Key result
99mTc-HMDP bone scintigraphy incidentally detects ATTRwt-CM in two breast cancer patients.
Why the study?
Incidental myocardial uptake on bone scintigraphy may indicate wild-type transthyretin amyloid cardiomyopathy, a frequently overlooked diagnosis with important clinical implications.
Can routine 99mTc-HMDP bone scintigraphy detect incidental wild-type transthyretin amyloid cardiomyopathy in oncology patients?
Can routine 99mTc-HMDP bone scintigraphy detect incidental wild-type transthyretin amyloid cardiomyopathy in oncology patients?
Incidental myocardial uptake on routine 99mTc-HMDP bone scintigraphy in oncology patients can facilitate the early detection of wild-type transthyretin amyloid cardiomyopathy.
Incidental uptake on bone scintigraphy may prompt ATTR-CM evaluation in oncology patients; leaves open the value of routine screening.
Background: Bone scintigraphy using technetium-99m hydroxymethylene diphosphonate (99mTc-HMDP) is extensively employed to detect bone metastases. However, incidental myocardial uptake may indicate wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM), a frequently overlooked diagnosis with important clinical implications. Case Presentation: Two elderly female patients with a history of breast cancer were subjected to 99mTc-HMDP bone scintigraphy as part of a routine evaluation for possible bone metastases. Both cases demonstrated incidental myocardial uptake (Perugini Grade 2 and Grade 3, respectively), raising suspicion for ATTRwt-CM, which was subsequently confirmed by endomyocardial biopsy. Review of the Literature: We reviewed published studies reporting cardiac uptake on bone scintigraphy, summarizing the frequency, patient demographics, and tracer types, and emphasizing the clinical relevance of this finding in cancer patients. Conclusions: In oncology patients, bone scintigraphy performed during routine metastatic screening may facilitate early detection of ATTRwt-CM, enabling timely diagnosis and treatment initiation, potentially improving clinical outcomes.
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Matsuki et al. (2026) studied this question. Incidental myocardial uptake on 99mTc-HMDP bone scintigraphy identified transthyretin amyloid cardiomyopathy in two patients with breast cancer, prompting timely diagnosis.
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