RT Journal Article SR Electronic T1 Reduced Hemithoracic Uptake on 99mTc-MDP Bone Scintigraphy: An Underrecognized Sign of Massive Pleural Effusion—A Case Report JF Journal of Nuclear Medicine Technology JO J. Nucl. Med. Technol. FD Society of Nuclear Medicine SP 25 OP 26 VO 31 IS 1 A1 Kottekkattu K. Balan A1 Somasundaram Ramkumar A1 Karwan Faraj A1 Arabinda K. Choudhary YR 2003 UL http://tech.snmjournals.org/content/31/1/25.abstract AB The uptake of 99mTc-methylene diphosphonate (MDP) in malignant pleural effusions and, rarely, in nonmalignant pleural effusions has been well documented in the literature. Although the exact mechanism of uptake in these conditions remains unclear, there have been attempts to use the bone scintigraphic features of pleural effusion to predict sensitivity and specificity for malignancy based on pleural fluid cytology. It has been suggested that activity in the chest increases with an increase in effusion volume. We report here, however, a case of malignant pleural effusion, that showed reduced hemithoracic activity in contrast to the expected increased activity. Our experience highlights the need for an open and inquisitive mind to avoid diagnostic pitfalls when confronted with a bone scintigram showing reduced uptake unilaterally or bilaterally in the chest.