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We report a case with altered biodistribution of 99m Tc-dicarboxypropane diphosphonate ( 99m Tc-DPD) on whole body bone scan after intravenous iron supplement therapy. A 47-year-old male patient who had recently been detected with a hepatic mass suggestive of hepatocellular carcinoma underwent bone scan as staging work-up before surgery. Bone scan images at 3 h after injection of 99m Tc-DPD demonstrated unusually increased blood pool activities in the heart, liver, and spleen with usual skeletal uptakes. The patient had been treated for severe anemia from hemorrhoid with two intravenous administration of ferric hydroxide carboxymaltose complex at approximately 22 h and 2 h prior to the 99m Tc-DPD injection, which we consider as the most probable cause of altered biodistribution of 99m Tc-DPD.

Altered Biodistribution of 99mTc-DPD on Bone Scan After Intravenous Iron Supplement