Abstract
We report 2 cases of diffusely increased gallium-67 (Ga-67) skeletal uptake with suppressed soft tissue uptake and highlight the importance of a detailed clinical history, because this affects scan interpretation. Suppressed soft tissue uptake of Ga-67 occurs in hyperferremia. Iron has a high affinity for transferrin, and Ga-67 is unable to displace iron-bound transferrin. This leads to suppressed soft tissue uptake and relatively higher Ga-67 bone activity with increased urinary activity. Causes of hyperferremia include red cell transfusion, chemotherapy, and hereditary hemochromatosis. Chemotherapy increases blood iron levels by suppressing erythropoiesis. Other causes include recent radiotherapy and gadolinium for magnetic resonance imaging (MRI).
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