Discussions By Condition: I cannot get a diagnosis.

don't know

Posted In: I cannot get a diagnosis. 3 Replies
  • Posted By: denaaa
  • January 9, 2009
  • 04:05 AM

i had a bone scan done with the radiation dye the report came back that a lot of the dye went to my kidney they want to do an altra sound which is fine but my question is does the dye that went to the kidney mean cancer that is why i had the bone scan to make sure there was no cancer on my spine to begin with?

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3 Replies:

  • I'm pretty sure it doesn't mean cancer.
    richard wayne2b 1232 Replies
    • January 9, 2009
    • 01:51 PM
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  • Hi denaaa. Maybe you could tell everybody a little more info, like what your primary tumor was that made the doctor want to do a bone scan? Breast cancer/DCIS + lumpectomy? Something else? An idea of what your primary is and the extent of disease with treatment would give a more complete picture, but I'm sure Richard is on the mark with this one.
    fewd4thought 126 Replies
    • January 10, 2009
    • 05:36 AM
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  • It would indeed be helpful to know the original complaint. In the performance of a bone scan, either limited or 3 phase, we use a radioactive tracer rather than a dye. This tracer is technetium and constitutes a radioactive phosphate that is readily absorbed by bone. It's absorption is increased at areas of high metabolic activity, ie aggressive tumor growth. In your specific case, however, realize that depending upon what your doctors were looking for, they would have used a specific phosphate tracer. Clearance of the normal diphosphonates by the body is more rapid and therefore these tracers, while excellent for skeletal abnormality enhancement, are not the best choice for close inspection of extra-skeletal involvement, ie a soft-tissue tumor with spinal compression features. In these cases, it is a common practice to use something called a pyrophosphate, which does not localize to the bone as quickly and therefore remains in soft tissues for a longer period of time. Where pyrophosphate tracers are used, a large amount of the tracer builds up at the level of the kidneys over a more continuous time period so the scan at this area indicates high uptake. Understand that the kidneys are the point of excretion of the phosphate tracer and eliminated in the urine. So in the case where your doctors are seeking to identify an extra-skeletal tumor against the spinal process, a PYP, or pyrophosphate tracer would be preferable and hence cause higher uptake at the kidneys. In this instance, the increased uptake would be a normal finding which is what we're probably looking at in your case. The ultrasound would likely only be precautionary and I would be surprised if the nuclear medicine folks aren't fully aware of the characteristics of the various phosphate tracers. You'll be fine and again, we'd be interested in knowing the original complaint that warranted the scan. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • January 10, 2009
    • 01:43 PM
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