Unforeseen COVID-19 on Oncologic Bone Scan with SPECT/CT in a High Prevalence Area

A 65-year-old woman with known diabetes and hypertension underwent a technetium methylene diphosphonate (Tc-99m MDP) bone scan with single photon emission computed tomography/computed tomography (SPECT/CT) for shoulder pain. She was initially treated for breast cancer and later for hepatocellular carcinoma. SPECT/CT showed MDP nonavid and scattered pulmonary ground-glass opacities bilaterally along with rounded nodular densities. Another 56-year-old patient who was newly diagnosed with right breast invasive ductal carcinoma underwent a bone scan with SPECT/CT, which revealed bilateral pulmonary infiltrates. Both patients later tested positive for Coronavirus Disease-2019 (COVID-19). Therefore, nuclear physicians should be watchful of findings related to COVID-19 on SPECT/CT thorax as this is becoming the new normal.