"Cold" bone lesions: a newly recognized phenomenon of bone imaging.

Abstract

“Cold” (photon-deficient) bone scan lesions are reported in seven patients with a variety of disease processes including metastatic disease, post-traumatic aseptic necrosis, and sickle cell-C crisis. Patients were studied with 99mTc-polyphosphate and/or 18F scans and in two cases, 111In-chloride bone marrow scans. Foci of decreased radioisotope activity were identified corresponding to sites of metastatic tumor and bone infarcts. Infarction may be a primary mechanism in the production of diminished radionuclide uptake in some of the cases. Consideration is given to a spectrum of abnormal bone-imaging manifestations (increased uptake, “normal” uptake, to photon-deficient) as a useful concept in the interpretation and understanding of bone scans.