Sacral insufficiency fracture as shown by 18F-FDG PET/CT and 99mTc-MDP bone scintigraphy

Alpay İbrahim Kasman; Zehra Pınar Koç; Pınar Pelin Özcan; Vehbi Erçolak

doi:10.71286/moi.1849051

Sacral insufficiency fracture as shown by 18F-FDG PET/CT and 99mTc-MDP bone scintigraphy

Abstract

Sacral insufficiency is a frequent cause of false positivity in diagnosis of bone metastasis. The specific ‘H’ shaped accumulation of the radiopharmaceutical and previous history of pelvic radiation therapy should indicate this diagnosis as presented in this case report.

Keywords

References

1. Baldwin, M. J., & Tucker, L. J. (2014). Sacral insufficiency fractures: a case of mistaken identity. International medical case reports journal, 7, 93–98. https://doi.org/10.2147/IMCRJ.S60133
2. Zhang, L., He, Q., Jiang, M., Zhang, B., Zhong, X., & Zhang, R. (2018). Diagnosis of Insufficiency Fracture After Radiotherapy in Patients With Cervical Cancer: Contribution of Technetium Tc 99m-Labeled Methylene Diphosphonate Single-Photon Emission Computed Tomography/Computed Tomography. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 28(7), 1369–1376. https://doi.org/10.1097/IGC.0000000000001337
3. Fujii M, Abe K, Hayashi K, Kosuda S, Yano F, Watanabe S, Katagiri S, Ka WJ, Tominaga S. Honda sign and variants in patients suspected of having a sacral insufficiency fracture. Clin Nucl Med. 2005 Mar;30(3):165-9. doi: 10.1097/00003072-200503000-00004. PMID: 15722819.
4. Kara, P. Ö., Koç, Z. P., Gümüş, A., Süleymanoğlu, M. (2023). PET-CT Imaging in Cancer of Unknown Primary in a Patient with Cranial Metastatic Mass. Molecular Oncologic Imaging, 3(1), 4-6.
5. Al-faham, Z., Rydberg, J. N., & Oliver Wong, C. Y. (2014). Use of SPECT/CT with 99mTc-MDP bone scintigraphy to diagnose sacral insufficiency fracture. Journal of nuclear medicine technology, 42(3), 240–241. https://doi.org/10.2967/jnmt.114.137547
6. Xiao, Z., Dong, A., Nian, S., Bai, Y., & Zuo, C. (2025). Sacral Insufficiency Fracture Mimicking Metastatic Prostate Cancer on 18 F-PSMA-1007 PET/CT. Clinical nuclear medicine, 50(12), 1197–1200. https://doi.org/10.1097/RLU.0000000000006030
7. Lyders, E. M., Whitlow, C. T., Baker, M. D., & Morris, P. P. (2010). Imaging and treatment of sacral insufficiency fractures. AJNR. American journal of neuroradiology, 31(2), 201–210. https://doi.org/10.3174/ajnr.A1666

Details

Primary Language

English

Subjects

Nuclear Medicine

Journal Section

Case Report

Authors

Alpay İbrahim Kasman ^*
0009-0003-3443-4616
Türkiye

Zehra Pınar Koç
0000-0002-3274-5790
Türkiye

Pınar Pelin Özcan
0000-0003-0147-2678
Türkiye

Vehbi Erçolak
0000-0003-1014-1694
Türkiye

Publication Date

January 13, 2026

Submission Date

December 25, 2025

Acceptance Date

January 8, 2026

Published in Issue

Year 2025 Volume: 5 Number: 3

DOI

https://doi.org/10.71286/moi.1849051

IZ

https://izlik.org/JA28TD73SK

Cite

RIS / Bibtex

APA

Kasman, A. İ., Koç, Z. P., Özcan, P. P., & Erçolak, V. (2026). Sacral insufficiency fracture as shown by 18F-FDG PET/CT and 99mTc-MDP bone scintigraphy. Molecular Oncologic Imaging, 5(3), 10-12. https://doi.org/10.71286/moi.1849051

AMA

1.Kasman Aİ, Koç ZP, Özcan PP, Erçolak V. Sacral insufficiency fracture as shown by 18F-FDG PET/CT and 99mTc-MDP bone scintigraphy. Molecular Oncologic Imaging. 2026;5(3):10-12. doi:10.71286/moi.1849051

Chicago

Kasman, Alpay İbrahim, Zehra Pınar Koç, Pınar Pelin Özcan, and Vehbi Erçolak. 2026. “Sacral Insufficiency Fracture As Shown by 18F-FDG PET CT and 99mTc-MDP Bone Scintigraphy”. Molecular Oncologic Imaging 5 (3): 10-12. https://doi.org/10.71286/moi.1849051.

EndNote

Kasman Aİ, Koç ZP, Özcan PP, Erçolak V (January 1, 2026) Sacral insufficiency fracture as shown by 18F-FDG PET/CT and 99mTc-MDP bone scintigraphy. Molecular Oncologic Imaging 5 3 10–12.

IEEE

[1]A. İ. Kasman, Z. P. Koç, P. P. Özcan, and V. Erçolak, “Sacral insufficiency fracture as shown by 18F-FDG PET/CT and 99mTc-MDP bone scintigraphy”, Molecular Oncologic Imaging, vol. 5, no. 3, pp. 10–12, Jan. 2026, doi: 10.71286/moi.1849051.

ISNAD

Kasman, Alpay İbrahim - Koç, Zehra Pınar - Özcan, Pınar Pelin - Erçolak, Vehbi. “Sacral Insufficiency Fracture As Shown by 18F-FDG PET CT and 99mTc-MDP Bone Scintigraphy”. Molecular Oncologic Imaging 5/3 (January 1, 2026): 10-12. https://doi.org/10.71286/moi.1849051.

JAMA

1.Kasman Aİ, Koç ZP, Özcan PP, Erçolak V. Sacral insufficiency fracture as shown by 18F-FDG PET/CT and 99mTc-MDP bone scintigraphy. Molecular Oncologic Imaging. 2026;5:10–12.

MLA

Kasman, Alpay İbrahim, et al. “Sacral Insufficiency Fracture As Shown by 18F-FDG PET CT and 99mTc-MDP Bone Scintigraphy”. Molecular Oncologic Imaging, vol. 5, no. 3, Jan. 2026, pp. 10-12, doi:10.71286/moi.1849051.

Vancouver

1.Alpay İbrahim Kasman, Zehra Pınar Koç, Pınar Pelin Özcan, Vehbi Erçolak. Sacral insufficiency fracture as shown by 18F-FDG PET/CT and 99mTc-MDP bone scintigraphy. Molecular Oncologic Imaging. 2026 Jan. 1;5(3):10-2. doi:10.71286/moi.1849051