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Figures 15–17. (a) 99Tcm MDP scintigrams of three patients with superscan appearance in the bone. In all of them the kidneys were either not visualized or were very faintly visualized. (b) 99Tcm(V)DMSA whole body scan at 3 h post injection showed diffusely increased tracer uptake in almost the entire axial skeleton and a few areas of focally increased uptake corresponding to those in the bone scans. Both the kidneys were well visualized in all three cases. Note the extent of skeletal involvement in the superscans cited is variable. This can be interpreted with a greater degree of certainty from the 99Tcm(V)DMSA scans, e.g. in Figure 16 the forearms distal to the lower end of both humeri are not involved, which is clearly depicted in 99Tcm(V)DMSA scintigraphy as only soft tissue visualization. This helps in better assessment of disease activity as well as better treatment monitoring.
