming Tc99m-MDP or hydroxydiphosphonate (HDP) forming Tc99m-HDP. Mar 5, 2020 · Superscan appearance in the liver in 18 F-FDG PET/CT is usually associated with malignancy, like massive liver metastases (breast primary), primary hepatic lymphoma, diffuse angiosarcoma of the liver, secondary lymphomatous or leukemic involvement of liver etc. Nov 25, 2009 · More recently a super-superscan has been described, representing superimposed metastatic and metabolic superscan. Tc-99m MDP and Tc-99m MIBI scans were performed. , 2003). Out of 307 patients with prostate cancer, 46 had superscan appearance. The bone scan flare phenomenon appeared within a short time after radiotherapy. 98%. “Superscan” appearance is an interesting terminology that has long been in use in nuclear medicine. Usually infective etiologies like hepatic tuberculosis, 3 Q fever hepatitis will Aug 1, 2007 · A superscan is defined as a bone scan which demonstrates markedly increased skeletal radioisotope uptake relative to soft tissues, in association with absent or faint genito-urinary tract activity. Expand 15 In this review, we investigate the different etiologies causing superscan and the reported frequency of superscan among different disease entities. The search terms were ‘bone’ AND ‘superscan’ OR ‘superscan’, and the search Reported cases of metabolic bone diseases producing a superscan appearance were reviewed, an … Distal renal tubular acidosis (RTA) is known to cause metabolic bone abnormalities. With metabolic bone disease, the increased uptake is often more homogeneous and may extend to the distal appendicular skeleton. Keywords: PSMA, 68Ga, Lu-177, prostate cancer First case was a 12-year-old male child, a known case of mediastinal NB [Figure [Figure1a, 1a, anterior and and1b, 1b, posterior] and second was a 4-year-old male child, a known case of abdominal NB [Figure [Figure1c, 1c, anterior and and1d, 1d, posterior] sent to our department to rule out cortical bone involvement. Keywords: Superscan, Bone scintigraphy, Diffuse bone metastasis, 99mTc- HMDP, Marrow infiltration Corresponding Author: Jan 1, 2021 · A “superscan” is defined as bone scan planar imaging with diffuse increased skeletal tracer uptake relative to soft tissue, combined with diminished or non-existent renal activity (Brenner et al. The search terms were ‘bone’ AND ‘superscan’ OR ‘superscan’, and the search SuperScan is a free connect-based port scanning software designed to detect open TCP and UDP ports on a target computer, determine which services are running on those ports, and run queries such as whois, ping, ICMP traceroute, and Hostname lookups. ozlinaepjqpdbuwghdzhnnjxlvgeuryjfeuzdkhem