Superscan

Last revised by Sonam Vadera on 19 Jan 2022

A superscan is an imaging appearance on a Tc-99m diphosphonate bone scan which occurs as a result of a high ratio of bone to soft tissue tracer accumulation. Intense osteoblastic activity in the bones causes diminished renal and background soft tissue uptake.

This appearance can result from a range of causes:

A metastatic superscan tends to have uptake throughout the axial skeleton and proximal appendicular skeleton, often somewhat heterogeneous. In contrast, a metabolic superscan tends to be more uniform and involve both the axial and more peripheral skeleton, including the distal extremities, calvarium, and mandible.

Little/no activity is seen within the urinary tract or soft tissues, as most of the tracer is concentrated within the bones. 

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Cases and figures

  • Case 1: metastatic prostate cancer
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  • Case 2: metastatic prostate cancer
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  • Case 3: osseous metastases
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  • Case 4: secondary hyperparathyroidism
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  • Case 5: metastatic breast disease
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  • Case 6: metastatic prostate cancer with superscan
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  • Case 7: prostate cancer skeletal metastases - superscan
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  • Case 8: from prostate cancer
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