Tc-99m TRODAT uptake in an osteoid tumor of clivus

Sameer Taywade; Madhavi Tripathi; Vivek Tandon; Chandan Jyoti Das; Nishikant Avinash Damle; Shamim Ahmed Shamim; Parul Thukral; Chandrasekhar Bal

doi:10.4103/0972-3919.190805

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31 (

); 309-310

doi:

10.4103/0972-3919.190805

Tc-99m TRODAT uptake in an osteoid tumor of clivus

Sameer Taywade, Madhavi Tripathi^,, Vivek Tandon¹, Chandan Jyoti Das², Nishikant Avinash Damle, Shamim Ahmed Shamim, Parul Thukral, Chandrasekhar Bal

Department of Nuclear Medicine and PET/CT, All India Institute of Medical Sciences, New Delhi, India

1Department of Neurosurgery, CN Centre, All India Institute of Medical Sciences, New Delhi, India

2Department of Radiology, All India Institute of Medical Sciences, New Delhi, India

Address for correspondence: Dr. Madhavi Tripathi, Department of Nuclear Medicine and PET/CT, All India Institute of Medical Sciences, New Delhi - 110 029, India. E-mail: madhavi.dave.97@gmail.com

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Abstract

Tc-99m TRODAT is cocaine analog and binds to the dopamine transporter in vivo. Tc-99m TRODAT single-photon emission computed tomography/computed tomography. (SPECT/CT) is useful for demonstrating presynaptic dopaminergic dysfunction in patients with Parkinsonism. However, few reports have shown extrastriatal uptake of Tc-99m TRODAT. We present the case of a 67-year-old male who underwent Tc-99m TRODAT SPECT/CT for evaluation of Parkinsonism. In addition to tracer binding in the striatum, tracer uptake was noted in an osteoid tumor of the clivus. Integrated SPECT/CT enabled precise localization and characterization of the extrastriatal site of tracer binding and emphasizes the importance of such coincidental findings.

Keywords

Osteoid tumor

Parkinson's disease

single-photon emission computed tomography/computed tomography

Tc-99m TRODAT

Show Related Articles from PubMed

A 67-year-old male patient complained of gait imbalance for the past 1 year. The treating neurologist referred him for ([2-[2-[3-(4-chlorophenyl)-8-methyl-8-azabicyclo [3,2,,1] oct-2-yl] methyl](2-mercaptoethyl)-amino] ethyl] amino] ethanethiolato (3-)-N2, N2', S2, S2']oxo-[1R-(exo-exo)]) (Tc-99 m TRODAT) single-photon emission computed tomography/computed tomography (SPECT/CT). Axial fused SPECT/CT [Figure 1a] showed asymmetric tracer accumulation in the basal ganglia. The corresponding plain CT axial image [Figure 1b] showed an infarct in the right frontal white matter with no lesion in the basal ganglia. Axial fused SPECT/CT image at the level of pons showed increased radiotracer uptake in the clival region [Figure 1c] while corresponding axial plain CT image in the bone window showed a predominantly sclerotic lesion in the clivus [Figure 1d]. On taking a detailed history again, the patient revealed that he had undergone a magnetic resonance imaging 2 years back which had revealed the lesion which was considered as a benign osteoid tumor of the clivus and no active intervention was planned.

Tc-99m TRODAT (a) axial fused single-photon emission computed tomography/computed tomography images showed asymmetric tracer accumulation in the basal ganglia. The corresponding computed tomography axial image (b) showed an infarct in the right frontal white matter with no lesion in the basal ganglia. Axial fused single-photon emission computed tomography/computed tomography image (c) at the level of pons showed increased radiotracer uptake in the clival region, while corresponding axial plain computed tomography image in bone window showed a predominantly sclerotic lesion in the clivus (d)

Dopamine transporter imaging has been widely used in movement disorders including Parkinson's disease.[1 2 3] Tc-99m TRODAT, a cocaine derivative, is a neutral lipophilic complex that contains N-(alkylthiolate) tropane, aminobis (ethylthiolate) and a center core of Tc-99m.[4] Although it has high specificity and affinity for dopamine transporter, few studies elucidated uptake in extrastriatal pathology.[5 6 7 8 9 10 11 12] Osteoid is composed of fibers (type-1 collagen) and ground substance (chondroitin sulfate and osteocalcin). TRODAT uptake in an osteoid lesion has not been described in the literature, and the mechanism of this localization needs consideration.

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There are no conflicts of interest.

REFERENCES

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Chen YR, Hseih TC, Yen KY, Kao CH, . Increased Tc-99m TRODAT-1 uptake in anaplastic oligodendroglioma. Clin Nucl Med. 2014;39:104-105.
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Financial support and sponsorship
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[1] Huang WS, Lee MS, Lin JC, Chen CY, Yang YW, Lin SZ, . Usefulness of brain 99mTc-TRODAT-1 SPET for the evaluation of Parkinson's disease. Eur J Nucl Med Mol Imaging. 2004;31:155-61.
[Google Scholar]

[2] Marshall V, Grosset D, . Role of dopamine transporter imaging in routine clinical practice. Mov Disord. 2003;18:1415-23.
[Google Scholar]

[3] Huang WS, Lin SZ, Lin JC, Wey SP, Ting G, Liu RS, . Evaluation of early-stage Parkinson's disease with 99mTc-TRODAT-1 imaging. J Nucl Med. 2001;42:1303-8.
[Google Scholar]

[4] Meegalla SK, Plössl K, Kung MP, Chumpradit S, Stevenson DA, Kushner SA, . Synthesis and characterization of technetium-99m-labeled tropanes as dopamine transporter-imaging agents. J Med Chem. 1997;40:9-17.
[Google Scholar]

[5] Tripathi M, Arora G, Das CJ, Grover T, Gupta R, Bal C, . Incidental detection of intracranial tuberculomas on (99m) Tc-TRODAT-1 SPECT/CT. Clin Nucl Med. 2015;40:e321-2.
[Google Scholar]

[6] Hsieh TC, Kao CH, Wu YC, Wang CH, Yen KY, Sun SS, . Findings of subdural hematoma on Tc-99m-TRODAT-1 SPECT. Clin Nucl Med. 2009;34:245-6.
[Google Scholar]

[7] Hsieh TC, Wu YC, Sun SS, Hsu CN, Kao CH, . Pituitary macroadenoma on 99mTc-TRODAT-1 brain SPECT. Clin Nucl Med. 2014;39:e398-401.
[Google Scholar]

[8] Chiu YL, Hu C, Li JY, Weng MJ, Lin WC, Peng NJ, . An incidental finding of cerebral meningioma on 99mTc-TRODAT-1 dopamine transporter SPECT/CT. Clin Nucl Med. 2012;37:899-900.
[Google Scholar]

[9] Chen YR, Hseih TC, Yen KY, Kao CH, . Increased Tc-99m TRODAT-1 uptake in anaplastic oligodendroglioma. Clin Nucl Med. 2014;39:104-105.
[Google Scholar]

[10] Wu YC, Hsieh TC, Sun SS, Yen KY, Wang CH, Lin YY, . Findings of cerebral metastasis demonstrated on Tc-99m TRODAT-1 SPECT. Clin Nucl Med. 2010;35:107-8.
[Google Scholar]

[11] Cascini GL, Ciarmiello A, Labate A, Tamburrini S, Quattrone A, . Unexpected detection of melanoma brain metastasis by PET with iodine-124 betaCIT. Clin Nucl Med. 2009;34:698-9.
[Google Scholar]

[12] Boronat-Ferrater M, Lorenzo-Bosquet C, León A, Aguadé-Bruix S, Rossi-Seoane S, Hernández-Vara J, . Unexpected I-123 FP-CIT uptake in a brain tumor. Clin Nucl Med. 2009;34:608-9.
[Google Scholar]

Tc-99m TRODAT uptake in an osteoid tumor of clivus

Abstract

Keywords

Osteoid tumor

Parkinson's disease

single-photon emission computed tomography/computed tomography

Tc-99m TRODAT

Financial support and sponsorship

Conflicts of interest

REFERENCES

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