Indian Journal of Nuclear Medicine

: 2016  |  Volume : 31  |  Issue : 4  |  Page : 309--310

Tc-99m TRODAT uptake in an osteoid tumor of clivus

Sameer Taywade1, Madhavi Tripathi1, Vivek Tandon2, Chandan Jyoti Das3, Nishikant Avinash Damle1, Shamim Ahmed Shamim1, Parul Thukral1, Chandrasekhar Bal1,  
1 Department of Nuclear Medicine and PET/CT, All India Institute of Medical Sciences, New Delhi, India
2 Department of Neurosurgery, CN Centre, All India Institute of Medical Sciences, New Delhi, India
3 Department of Radiology, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Madhavi Tripathi
Department of Nuclear Medicine and PET/CT, All India Institute of Medical Sciences, New Delhi - 110 029


Tc-99m TRODAT is cocaine analog and binds to the dopamine transporter in vivo. Tc-99m TRODAT single-photon emission computed tomography/computed tomography. (SPECT/CT) is useful for demonstrating presynaptic dopaminergic dysfunction in patients with Parkinsonism. However, few reports have shown extrastriatal uptake of Tc-99m TRODAT. We present the case of a 67-year-old male who underwent Tc-99m TRODAT SPECT/CT for evaluation of Parkinsonism. In addition to tracer binding in the striatum, tracer uptake was noted in an osteoid tumor of the clivus. Integrated SPECT/CT enabled precise localization and characterization of the extrastriatal site of tracer binding and emphasizes the importance of such coincidental findings.

How to cite this article:
Taywade S, Tripathi M, Tandon V, Das CJ, Damle NA, Shamim SA, Thukral P, Bal C. Tc-99m TRODAT uptake in an osteoid tumor of clivus.Indian J Nucl Med 2016;31:309-310

How to cite this URL:
Taywade S, Tripathi M, Tandon V, Das CJ, Damle NA, Shamim SA, Thukral P, Bal C. Tc-99m TRODAT uptake in an osteoid tumor of clivus. Indian J Nucl Med [serial online] 2016 [cited 2020 Jul 12 ];31:309-310
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Full Text

A 67-year-old male patient complained of gait imbalance for the past 1 year. The treating neurologist referred him for ([2-[2-[3-(4-chlorophenyl)-8-methyl-8-azabicyclo[3,2,1]oct-2-yl] methyl](2-mercaptoethyl)-amino] ethyl] amino] ethanethiolato (3-)-N2, N2', S2, S2']oxo-[1R-(exo-exo)]) (Tc-99 m TRODAT) single-photon emission computed tomography/computed tomography (SPECT/CT). Axial fused SPECT/CT [Figure 1]a showed asymmetric tracer accumulation in the basal ganglia. The corresponding plain CT axial image [Figure 1]b showed an infarct in the right frontal white matter with no lesion in the basal ganglia. Axial fused SPECT/CT image at the level of pons showed increased radiotracer uptake in the clival region [Figure 1]c while corresponding axial plain CT image in the bone window showed a predominantly sclerotic lesion in the clivus [Figure 1]d. On taking a detailed history again, the patient revealed that he had undergone a magnetic resonance imaging 2 years back which had revealed the lesion which was considered as a benign osteoid tumor of the clivus and no active intervention was planned.{Figure 1}

Dopamine transporter imaging has been widely used in movement disorders including Parkinson's disease.[1],[2],[3] Tc-99m TRODAT, a cocaine derivative, is a neutral lipophilic complex that contains N-(alkylthiolate) tropane, aminobis (ethylthiolate) and a center core of Tc-99m.[4] Although it has high specificity and affinity for dopamine transporter, few studies elucidated uptake in extrastriatal pathology.[5],[6],[7],[8],[9],[10],[11],[12] Osteoid is composed of fibers (type-1 collagen) and ground substance (chondroitin sulfate and osteocalcin). TRODAT uptake in an osteoid lesion has not been described in the literature, and the mechanism of this localization needs consideration.

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Conflicts of interest

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