Tc-99m Sestamibi Uptake in Metastatic Prostate Carcinoma

Abstract

Chest pain developed in a 67-year-old man with a history of prostate carcinoma and he was referred for a myocardial perfusion scan. A Tc-99m sestamibi–dipyridamole study showed impaired coronary artery flow reserve to the interventricular septum and a fixed perfusion defect in the inferior wall of the left ventricle, consistent with previous myocardial infarction. Increased sestamibi uptake in an irregular pattern in multiple ribs was noted incidentally. The serum prostate-specific antigen concentration was markedly elevated at 84.3 μg/l (normal, <4.0 μg/l). A whole-body bone scan showed corresponding multiple foci of increased tracer accumulation in the ribs and elsewhere in the axial and appendicular skeleton, consistent with widespread prostatic carcinoma metastases in bone. Tc-99m sestamibi uptake has been reported in a wide range of benign and malignant tumors, but accumulation in prostate carcinoma has not been previously described. FIGURE 1

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