Brain Metastases Mimicking Hyperostosis Frontalis Interna on 99mTc HDP Bone Scintigraphy

Kang, Sae-Ryung; Kim, Jahae; Kwon, Seong; Min, Jung‐Joon; Bom, Hee‐Seung; Sohn, Myung‐Hee; Song, Ho‐Chun

doi:10.1097/rlu.0000000000001331

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…Increased osteoblastic activity on 18F-NaF positron emission tomography-computed tomography (PET/CT) has been reported without any demonstrable radiographic abnormality which suggests this to be an early marker of HFI [19] . Given tracer uptake appearances can be variable on planar or maximum intensity projection images, this can easily be confounded with bone metastases [11] . In these cases, evaluation with hybrid fusion imaging such as PET/CT or single-photon emission computed tomography/computed tomography can be valuable by identifying and characterizing tracer uptake in areas of frontal bone overgrowth.…”

Section: Discussionmentioning

confidence: 99%

Hyperostosis fronto-parietalis – radiology mimic of metastasis: A case report

Lai

Tomer

2021

Radiology Case Reports

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Hyperostosis frontalis interna (HFI) is a benign entity manifested by bony overgrowth in the frontal endocranial surface. It is most commonly reported incidentally among postmenopausal elderly women. Tracer uptake appearances of HFI can vary on planar bone scans, enabling it to be easily confounded with bone metastases. We report a case of HFI in a 69-year-old postmenopausal female with treated left breast cancer detected on bone scintigraphy, with subsequent confirmation by computed tomography. Our case highlights the importance of having awareness of HFI and its key pattern findings to avoid mistaking it for pathology, and to recognise the use of computed tomography and hybrid fusion imaging techniques as reliable diagnostic tools for HFI.

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Section: Discussionmentioning

confidence: 99%

Hyperostosis fronto-parietalis – radiology mimic of metastasis: A case report

Lai

Tomer

2021

Radiology Case Reports

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“…Bone scintigraphy is a commonly used functional imaging modality that can detect HFI. The typical appearance of HFI in planar bone scintigraphy involves a symmetrical bilateral area of increased uptake in the frontal bones [5,12]. More recently, hybrid imaging like PET combined with computed tomography (CT) using fluorine-18 sodium fluoride ([ 18 F]NaF) has been widely used clinically to evaluate the bony skeleton mainly in cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Hyperostosis frontalis interna on fluorine-18 sodium fluoride PET/computed tomography of obese cancer patients: a potential mimicker of metastasis

Alenezi,

Dannoon,

Alnafisi

et al. 2024

Nuclear Medicine Communications

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Objective The objective of this retrospective study was to identify the uptake patterns and suggest a quantitative method to detect hyperostosis frontalis interna (HFI) on fluorine-18 sodium fluoride ([18F]NaF) PET/computed tomography (CT). Methods Between January 2019 and December 2021, patients who underwent [18F]NaF PET/CT with a BMI of 30 and above, were included. Three nuclear medicine consultants reviewed the studies to determine the presence and identify the uptake patterns of HFI. Quantitative evaluation was performed on PET images using the total number of counts over the frontal bone and the ratio of counts between the frontal bone and iliac crest. Results A total of 105 out of 249 cases were included in this study. Among these scans, there were 67 positive HFI in [18F]NaF PET scans representing 64% of the studied population. As for the [18F]NaF PET uptake pattern, there were 53 with uniformly diffused and 14 with heterogeneous uptake pattern. There were 17 out of 67 with positive HFI in [18F]NaF PET scans but negative CT scans. Conclusion HFI is a common finding on [18F]NaF PET in obese patients and is probably underdiagnosed. HFI may present with a heterogeneous and diffuse pattern of uptake on [18F]NaF PET. The proposed quantitative analysis using the count ratios is in agreement with the visual evaluation of [18F]NaF PET images regardless of the CT findings. Awareness of this condition and its scintigraphic patterns is warranted since it can have clinical significance and may mimic other pathologies including metastasis in cancer patients.

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Osteoblastic and hyperostotic craniofacial lesion detected by 99mTc-labeled methylene diphosphonate bone scintigraphy and single-photon emission computed tomography/computed tomography: a pictorial essay

Paycha

2020

Nuclear Medicine Communications

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99m Tc-bisphophonates bone scan, planar and single-photon emission computed tomography/computed tomography (SPECT/CT) modalities, is a commonly used technique that provides high sensitivity and specificity for detection of osseous metastases. However, besides bone metastases, SPECT/CT provides an accurate evaluation of the localization of the lesions and supplies anatomic information that can be valuable for diagnosis of nonmalignant bone diseases, occasionally disclosed in the skull. Reporting of craniofacial lesions detected by 99m Tc-MDP ( 99m Tc-labeled methylene diphosphonate) bone scintigraphy and SPECT/CT in the literature is limited. The aim of this pictorial review is to present the findings detected by 99m Tc-MDP bone scintigraphy and SPECT/CT including cases under two broad categories: osteoblastic and hyperostosis craniofacial lesions.

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Brain Metastases Mimicking Hyperostosis Frontalis Interna on 99mTc HDP Bone Scintigraphy

Cited by 3 publications

References 8 publications

Hyperostosis fronto-parietalis – radiology mimic of metastasis: A case report

Hyperostosis fronto-parietalis – radiology mimic of metastasis: A case report

Hyperostosis frontalis interna on fluorine-18 sodium fluoride PET/computed tomography of obese cancer patients: a potential mimicker of metastasis

Osteoblastic and hyperostotic craniofacial lesion detected by 99mTc-labeled methylene diphosphonate bone scintigraphy and single-photon emission computed tomography/computed tomography: a pictorial essay

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