PMC9037869_01
Single-photon emission computed tomography/computed tomography of the left distal humerus (d-f) shows better delineation of the increased osteoblastic activity which has reduced at 12th month with computed tomography images (a-c) showing maintained cortical outline and appearance of the graft becoming homogenous to surrounding cortical bone
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F1
Serial scintigraphy revealed increased osteoblastic activity, which was more at 3rd month and decreased at 12th month [Figure 1a-f]]. Reduction and homogenization of osteoblastic activity [Figure 1a-f] are likely suggestive of incorporation of the graft.
99mTc-MDP serial blood pool (a-c) images reveal a focal area of mild hyperemia followed by normalization. Delayed 3 h spot images (d-f) reveals initially an increased followed by moderately reduced but well-circumscribed osteoblastic activity
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F2
Absent of increased blood flow and hyperemia [Figure 2a-f] correlated well with healing and no future complications of the graft.
PMC9037869_02
Blood flow images reveal normal tracer flow (not shown). Blood pool (a-c) reveals mild hyperemia initially with complete normalization by 15th month. Delayed spots (d-f) shows increased osteoblastic activity at the grafted region surrounding the screw which reduces in later months
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F3
The absence of increased blood flow and no significant hyperemia was noted at 1 month which helped ruling out the infection around the screw [Figure 3a-f].
Single-photon emission computed tomography /computed tomography (d-f) of proximal femur localizes the increased osteoblastic activity in greater and lesser trochanter surrounding the screw with computed tomography images (a-c) revealing regular cortical outline with osteoblastic activity nearing the normal cortical bone in the later scans (b and c)
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F4
Increased osteoblastic response at 1 month was thought to be associated with postoperative changes, followed by reduction of activity which was more homogenous to normal cortical bone by 10th month, suggesting ongoing osteoblastic healing [Figure 4a-f].
Blood flow was normal. Blood pool (a) of knee region reveals mildly increased tracer pooling in the right medial condylar region with a focal area of osteoblastic activity in delayed spots (b)
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F5
Single-photon emission computed tomography/computed tomography (c and d) of knee reveals a focal area of heterogeneously increased tracer activity in the medial condyle of the right femur with increased sclerotic and lytic changes on computed tomography (a and b) with irregular cortical outline, mostly suggestive of recurrence of the tumor
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F6