pyrophosphate and Bone-Neoplasms

N-BP, rapamycin and its derivatives have been originally developed respectively as anti-resorptive and anti-fungal agents. In fact, in vitro and in vivo experiments demonstrated that these compounds are multi-functional molecules exerting their effects on tumour cell growth and bone remodelling. The major challenge in treating cancer relates to mutations in key genes such as p53, Rb or proteins affecting caspase signalling carried by many tumour cells. Whether nitrogen containing bisphosphonates (N-BP) are potent bone inhibitors, they also inhibit tumour cell proliferation and increase atypical apoptosis of bone tumour cells regardless of the p53 and Rb status. N-BP may be then considered as effective therapeutic agents in clinical trials of bone tumours. Rapamycin and its derivatives inhibit mTOR dependent mRNA translation both in osteoclasts and tumour cells. Cellular physiological mechanisms regulated by mTOR integrate many environmental parameters including growth factors, hormones, cytokines, amino acids, energy availability and cellular stresses that are coupled with cell cycle progression and cell growth. Rapamycin and its derivatives as well as N-BP must be considered as bi-(multi) functional molecules affecting simultaneously bone and tumour metabolisms. The present survey describes these two molecular families and discusses their therapeutic interests for primary bone tumours and bone metastases.

Topics: Bone Neoplasms; Cell Division; Diphosphates; Diphosphonates; Humans; Osteosarcoma; Protein Kinases; Sirolimus; Structure-Activity Relationship; TOR Serine-Threonine Kinases

Bone scanning is a sensitive test for the detection of metastatic breast cancer, but not all abnormal findings on bone scan are diagnostic of skeletal metastasis. Recent studies have found a relatively low rate (less than or equal to 5%) of abnormal scans in patients with Stage I and II breast cancers, and only half of those with positive scans subsequently had documented bony metastasis. The overwhelming clinical experiences summarized here question the value of including bone scanning as part of the routine work-up of patients with early breast cancers.

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Diphosphates; False Negative Reactions; False Positive Reactions; Female; Fluorine; Humans; Neoplasm Staging; Prognosis; Radioisotopes; Radionuclide Imaging; Strontium Radioisotopes; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Carcinoma; Diphosphates; Diphosphonates; Fractures, Bone; Humans; Lung Neoplasms; Male; Osteomyelitis; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

The observation by Subramanian and his co-workers that a 99mTc-labeled polyphosphate had excellent affinity for bone has led to widespread use of 99mTc-labeled phosphates as bone scanning agents. Initially, only polyphosphate was employed, but because of somewhat inconstant results and difficulty in preparation of this product, other phosphate compounds were sought. We soon discovered that an inorganic compound, pyrophosphate, appeared to have certain advantages over polyphosphate. Other workers formulated diphosphonates (organic phosphates) which also demonstrated advantages over polyphosphates. Comparison studies in rabbits utilizing 85Sr, 87mSr, 18F, and several phosphates (inorganic and organic) proved the 99mTc-labeled phosphates to be clearly superior in delineating normal skeletal anatomy. Studies in humans confirmed that excellent visualization of bone was obtained with 99mTc-labeled phosphates using either a gamma camera or a rectilinear scanner. What was not known, however, was just how reliable this class of agents would prove to be in detecting bone disease when compared to bone-seeking radiopharmaceuticals such as 85Sr, 87mSr, and 18F. Further comparative analyses have clearly demonstrated that both inorganic and organic 99mTc phosphate complexes are extremely sensitive in revealing more bone disease than the older bone scanning agents.

Topics: Adult; Aged; Animals; Bone Neoplasms; Breast Neoplasms; Carcinoma, Squamous Cell; Colonic Neoplasms; Diphosphates; Female; Fluorine; Hodgkin Disease; Humans; Kidney Neoplasms; Lung Neoplasms; Male; Middle Aged; Nasopharyngeal Neoplasms; Neoplasm Metastasis; Phosphates; Prostatic Neoplasms; Rabbits; Radioisotopes; Radionuclide Imaging; Strontium Radioisotopes; Technetium

From 1977 to 1987, 7,604 out of a total of 20,483 Danish breast cancer patients had a bone scintigraphy in order to exclude or localise osseous metastases. The scintigrams were performed and interpreted at 14 local hospitals. In 1979, standardised guidelines for interpretation were agreed upon. Until 1983, the scintigrams were described centrally, based on the local reports. From 1979, the frequency of positive bone scintigrams suggesting bone metastases stabilised at about 5% of the patients compared with 12 and 20% in 1977-78. The local take-over of description did not change the frequency. The frequency was also stable from 1979 when evaluated in age groups. With increasing age the frequency of positive scintigrams increased. The frequency of positive scintigrams was significantly lower in patients entering a protocol than in those not entering a protocol. The conclusion is that on a nation-wide basis it is possible to establish a stable, uniform interpretation of bone scintigrams after a two-year introduction period.

Topics: Adult; Age Factors; Aged; Bone Neoplasms; Breast Neoplasms; Diagnosis, Differential; Diphosphates; Female; Humans; Intraoperative Period; Middle Aged; Multicenter Studies as Topic; Polyphosphates; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate; Time Factors

A new Soviet osteotropic agent 113mIn-indifor was used in clinical practice in 88 patients with primary (56), secondary (22), and systemic (10) skeletal diseases. The sensitivity of the method was 87.7%, its specificity--75%. The main indication for its use was a search for new or additional metastatic foci in malignant tumors of various sites. Investigations using 113mIn-indifor and 99m Tc-phosphates were conducted in 35 patients with different skeletal lesions. The authors obtained the results indicating the same informative value of both radiopharmaceuticals--90.3%. In view of some difficulties in supplies of generators of technetium, 113mIn-indifor can replace 99m Tc-phosphates in routine investigations of primary and especially metastatic skeletal lesions.

Topics: Bone and Bones; Bone Neoplasms; Clinical Trials as Topic; Diphosphates; Diphosphonates; False Negative Reactions; False Positive Reactions; Humans; Indium Radioisotopes; Organophosphorus Compounds; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Pyrophosphate

A total of 350 patient studies were carried out using clinical trials' batches of the Technetium (MDP) agent for bone scintigraphy (The Radiochemical Centre), and a commercially available Technetium pyrophosphate agent (CIS). The bone seeking properties of 99Tcm Sn-methylene-diphosphonate (MDP) and 99Tcm Sn-pyrophosphate (PYP) were evaluated by their comparative uptake in compact bone, cancellous bone and soft tissue using a region-of-interest technique. From these data uptake ratios were computed in order to correlate the values with (a) the amount of 99Tcm-MDP injected, (b) the time after injection and (c) the age of patients examined. All ratios derived with 99Tcm-MDP were superior to those using 99Tcm-PYP and were not dependent on the amount of 99Tcm-MDP injected. Uptake ratios determined for 99Tcm-MDP (1.5 h to 2.5 h after injection) were found to be higher than those for 99Tcm-PYP 2.5 to 3.5 h after injection. Soft tissue accumulation of 99Tcm-MDP, visible on scintiphotos, occurred only in 26% of cases but with 99Tcm-PYP, in 75% out of all cases studied. A decrease of cancellous bone/compact bone ratios with increasing age of the patients was found with both radiopharmaceuticals. This is most probably correlated with a diminished mass and/or surface of the cancellous bone in the elderly patient.

Topics: Adult; Age Factors; Aged; Bone and Bones; Bone Neoplasms; Computers; Diphosphates; Diphosphonates; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Technetium

Topics: Bone and Bones; Bone Neoplasms; Diphosphates; Humans; Male; Neoplasm Metastasis; Organophosphonates; Phosphates; Radiation Dosage; Radionuclide Imaging; Technetium; Whole-Body Counting

The effects of the tubulin-binding vascular-disrupting agents (VDAs), combretastatin A4 phosphate (CA4P), OXi4503/CA1P and OXi8007, in subcutaneous mouse models of the Ewing's sarcoma family of tumours (ESFTs) have been investigated alone and in combination with doxorubicin. Delay in subcutaneous tumour growth was observed following treatment of mice with multiple doses of OXi4503/CA1P but not with CA4P or OXi8007. A single dose of OXi4503/CA1P caused complete shutdown of vasculature by 24h and extensive haemorrhagic necrosis by 48h. However, a viable rim of proliferating cells remained, which repopulated the tumour within 10 days following the withdrawal of treatment. Combined treatment with doxorubicin 1h prior to administration of OXi4503/CA1P enhanced the effects of OXi4503/CA1P causing a synergistic delay in tumour growth (p<0.001). This study demonstrates that OXi4503/CA1P is a potent VDA in ESFT and in combination with conventional cytotoxic agents represents a promising treatment strategy for this tumour group.

Topics: Angiogenesis Inhibitors; Animals; Antineoplastic Agents, Phytogenic; Antineoplastic Combined Chemotherapy Protocols; Apoptosis; Bibenzyls; Bone Neoplasms; Cell Proliferation; Diphosphates; Disease Models, Animal; Doxorubicin; Drug Evaluation, Preclinical; Mice; Mice, Nude; Necrosis; Neoplasm Transplantation; Neovascularization, Pathologic; Sarcoma, Ewing; Stilbenes

Bisphosphonate (BP) therapy has modified the natural history of many bone metabolic diseases. Amino-bisphosphonates nowadays represent the primary therapeutic choice for the treatment of osteoporosis and for prevention of fractures. Osteonecrosis of the mandible and maxilla (ONJ) is a rare disease usually occurring in cancer patients with bone metastases treated with high doses of intravenous BPs. Some cases have been described in patients taking amino-BPs for osteoporosis, but the specific drug utilized, its dosage and use of the oral route have reduced that risk considerably (estimated at 1/100,000 subjects a year). Prevention of ONJ include good oral hygiene habits in all patients and, in a subject who has been treated for more than three years, conservative dental procedures when possible, an appropriate antibiotic therapy and a careful follow-up when invasive oral interventions are necessary, are recommended by dentists and bone metabolism experts alike.

Topics: Bone and Bones; Bone Neoplasms; Diphosphates; Dose-Response Relationship, Drug; Female; Humans; Jaw Diseases; Male; Osteonecrosis; Osteoporosis; Risk Factors

Topics: Bone Neoplasms; Diphosphates; Female; Humans; Middle Aged; Osteosarcoma; Radiography; Radionuclide Imaging; Talus; Technetium; Technetium Tc 99m Pyrophosphate

A scintigraphic picture was observed in 51 patients suffering from breast cancer with metastatic involvement of the skeleton (polychemotherapy + radiotherapy of pelvic bones and lumbar spine + hormonotherapy) to determine the role of scintigraphy in the assessment of therapeutic effectiveness. According to scintigraphic signs of changes in RP accumulation in metastases the following groups were singled out: a complete effect, a partial effect, stabilization, progression of disease. The mean interval from the onset of therapy up to the appearance of scintigraphic signs of a therapeutic effect was 8.6 mos. A high degree of correlation between scintigraphic signs of a therapeutic effect and the time course of the pain syndrome in the skeletal bones was shown.

Topics: Bone Neoplasms; Breast Neoplasms; Combined Modality Therapy; Diphosphates; Female; Humans; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

A report of two patients in which a soft tissue mass, initially regarded as a malignant tumor, was shown to be the result of calcium pyrophosphate deposition disease. The first case, a woman aged 71 years, presented with a mass involving the right fifth finger. In the second case, also a woman aged 71 years, the lesion involved the tissues adjacent to the right hip. Each lesion consisted of a mass of highly cellular tissue containing deposits of calcium pyrophosphate dihydrate crystals. The clinical, radiological, and pathological features of the two cases are compared with those of seven similar cases reported in the literature.

Topics: Aged; Bone Neoplasms; Calcium Pyrophosphate; Chondrocalcinosis; Diagnosis, Differential; Diphosphates; Electron Probe Microanalysis; Female; Fingers; Hip; Humans; Microscopy, Electron, Scanning; Radiography; X-Ray Diffraction

A case of severe hypercalcemia due to metastases to bone from a primary breast cancer is presented. The different drugs available for treating hypercalcemia are described, and the rationale for their use is discussed.

Topics: Bone Neoplasms; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Diphosphates; Drug Therapy, Combination; Female; Humans; Hypercalcemia; Middle Aged; Plicamycin

Osteoscintigraphy and dynamic scintigraphy of the kidneys with 99mTc-pyrophosphate were used for investigation of 24 pediatric patients with tumorous involvement of the retroperitoneal space. Bone metastases were detected by osteoscintigraphy in 8 patients, pathological changes of the kidneys and urinary tract in 9 patients. Dynamic investigation of the kidneys with 99mTc-pyrophosphate performed in the first 20 min. after the drug injection showed disorders of renal evacuatory function of a varied degree of expression in all 24 patients. Dynamic investigation of the kidneys with 99mTc-pyrophosphate was not accompanied by an increase in radiation exposures therefore it was recommended at the first stage of radionuclide investigation of children with tumorous involvement of the retroperitoneal space followed by osteoscintigraphy.

Topics: Adult; Bone Neoplasms; Child; Child, Preschool; Diphosphates; Hodgkin Disease; Humans; Infant; Kidney Neoplasms; Neuroblastoma; Radioisotope Renography; Retroperitoneal Neoplasms; Technetium; Technetium Tc 99m Pyrophosphate; Wilms Tumor

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Diphosphates; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

The objective of this study is to correlate the presence of bone and liver metastases in patients with breast cancer with respect to the results of bone and liver scans, axillary nodal status, and serum alkaline phosphatase levels. One hundred ninety-seven patients with breast cancer treated by modified radical mastectomy between the years 1978 and 1981 were studied. Fifty-nine (30%) of the total group had distant metastases during the course of observation of 60 to 96 months; of 35 patients in whom bone metastases developed, 30 had normal preoperative bone scan results. Of 21 patients who had liver metastases, 19 had normal preoperative liver scans. Nineteen (70%) of the 27 patients with abnormal bone scans had normal alkaline phosphatase levels. Seven (63%) of the 11 patients who had abnormal liver scans had a normal alkaline phosphatase. The study supports the concept that preoperative bone and liver scans are ineffective indicators of metastatic involvement. Selection of patients for screening by bone and liver scans according to alkaline phosphatase determinations was not supported by this study. The appropriate use of bone scans for screening in patients with breast carcinoma is suggested as a follow-up device in patients with positive lymph nodes.

Topics: Alkaline Phosphatase; Bone Neoplasms; Breast Neoplasms; Diphosphates; Female; Humans; Liver Neoplasms; Mastectomy; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Technetium Tc 99m Sulfur Colloid

The optimum value of diagnostic procedure in the assessment of RP tumoritrophism (99mTc-pyrophosphate) was shown. The results of radionuclide studies using 99mTc-pyrophosphate in 193 patients with bone pathology were cited by way of example. Diagnostic thresholds with error levels were established. The diagnostic criteria (sensitivity, specificity, accuracy, etc.) were established proceeding from the criteria of malignant and benign features. Some differential-diagnostic potentialities of 99mTc-pyrophosphate in the recognition of certain groups of bone pathology were revealed.

Topics: Bone Diseases; Bone Neoplasms; Diagnosis, Differential; Diagnostic Errors; Diphosphates; Humans; Mathematics; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Bone Neoplasms; Diphosphates; Humans; Radionuclide Imaging; Strontium Radioisotopes; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Adolescent; Bone Neoplasms; Child; Child, Preschool; Diagnosis, Differential; Diphosphates; Evaluation Studies as Topic; Humans; Infant; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Pyrophosphate

The diagnosis of chondrosarcoma may be difficult if there is an atypical radiographic appearance or an inconclusive biopsy. Radionuclide bone scans of 13 patients with chondrosarcoma were reviewed to assess if a pattern of scan features could be recognised in association with this tumour. A combination, including increased blood pool activity, moderate intensity of uptake, patchy uptake with cortical predominance of activity, minimal distortion of bony outline, and a well-defined scintigraphic margin, occurred regularly in the series. Recognition of this characteristic pattern of scintigraphic features in cases of suspected chondrosarcoma may assist in the diagnostic assessment.

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Chondrosarcoma; Diphosphates; Diphosphonates; Female; Humans; Male; Middle Aged; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

The use of bone scans in the evaluation of renal cell carcinoma has become routine in many centers. In a retrospective analysis of 42 patients undergoing radical nephrectomy for renal cell carcinoma, we analyzed the cost-effectiveness of routine preoperative bone scans. Although these scans accurately predict metastatic disease to bone, they are not cost-effective as a routine preoperative tool because they do not alter outcome. In selected patients with bone pain and no other positive staging studies, preoperative bone scans may be of value in the decision to perform extirpative surgery.

Topics: Bone Neoplasms; Carcinoma, Renal Cell; Cost-Benefit Analysis; Diphosphates; Female; Follow-Up Studies; Humans; Kidney Neoplasms; Middle Aged; Neoplasm Staging; Nephrectomy; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Pyrophosphate; Time Factors

Three cases are reported in which visualization of the thyroid occurred during Tc-99m pyrophosphate bone scans. All were found to be hyperthyroid with elevated serum thyroid hormone and two patients also had elevated 4-hour radioactive iodine uptakes.

Topics: Adolescent; Bone Neoplasms; Diphosphates; Female; Humans; Hyperthyroidism; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thyroid Gland

Topics: Adolescent; Angiography; Bone Neoplasms; Diphosphates; Female; Humans; Radionuclide Imaging; Strontium Radioisotopes; Technetium; Technetium Tc 99m Pyrophosphate

For diagnosis of metastatic bone pathology x-ray and radionuclide studies were combined into one: electroroentgenoscanography. A total of 48 patients with different sites of a primary tumor process were examined using 99mTc-pyrophosphate. Electroroentgenograms were obtained with the help of the Soviet ERGA-MP apparatus in the negative regimen without enlarging the scale of skeletal imaging. The scanning was done on the Scinticart and Deltronix-Nuclear units. The peculiarity o this technique is visualization of the skeleton 2-4 and 20-24 h after i.v. injection of the radioactive indicator. Bone pathology was observed in 85.4% of the cases, and the results of the roentgenoradionuclide studies were identical. In 18 out of the 41 patients visualization of the skeleton with 99mTc-pyrophosphate made it possible to specify the number of foci of pathological bone tissue transformation. In 5 patients (10.4%), secondary metastatic involvement of the skeleton was found by the radionuclide method only. The results of repeated x-ray studies of these patients over the period of 3 months were negative. Clinical-radionuclide information was the reason for revising the clinical staging of tumors and correcting therapeutic methods. The new methodological approach in the diagnosis of bone pathology: electroroentgenoscanning on the 1st and 2nd days after injection of 99mTc-pyrophosphate opens up other opportunities for diagnosing metastatic involvement of the osseous system.

Topics: Bone Neoplasms; Diphosphates; Female; Humans; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Xeroradiography

As for the frequency of metastases to the bones breast cancer ranks third among all tumors, as for the general frequency of metastases it ranks first (25-45%). Early diagnosis of breast cancer metastases to the bones using scintigraphy of the skeleton in the preoperative period gives an opportunity to reveal tumor dissemination and to provide adequate treatment without imposing on patients inappropriate therapeutic measures. The study was performed using 99mTc-pyrophosphate. In revealing the foci of high activity accumulation by more than 20% as compared to symmetrical or adjacent zones, the changes were looked upon as metastatic ones. Out of 85 patients foci of high activity accumulation in the skeleton were noted in 7 (8.3%). In 5 patients, metastases were confirmed directly on roentgenography, and in 2 patients, they manifested themselves 2 and 5 months later. Stage I-IIa disease was observed in 48 (56.5%) out of the 85 patients. Out of the 40 patients with Stage I disease, skeletal metastases confirmed by x-ray were found in 2. All 7 patients were given together with mastectomy adjuvant treatment. Thus scintigraphy of the skeleton together with chest x-ray, liver scintigraphy, physical examination and palpation should become obligatory in the preoperative examination of patients to specify breast cancer stage.

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Diphosphates; Female; Humans; Neoplasm Staging; Preoperative Care; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

A total of 401 patients: 148 men, 134 women and 119 children with Hodgkin's disease were examined to determine the diagnostic value of the radioisotope and x-ray methods in the early detection of metastatic involvement of the skeletal bones. Specific skeletal bone lesions were revealed in 72 patients. Metastatic lesions of the skeletal bones develop more frequently in adults than in children. No significant differences in the site of metastases were noted. Radioisotope examination is an earlier diagnostic method in the early detection of metastatic involvement of the skeletal bones in Hodgkin's disease and more informative in the diagnosis of costal and cranial bone lesions.

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Child; Child, Preschool; Diphosphates; Female; Hodgkin Disease; Humans; Male; Middle Aged; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Data on 97 patients were analysed. Of these, 42 received combined therapy, 30 radiotherapy and 25 chemotherapy. The utmost therapeutic effect (by the selected criteria) was obtained with combined treatment (88.1%). Radionuclide signs of the efficacy of radiotherapy were noted in 70% of the patients, whereas 23.3% did not respond. The least effect was obtained with chemotherapy: the absence of improvement or deterioration were noted in 48% of the patients. The correlation of the data obtained with the clinical ones (the painful syndrome) was observed. A high sensitivity of the method does not only help reveal pathological skeletal changes but also plan adequate therapy.

Topics: Bone Neoplasms; Combined Modality Therapy; Diphosphates; Diphosphonates; Female; Humans; Male; Neoplasms; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Pyrophosphate

Radiologic studies of 50 giant cell tumors of bone in 48 patients were useful in assessing the anatomic extent for planning surgical treatment. Contrast-enhanced computed tomography (CT) provided the most useful and complete evaluation, including soft tissue extent and relationship to major vessels. Angiography was useful when the extraosseous extent and vascular relationships were not entirely clear on CT. Arthro-tomography was the best way to evaluate tumor invasion through subchondral cortex and articular cartilage. Reactive soft tissues, with edema and hyperemia, were difficult to distinguish from tumor tissue on CT and angiograms. Bone scintigrams often showed intense uptake beyond the true tumor limits.

Topics: Adolescent; Adult; Angiography; Bone and Bones; Bone Neoplasms; Diphosphates; Female; Giant Cell Tumors; Humans; Male; Middle Aged; Polyphosphates; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Pyrophosphate; Tomography, X-Ray; Tomography, X-Ray Computed

Radionuclide bone scans and skeletal radiographs were obtained before and during combination chemotherapy or initial hormonal treatment in 46 patients with disseminated adenocarcinoma of the prostate. The purpose of the study was to determine the usefulness of these two modalities in evaluating tumor response to therapy. Prior to treatment, bone scans were positive in 44 patients (96%). In all but one patient either bone radiographs or bone marrow biopsy revealed evidence of osseous metastases. In 22 patients partial response to therapy was documented by a variety of other staging tests. Eleven of these patients showed concurrent or later improvement on bone scans; one showed improvement on a radiograph. "Flare phenomena" were observed relatively frequently since 23% of the scans and 50% of the radiographs showed worsening at the time of response. Bone scans revealed worsening in 79% of 33 patients with disease progression of extraosseous tumor; radiographs were equally sensitive (82% worsening). It is concluded that bone scans in particular are useful for monitoring tumor status in systemically treated patients with prostate cancer. However, because of the lack of sensitivity for response and paradoxical worsening with tumor regression in some patients, scans are not accurate enough to be employed as the sole test in following these patients.

Topics: Adenocarcinoma; Aged; Bone Neoplasms; Castration; Cisplatin; Cyclophosphamide; Diphosphates; Diphosphonates; Doxorubicin; Drug Therapy, Combination; Humans; Male; Middle Aged; Prostatic Neoplasms; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Diphosphates; Female; Humans; Male; Middle Aged; Osteolysis; Radiography; Radionuclide Imaging; Ribs; Strontium Radioisotopes; Technetium; Technetium Tc 99m Pyrophosphate; Time Factors

Radionuclide joint imaging with the technetium-99m-labeled phosphates is a sensitive technique for the detection of inflammatory articular disease, although it is nonspecific as to the cause of the increased uptake and offers poor resolution in comparison to conventional radiography. There does not appear to be any place for the routine use of joint imaging of the peripheral joints, as there is little evidence that it benefits patient management. Scintigraphy is of benefit in the detection of osteomyelitis, Legg-Perthes' disease, and osteonecrosis, where changes may antedate roentgenologic abnormalities. Technetium-99m-phosphates may have an increasing role in the evaluation of knee and hip prosthetic joint loosening and infection, especially regarding the femoral components. Scintigraphy may be useful in excluding synovitis and allaying concern in selected patients with chronic articular pain in whom a conventional diagnostic evaluation is unrewarding. Attempts have been made to use radionuclide joint imaging to quantitate the degree of synovitis present in individual joints, particularly the sacroiliac joints. To date, reliable methods that distinguish normal from abnormal joints have not been established, although this remains an area of potential usefulness and active research. Scintigraphy with 99mTc-phosphates is useful in the detection of spinal fracture and pseudoarthrosis in individuals with ankylosing spondylitis.

Topics: Adult; Arthritis; Bone Neoplasms; Child; Diphosphates; Diphosphonates; Female; Gallium Radioisotopes; Humans; Joint Diseases; Legg-Calve-Perthes Disease; Male; Middle Aged; Osteoarthritis; Osteomyelitis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Spondylitis, Ankylosing; Synovitis; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Topics: Bone and Bones; Bone Neoplasms; Diphosphates; Head and Neck Neoplasms; Humans; Neoplasm Staging; Radionuclide Imaging; Scintillation Counting; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Pyrophosphate

Two hundred and thirty-one patients had 270 bone scans. Increased rib uptake was correlated with radiological findings. Interpretation of results whether due to benign or to metastatic disease depends on other observations. These include whether the uptake is localized or along the rib outline, single or multiple, and associated with other abnormal uptake in the rest of the skeleton. Abnormal rib uptake was encountered in 23% of patients scanned for malignant disease and 10% of patients scanned for benign conditions. In the first group 34% were true positive and of these, rib lesions were multiple in 32% and solitary in 2%. In 20% the rib uptake was due to benign conditions and in 46% it was indefinite because of absent radiological findings. In this last difficult group 17% were due to probably early rib metastases and 29% were due to benign causes. Rib metastases were missed in only two cases, 1.1%. One case was multiple myeloma and the other was direct extension from underlying anaplastic lung carcinoma.

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Child; Child, Preschool; Diagnosis, Differential; Diphosphates; Female; Humans; Infant; Male; Middle Aged; Radiography; Radionuclide Imaging; Ribs

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Diphosphates; Diphosphonates; Female; Follow-Up Studies; Humans; Middle Aged; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Pyrophosphate

The pathologic specimens of 18 osteosarcomas of long bones were examined to correlate histologic abnormalities with abnormalities seen on preoperative 99mTc pyrophosphate or methylene diphosphonate bone scans. Seven scans accurately represented the extent of the tumor. Eleven scans disclosed increased activity extending beyond the radiographic abnormalities. In eight of these, there was no occult tumor extension and in the other three, the scan activity did not accurately portray the skip metastases that were present. Therefore, these 11 scans demonstrated the falsely extended pattern of uptake beyond the true limits of the tumors. Pathologic slides were available for 10 of the 11 areas of bone that exhibited extended uptake. In two instances, there was no pathologic abnormality. In the other eight cases we found marrow hyperemia, medullary reactive bone, or periosteal new bone. This is the first description of these histologic abnormalities of medullary bone in areas of extended uptake on radionuclide bone scans.

Topics: Adolescent; Adult; Bone Neoplasms; Child; Child, Preschool; Diphosphates; Diphosphonates; Female; Femoral Neoplasms; Humans; Male; Osteosarcoma; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Radiography and scintigraphy were correlated in 70 patients with recently diagnosed, untreated multiple myeloma, including 59 with and 11 without primary lytic bone lesions. A site-by-site comparison showed that scintigraphy was more sensitive than radiography in only 18% of cases, whereas radiography was more sensitive in 38% (p less than 0.001). Patients whose bone scan was as sensitive or more so than the radiograph ("hot" myeloma) had more active disease than those with the "cold" form. Remission was indicated by significant regression or disappearance of scintigraphic abnormalities in 90% of cases. The authors conclude that scintigraphy is not helpful in detecting myelomatous bone lesions, but does have prognostic value for diagnosis and chemotherapy: a positive bone scan indicates initial or residual activity.

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Diphosphates; Diphosphonates; Female; Humans; Male; Middle Aged; Multiple Myeloma; Prospective Studies; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Topics: Adult; Bone and Bones; Bone Neoplasms; Child; Chondroma; Chondrosarcoma; Diagnosis, Differential; Diphosphates; Diphosphonates; Female; Humans; Infant; Osteosarcoma; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

The low incidence of measurable or evaluable metastases in patients with prostatic cancer makes evaluation of response difficult. This is particularly true in patients with bone metastases only. With a digital model it is possible to measure quantitatively from the radioisotope bone scan the total area of skeletal involvement by metastatic tumor. Definitions of response in bone have been derived from this model. These response criteria have been compared to response in acid phosphatase determinations and clinical status in a study of 44 patients with advanced prostatic cancer treated with estramustine phosphate. Based on serial quantitative bone scans, serial measurements of acid phosphatase levels and repeat clinical evaluations a system is proposed for defining response to systemic therapy that is applicable to the majority of patients with metastatic prostatic cancer.

Topics: Acid Phosphatase; Adenocarcinoma; Adult; Aged; Bone Neoplasms; Diphosphates; Diphosphonates; Estramustine; Humans; Male; Middle Aged; Nitrogen Mustard Compounds; Prostatic Neoplasms; Radionuclide Imaging; Technetium

The accuracy levels of serial radioisotope bone scans and conventional bone radiographs in assessing the response of bone metastases to systemic therapy were compared in 34 women with metastatic breast cancer. Each patient had measurable or evaluable nonosseous metastases, which were assessed independently of skeletal disease. The bone scan was found to be more accurate and sensitive indicator of the status of bone metastases than the radiograph. The bone scan correlated well with response of soft tissue or visceral disease, while the results of repeated bone radiographs were frequently misleading. With use of a digital model, it was possible to accurately measure the area of skeletal involvement of the bone scan, and from this derive quantitative criteria for response in bone metastases analogous to response criteria currently in use for soft tissue and visceral disease. It is suggested that serial quantitative bone scans be done, in preference to radiographs, to assess the response of bone metastases to systemic therapy.

Topics: Adult; Aged; Bone Neoplasms; Breast Neoplasms; Diphosphates; Female; Humans; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Radionuclide bone scans were performed before and during combination chemotherapy in 119 systematically staged patients with small cell carcinoma of the lung. Before therapy, 49 patients (41%) had positive scans. Scan positivity was significantly associated with the presence of metastatic tumor in the bone marrow, positive skeletal radiographs, and elevated serum alkaline phosphatase levels. Nonosseous distant metastases were significantly more likely to be detected as the number of areas of focal abnormalities on bone scan increased. The survival of patients with documented distant metastases in bone and nonosseous sites was significantly inferior to the survival of patients with limited disease, isolated osseous extensive disease, and extensive disease occurring only in nonbony sites. Of 36 patients with initially abnormal scans and tumor regression documented by other methods, scan findings improved in 24 (67%). In 26 (36%) of 72 scans in patients demonstrating disease progression in extraosseous sites, new areas of increased radionuclide uptake appeared. Improvement or worsening in follow-up scans was associated with nonbony tumor response or progression, respectively, 70% of the time. Serial bone scans provide reasonably accurate staging and prognostic information in patients with small cell lung cancer, although they are probably not sufficiently reliable to be used as the sole parameter in therapeutic decision-making.

Topics: Antineoplastic Agents; Bone Neoplasms; Carcinoma, Small Cell; Diphosphates; Drug Therapy, Combination; Evaluation Studies as Topic; Humans; Lung Neoplasms; Prognosis; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Acid Phosphatase; Aged; Alkaline Phosphatase; Bone Neoplasms; Diphosphates; Diphosphonates; Humans; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Scintigraphy is a non-invasive technically simple tool for diagnostic in the head and neck. Using nuclides with a short life time the irradiation of the skeleton is less than 1 rd. Scintigraphy in addition to X-ray examination is useful in diagnosis and surveillance of different osteoplastic tumors (like osteoma, osteoplastoma, cementoma, meningioma) and in systemic diseases of the bones (fibrotic dysplasia, Morbus Paget). Concerning inflammatory diseases osteomyelitis is the main indication for scintigraphy, but it is as well usefull in the diagnosis of complications of inflammatory diseases of the sinuses, like mucocelia or non resorbed antibiotics which provoked an inflammatory reaction of the mucosa. There is no indication for scintigraphy regarding its low specificity in common acute or chronic sinusitis.

Topics: Adult; Aged; Bone Neoplasms; Diagnosis, Differential; Diphosphates; Diphosphonates; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Osteolysis; Osteoma; Osteomyelitis; Radionuclide Imaging; Sinusitis; Technetium; Technetium Tc 99m Pyrophosphate; Tomography, X-Ray

The value of radioisotope bone scanning at the time of presentation and serially during follow-up has been evaluated in 55 patients with biopsy-proven osteogenic sarcoma. Many of the patients studied were treated with adjuvant chemotherapy. Bone metastases were detected at presentation in only one patient and in a second patient, proximal extension of the primary tumor not evident on radiographs was demonstrated by the radioisotope technique. During fellow-up, 20 patients experienced bone metastases and each had an abnormal bone scan. Eleven of these patients were asymptomatic for bone metastases at the time the scan became abnormal. Seven patients experienced bone metastases as their first site of tumor recurrence. The detection rate for soft tissue metastases was low, but the scan indicated stump recurrence in three patients. Although the yield is small, bone scanning is justified at presentation be cause the results may profoundly after the management. During follow-up, routine bone cans are indicated in all patients, whether they have symptoms or not.

Topics: Adolescent; Adult; Bone Neoplasms; Child; Diphosphates; Diphosphonates; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Osteosarcoma; Prognosis; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Staging bone scans or skeletal surveys were obtained of 97 patients with endometrial carcinoma. Of the 77 patients with Stage I or II disease, no metastases were identified at staging. Three patients in the entire series demonstrated bony metastases; all of these metastases were detectable by radionuclide bone scan and radiographic bone survey. Eighty-nine patients were examined with radionuclide liver/spleen scanning at the time of staging. Four of the 89 initial scans were interpreted as demonstrating hepatocellular disease, and all four patients had abnormal liver function studies. Only one patient demonstrated a possible hepatic metastasis at initial diagnosis. This patient also had abnormal liver function studies. Based on these results, bone surveys and radionuclide bone scans are not indicated as screening procedures in endometrial carcinoma. It is suggested that screening for liver metastases in patients with endometrial carcinoma is not warranted in patients with normal liver function studies.

Topics: Bone Neoplasms; Carcinoma; Diphosphates; Diphosphonates; Female; Humans; Liver Neoplasms; Neoplasm Staging; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Uterine Neoplasms

Serial skeletal scintigraphy was carried out on 259 patients with carcinoma of the prostate; 5-10% developed bone metastases each year. Isotope uptake was measured in 79 patients receiving treatment; in 60.6% (48 patients) there was a reduction or disappearance of the areas of uptake, in 16.6% (13 patients) they were stationary and 22.8% (18 patients) the metastases progressed. Skeletal scintigraphy is therefore useful during the course of the disease in showing its extent and the effect of treatment.

Topics: Antineoplastic Agents; Bone Neoplasms; Castration; Diphosphates; Diphosphonates; Estrogens; Humans; Male; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Pyrophosphate

Eight patients with persistent pain due to disseminated bone metastases from mammary carcinoma were given about 370 MBq (10 mCi) of 32P-pyrophosphate on 10 occasions. All but one of the patients experienced alleviation of pain lasting 1 to 4 months. The side effects, which derived mainly from haematopoetic tissue, prevent the routine use of this compound.

Topics: Blood Cell Count; Bone Neoplasms; Breast Neoplasms; Diphosphates; Female; Humans; Male; Palliative Care; Phosphorus Radioisotopes

Topics: Bone Neoplasms; Diagnosis, Differential; Diphosphates; False Negative Reactions; Humans; Kidney Diseases; Radionuclide Imaging; Retrospective Studies; Technetium

Within 1 yr after localized irradiation of a hind limb with single (1756 rads) or fractionated (4650 rads in 3 wk) x-ray doses, radiation-induced osteosarcomas were observed in four of nine single-dose rabbits and two of 11 fractionated-dose rabbits. Tumors were observed in the proximal tibia in five cases and the distal femur in one case. In terms of production of osteoid or osseous tissue, three tumors were well differentiated, one slightly differentiated, and two (spindle-cell tumors) undifferentiated. This report summarizes the Tc-99m pyrophosphate (TcPPi) imaging and autoradiographic, radiographic, and histologic studies of these osteosarcomas. The four differentiated osteosarcomas were detected 1--2.5 mo earlier by TcPPi imaging than by radiography, whereas the two undifferentiated tumors were suspected 2 wk or 3.5 mo earlier radiographically. Autoradiograms showed TcPPi localization in bone produced by differentiated osteosarcomas, and in regions of reactive bone resorption and formation peripheral to tumors. The results support a recommendation for combined radiographic and scintigraphic techniques for the early detection of osteosarcomas.

Topics: Animals; Bone and Bones; Bone Neoplasms; Diphosphates; Male; Neoplasms, Experimental; Neoplasms, Radiation-Induced; Osteosarcoma; Rabbits; Radiography; Radionuclide Imaging; Technetium

Topics: Biopsy; Bone Neoplasms; Diphosphates; Hodgkin Disease; Humans; Radiography; Radionuclide Imaging; Technetium

Topics: Adolescent; Adult; Animals; Bone and Bones; Bone Neoplasms; Diphosphates; Diphosphonates; Drug Evaluation; Drug Evaluation, Preclinical; Drug Interactions; Humans; Hydrogen-Ion Concentration; Middle Aged; Phosphates; Rats; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate; Tin; Tin Compounds; Tissue Distribution

Topics: Animals; Bone and Bones; Bone Neoplasms; Diphosphates; Diphosphonates; Dogs; Fluorine; Humans; Krypton; Neoplasm Transplantation; Neoplasms, Experimental; Rabbits; Radioisotopes; Radionuclide Imaging; Spinal Neoplasms; Strontium Radioisotopes; Technetium

Topics: Bone Neoplasms; Chondroblastoma; Chondroma; Diphosphates; Evaluation Studies as Topic; Giant Cell Tumors; Humans; Multiple Myeloma; Osteoma, Osteoid; Radionuclide Imaging; Sarcoma; Strontium Radioisotopes; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Bone and Bones; Bone Neoplasms; Diphosphates; Humans; Joint Diseases; Ossification, Heterotopic; Osteoma; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Diphosphates; Female; Humans; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate

A case of tumoural calcinosis in a 61-years-old man. This is a rare condition (60 published cases), affecting above all black subjects. It takes the form of hard rounded masses which progressively increase in size and vary in their location (hips, elbows, shoulders, periscapular region). On X-rays, the tumour is rounded, consisting of a mass of several calcified small nodules. On technetium pyrophosphate isotope scanning, there is very marked and periarticular uptake. There is often hyperphosphoraemia associated with normal blood calcium levels, without any abnormality in the hormones controlling calcium and phosphate metabolism. Treatment usually consists of the excision of the tumour masses. More recently, the reduction of hyperphosphoraemia by the prescription of aluminium salts and a reduction in phosphorus intake has been suggested.

Topics: Bone Neoplasms; Calcinosis; Calcium; Diphosphates; Humans; Male; Middle Aged; Phosphorus; Radionuclide Imaging; Technetium; White People

Studies of 12 children with neuroblastoma were performed to assess the comparative sensitivity of skeletal radiography and 99mTc pyrophosphate bone scintigraphy in the detection of metastases to the ends of long bones. A total of 18 lesions were detected in six patients. Fourteen were demonstrated only by radiography, whereas four were positive by both methods. In no case was a lesion detected by scintigraphy alone. Small lesion size, lytic radiographic appearance, metaphyseal location, and technical difficulties in imaging the knee all contribute to the high incidenmce of false negative scans. Lesions in two of the nine patients with metastatic disease to bone would have been missed on the basis of bone scans alone. Accordingly, the radiographic skeletal survey seems to remain a necessary part of the neuroblastoma workup.

Topics: Bone Neoplasms; Child; Child, Preschool; Diphosphates; False Negative Reactions; Female; Humans; Infant; Male; Neoplasm Metastasis; Neuroblastoma; Radionuclide Imaging; Technetium

Thirty patients had bone scintigraphy with both Tc-99m pyrophosphate (Tc-PPi) and Tc-99m diphosphonate (Tc-HEDP). The images were given a composite rating for quality and the basis of three sets of criteria, and were also compared for the number of lesions detected by each agent. The two agents provided no difference in scan quality. Nevertheless, in ten of the 30 patients, at least two of the three readers detected with Tc-HEDP lesions that were not seen with Tc-PPi, and in two such cases all three readers considered the Tc-PPi scan normal. In another of these ten, two of three readers felt the Tc-PPi image was norm, whereas all three detected the lesion with Tc-HEDP. The reverse never occurred (P less than 0.01).

Topics: Bone Neoplasms; Diphosphates; Etidronic Acid; Evaluation Studies as Topic; Humans; Neoplasm Metastasis; Radionuclide Imaging; Technetium

Topics: Adolescent; Adult; Aged; Bone and Bones; Bone Diseases; Bone Neoplasms; Child; Child, Preschool; Diphosphates; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Technetium

Topics: Adenocarcinoma; Adenocarcinoma, Scirrhous; Adult; Bone Neoplasms; Breast Neoplasms; Carcinoma; Diphosphates; Female; Humans; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Technetium

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Child; Child, Preschool; Diagnosis, Computer-Assisted; Diphosphates; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Radiography; Radionuclide Imaging; Technetium

Metastatic soft tissue calcification is known to occur in hypercalcemia and is usually present in the kidneys, stomach and lungs. 1--3 This case presents two unusual features: 1) ectopic parathormone production in association with poorly differentiated lymphocytic lymphoma; and and 2) uptake of 99mTc-pyrophosphate in the liver in the absence of demonstrable abnormality at autopsy. The more usual sites of metastatic calcification also showed uptake of the radionuclide. We will discuss metastatic soft tissue calcification, ectopic parathyroid hormone production, hypercalcemia in malignancy and bone scan agent localization in soft tissues.

Topics: Aged; Bone Neoplasms; Calcinosis; Diphosphates; Female; Hormones, Ectopic; Humans; Hypercalcemia; Liver; Lymphoma, Non-Hodgkin; Neoplasm Metastasis; Parathyroid Hormone; Radionuclide Imaging; Technetium

Topics: Animals; Bone and Bones; Bone Neoplasms; Diphosphates; Diphosphonates; Female; Guinea Pigs; Humans; Isotope Labeling; Male; Neoplasm Metastasis; Phosphates; Quality Control; Radionuclide Imaging; Rats; Technetium

Three hundred and ten bone scintigraphies were carried out in patients with a carcinoma of the breast. The results of these studies were compared not only with radiological findings but also the clinical and paraclinical course of the patients, the period of observation being between 8 and 44 months. Amongst the scintigrams in which no abnormality was detected, approximately 3.3% were obtained in patients with osteolytic metastases, the majority of these patients also having a rapidly growing primary tumourmamongst the patients with zones of hyperfixation and, at the same time, non-fixing metastases, 14/22 diedvery rapidly with diffuse bone metastases, this confirming the notion of poor prognosis in this "false negative" group. 11.3% of the abnormal results involved patients who showed no bone lesions more than 6 months after radio-isotopic examination "false positives". Of these, 12/18 were single lessions (41%). 14% of examinations carried out on a routine basis demonstrated metastases for which clinical and/or radiological confirmation was obtained only 2 to 9 months later.

Topics: Bone Neoplasms; Breast Neoplasms; Diphosphates; Humans; Neoplasm Metastasis; Prognosis; Radionuclide Imaging; Technetium

Of 70 consecutive cancer patients referred from radiotherapy for bone scans, 32% showed cardiac uptake of 99mTc-(Sn)-pyrophosphate; only 9% of a control group showed this uptake. Of those with prior left hemithorax irradiation, 60% showed cardiac uptake; only 12% of those with irradiation elsewhere showed this phenomenon (p less than .01). The patients who had no increased uptake tended to have shorter irradiation-to-scan time intervals (less than 10 months) than those who did show increased uptake (mean of 22 months).

Topics: Adult; Aged; Bone Neoplasms; Breast Neoplasms; Diphosphates; Female; Hodgkin Disease; Humans; Lung Neoplasms; Male; Middle Aged; Myocardium; Radionuclide Imaging; Radiotherapy; Technetium; Thorax

Three patients with foregut (bronchial), hindgut (rectal) or (ovarian) carcinoid tumors had symptomatic bone metastasis with abnormal 99m Tc pyrophosphate bone scans and bone roentgenograms. Six patients with midgut (small intestine or caecal) carcinoid) carcinoid tumors who had no symptoms of bone metastasis had no evidence of bone metastasis on bone scan or bone roentgenographic examination. This study supports the clinical impression that patients with midget carcinoid tumors have a low incidence of bone metastasis.

Topics: Bone Neoplasms; Carcinoid Tumor; Diphosphates; Female; Femoral Neoplasms; Frontal Bone; Humans; Lung Neoplasms; Male; Neoplasm Metastasis; Ovarian Neoplasms; Radionuclide Imaging; Rectal Neoplasms; Ribs; Spinal Neoplasms; Technetium

Bone-to-bone, iliosacral joint-to-os sacrum and joint-to-joint ratios were computed using the region-of-interest technique 2 to 3 hrs. after injection of 99mTc Sn-methylene-diphosphonate or 99mTc Sn-pyrophosphate in 139 patients with skeletal diseases (bone tumours, degenerative changes of the spine and joints, inflammatory changes of joints) as well as in 123 patients with normal skeletal states. In the latter group, iliosacral joint-to-os sacrum ratios decreased with increasing age of the patients. In patients with osseous metastases of the spine ratios of 0.80 to 4.0 occurred ( reference area second vertebra below or above the affected vertebra). In degenerative changes of the spine values of 0.80 to 1.69 were computed. These results show, that 74% of the spine metastases could not be differentiated from benign changes of the spine by determining their relative amounts of bone uptake. In bone tumours of the extremities and in rheumatoid or gouty arthritis of the small joints (hands and feet) the highest ratios, i.e. contrasts, occurred referring to a contralateral reference area. Osteoarthritic and inflammatory alterations of the big joints could not be differentiated because of percentual distribution of the increased joint-to-joint ratios turned out to be nearly identical.

Topics: Adult; Aged; Arthritis; Arthritis, Rheumatoid; Bone Diseases; Bone Neoplasms; Colonic Neoplasms; Diphosphates; Diphosphonates; Extremities; Femur; Gout; Hemangiosarcoma; Humans; Hypertrophy; Lumbar Vertebrae; Melanoma; Middle Aged; Neoplasm Metastasis; Osteoarthritis; Radionuclide Imaging; Spinal Neoplasms; Spinal Osteophytosis; Spondylolisthesis; Technetium

We have compared bone images from a number of patients using three instruments. In 38 patients, Cleon body images were compared with whole-body rectilinear scans. Cleon images were also compared with scintillation camera images of the trunk or extremities of 31 patients and of the skull of 70 patients. The Cleon was superior to the rectilinear scanner in resolution, lesion detectability, and speed of scanning. The Cleon and gamma camera were comparable in lesion detection, but the Cleon was consdierably faster. Clinical studies and comparative evaluation are presented.

Topics: Bone Neoplasms; Diphosphates; Evaluation Studies as Topic; Female; Humans; Male; Neoplasm Metastasis; Prostatic Neoplasms; Radionuclide Imaging; Ribs; Skull Neoplasms; Technetium

Topics: Adult; Bone Neoplasms; Diphosphates; Hodgkin Disease; Humans; Male; Radionuclide Imaging; Technetium

Topics: Adolescent; Adult; Aged; Bone and Bones; Bone Neoplasms; Diphosphates; Diphosphonates; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Reagent Kits, Diagnostic; Technetium

Topics: Bone and Bones; Bone Neoplasms; Diphosphates; Diphosphonates; Female; Humans; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Reagent Kits, Diagnostic; Technetium

Topics: Bone Diseases; Bone Neoplasms; Diphosphates; Humans; Radionuclide Imaging; Technetium; Tin

A positive 99mTc-pyrophosphate bone scan is reported in a proven case of large compact bone island. Pyrophosphate uptake in this case is presumed to be due to either large size or growth of the bone island. A radionuclide bone scan does not always differentiate bone islands from metastatic or inflammatory sclerotic bone lesions.

Topics: Adult; Bone Neoplasms; Diagnosis, Differential; Diphosphates; Humans; Male; Melanoma; Neoplasm Metastasis; Radionuclide Imaging; Technetium

A comparative study on 99m-Tc-phosphate compounds (TcPP) in detecting tumor metastasis to bone and problems accompanying it are reported. TcPP revealed metastatic foci which are unrecognized by conventional bone survey. To recognize these foci, exclusion of following problems is necessary: Accumulation at front of neck, asymmetrical image of joint, increased bone density of the aged, Tc-photon absorption and radiotherapy effect. The mechanism of TcPP accumulation is discussed.

Topics: Absorption; Adult; Age Factors; Aged; Bone Neoplasms; Diphosphates; Elementary Particles; Female; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Organophosphonates; Phosphates; Prostatic Neoplasms; Radionuclide Imaging; Technetium

Bone scan findings (using 99mTc-stannous pyrophosphate) in five patients with diffuse metastatic carcinoma of the axial skeleton are reviewed. Although there were few visually recognizable asymmetries of tracer localization, the diffuse involvement was diagnosed through abnormally elevated counting rates in the axial skeleton, decreased visualization of the kidneys, and faint or absent visualization of the appendicular skeleton.

Topics: Adenocarcinoma; Aged; Bone Neoplasms; Carcinoma, Transitional Cell; Diphosphates; Humans; Kidney Neoplasms; Kidney Pelvis; Male; Middle Aged; Neoplasm Metastasis; Prostatic Neoplasms; Radionuclide Imaging; Ribs; Skull Neoplasms; Spinal Neoplasms; Sternum; Technetium

Technetium-99m labelled imidodiphosphate was prepared in the presence of stannous ions. It was evaluated as a bone-scanning agent in animals and patients. Comparative tissue distribution studies in mice showed a relatively higher uptake of radioactivity in bone when 99Tcm -labelled pyrophosphate and diphosphonate. Accumulation of radioactivity in soft tissues, especially kidneys, was less with this radiopharmaceutical. Results in patients were most satisfactory in delineating skeletal bone and identifying bone lesions with relatively small tracer doses of the radiopharmaceutical.

Topics: Animals; Bone and Bones; Bone Neoplasms; Diphosphates; Dogs; Female; Humans; Imides; Male; Mice; Middle Aged; Neoplasm Metastasis; Organophosphonates; Phosphates; Rabbits; Radionuclide Imaging; Technetium

The purpose of the present work is to "quantify" bone scanning, in order to calculate indices of localized uptake that will make it possible to differentiate between normal and pathological uptake, and approach an etiologicial diagnosis. The authors use an Elscint dual head whole body scanner and an offline video display calculator. The patient is given 8 mc technetium 99m pyrophosphate 4 hours prior to scanning. The whole body count is expressed in thousands of counts multipled by two so that the knee to whole body ratio is close to one, to facilitate comparison of the indices. Results show that the presence of metastases is demonstrated more clearly by using a ratio bone segment to whole body. Quantitative scanning with 99mTc-pyrophosphate makes it possible to: 1) detect bone metastases easily, 2) follow the metastases during treatment, 3) avoid the gross errors that can be made in nomquantitative scanning.

Topics: Bone Neoplasms; Diphosphates; Female; Humans; Knee; Male; Neoplasm Metastasis; Radionuclide Imaging; Spinal Neoplasms; Technetium

Bone scintigraphy with 99mTc-polyphosphate or 99mTc-pyrophosphate was carried out in 54 children suspected of bone disease. Signs of skeletal metastases were recognized in 13 children by scintigraphy whereas X-ray examination showed lesions in only 10 of these. In 5 children with primary osteosarcoma, three cases of fibrous dysplasia, and 4 cases of osteomyelitis, the lesions were clearly demonstrated by scintigraphy. Abnormal accumulation of radioactivity in soft tissue lesions was observed in primary adrenal neuroblastoma, Hodgkin's granuloma, and metastatic Burkitt's lymphoma. Several cases are reported, and the value of bone scintigraphy in children is discussed.

Topics: Adolescent; Bone Diseases; Bone Neoplasms; Child; Child, Preschool; Diphosphates; Female; Humans; Infant; Male; Phosphates; Radionuclide Imaging; Technetium

Topics: Adolescent; Bone Diseases; Bone Neoplasms; Child; Diphosphates; Female; Fractures, Bone; Humans; Male; Middle Aged; Radionuclide Imaging; Technetium

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Child; Diphosphates; Female; Giant Cell Tumors; Hodgkin Disease; Humans; Male; Middle Aged; Osteoma, Osteoid; Radionuclide Imaging; Sarcoma; Technetium

Thekinetic of 99mTc-labeled pyrophosphate were compared with those of polyphosphate in ten patients in a combined study. Both agents cleared from the blood in a biexpoential fashion. The clearance half-time of Exponent I was the same for both and was shorter than the clearance half-time of Exponent ii. Urinary excretion of both agents was the same during the first hour but during the next 3 hr Tc-pyrophosphate cleared at a slightly more rapid rate, resulting in lower blood background radioactivity. Both agents were bound loosely to plasma proteins, mainly to globulin fractions. The sensitivity of lesion detection was similar for both. Excellent bone images were obtained with both agents. The images with Tc-pyrophosphatewere consistently superior owing to the low blood background and they took less time to accumulate an identical number of counts from identical regions. With the amount of 99mTc-complex used, no hyocalcemia or tetany was noted, nor was there any significant effect on 1-hr serum levels of inorganic phosphours and alkaline phosphatase. Four hours after injection, 9.5% of the dose of Tc-pyrophosphate was circulating in blood, 31.7% was excreted in urine, and the remaining 58.8% was taken up by bone and other tissues. The corresponding values with Tc-polyphosphate were 12.5% in blood, 29.0% in urine, and 58.5% in bone and other tissues. Among the soft tissues, the genitourinary system is most consistently visualized. It is concluded that both Tc-pyroposphate and Tc-polyphosphate are excellent skeletal-imaging agents and that Tc-pyrophosphate appears slightly superior to Tc-polyphosphate.

Topics: Blood Proteins; Bone and Bones; Bone Neoplasms; Diphosphates; Humans; Kinetics; Phosphates; Protein Binding; Radionuclide Imaging; Technetium

A retrospective study of 795 consecutive bone scans employing either 18F or 99mTc-pyrophosphate to evaluate the diagnostic value of renal asymmetry in such scans has been carried out. It is concluded that asymmetric renal images in bone scans convey relatively specific information regarding renal pathology, especially in the 99mTc-pyrophosphate studies.

Topics: Adenocarcinoma; Adult; Aged; Bone Neoplasms; Carcinoma, Bronchogenic; Diphosphates; Female; Fluorine; Humans; Kidney; Kidney Diseases; Kidney Neoplasms; Male; Melanoma; Radioisotopes; Radionuclide Imaging; Retrospective Studies; Technetium; Ureteral Obstruction

Uptake of 99mTc bone-scanning agent into lungs containing metastatic calcification was demonstrated in a patient with a carcinosarcoma of the bladder. This gives further support to the hypothesis that 99mTc bone agents are associated with hydroxyapatite.

Topics: Bone Neoplasms; Calcinosis; Carcinosarcoma; Diphosphates; Humans; Lung Diseases; Male; Middle Aged; Phosphates; Radionuclide Imaging; Technetium; Urinary Bladder Neoplasms

99MTc pyrophosphate has restored bone scintigraphy to the position of respectability it had lost with radiostrontium 85 and 87m, and it has rapidly become the method of choice for the detection of osteogenic hyperactivity. In cases of tumor the histologic disorder is frequently detected prior to the morphologic changes seen in X-ray pictures. The biophysical properties of 99mTc pyrophosphate provide high quality imaging of the skeleton. The scans or scintiphotos render possible a more sensitive and earlier diagnosis than radiography, though bone scanning does not of course supersede radiography. The two methods are complementary. In present day oncologic practice, however, bone scintigraphy with 99mTc pyrophosphate replaces to advantage the conventional radiographic "bone survey". In neurology the change is already appreciable and has proved its worth. In the light of results in 78 neurologic patients attention is drawn to the significant changes bone scintigraphy has brought about in diagnosis and therapeutic planning. The indications which have already emerged from this new method of nuclear neurology are tabulated, discussed and illustrated.

Topics: Adult; Aged; Bone Neoplasms; Diagnosis, Differential; Diphosphates; Female; Fractures, Bone; Histiocytoma, Benign Fibrous; Humans; Male; Neoplasm Metastasis; Nervous System Diseases; Radionuclide Imaging; Skull Neoplasms; Technetium

The authors report the results they obtained by bone scintigraphy using technetium pyrophosphate. In a study of 142 patients with cancer, the authors show, as others have done, that bone scintigraphy makes it possible to find bone metastases that are radiologically undetectable and they emphasize the importance of this discovery. In 7 patients with spondylodiscitis, of whom 1 was without radiological signs at the time the scintigraphy was carried out, the authors always observed localized vertebral hyperfixation and they noted that this examination can be valuable for distinguishing spondylodiscitis from pseudo-Pott's discarthroses and from the lesions of vertebral epiphysitis, which in their experience do not result in isotopic hyperfixation. In 7 patients with epiphyseal osteonecrosis, the authors observed isotopic hyperfixation before the appearance of radiological signs. In 12 patients with osteoporosis, the authors observed hyperfixation in bone in certain compressed vertebrae, whereas other vertebrae that had probably been compressed some considerable time earlier did not fix the isotope excessively. They never observed hyperfixation in vertebrae that were not compressed. Among 5 patients with ankylosing spondylitis with radiological signs of sacro-iliac arthritis, the authors observed sacro-iliac hyperfixation in only 3 cases. Two other patients who had signs indicating ankylosing spondylarthritis, but were without radiological signs of sacro-iliac arthritis did not show sacro-iliac hyperfixation of the isotope. Among 7 patients with Paget's disease, the authors observed hyperfixation in all the bones with radiological signs of disease; in addition, in 3 patients, there was also hyperfixation in certain bones that were radiologically clear.

Topics: Bone Diseases; Bone Neoplasms; Diphosphates; Epiphyses, Slipped; Humans; Joint Diseases; Knee Joint; Neoplasm Metastasis; Osteitis Deformans; Osteoarthritis; Osteoporosis; Radiography; Radionuclide Imaging; Spinal Diseases; Spondylitis; Spondylitis, Ankylosing; Technetium

A total of 146 patients were investigated for the presence of osseous metastases with 99mTc polyphosphate or 99mTc pyrophosphate bone scans. Results of bone imaging were retrospectively compared to roentgenographic results surveying similar anatomic areas in 128 patients. This comparison revealed that roentgenographic interpretations were in error in 19% of the cases. Thirty-three patients had bone scans and roentgenograms that were in agreement and considered abnormal, but in more than one third of these cases the patients had multiple abnormalities that were shown by the bone scan but were not recognized roentgenographically. In consideration of the low toxicity, ready availability, economy, shortened procedure time, and low radiation dose associated with the use of these new bone-seeking agents, it is concluded that they are superior to roentgenograms and previously utilized radionuclides for early detection of osseous metastases.

Topics: Bone Neoplasms; Carcinoma; Diphosphates; Fluorine; Humans; Lung Neoplasms; Male; Neoplasm Metastasis; Phosphates; Prostatic Neoplasms; Radioisotopes; Radionuclide Imaging; Scintillation Counting; Strontium Radioisotopes; Urinary Bladder Neoplasms

Topics: Adolescent; Adult; Aged; Bone and Bones; Bone Diseases; Bone Neoplasms; Child; Diphosphates; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Technetium

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Diphosphates; Female; Fluorine; Humans; Lung Neoplasms; Middle Aged; Neoplasm Metastasis; Radioisotopes; Radionuclide Imaging; Technetium; Uterine Cervical Neoplasms

Topics: Animals; Bone Diseases; Bone Neoplasms; Diphosphates; Evaluation Studies as Topic; Humans; Radionuclide Imaging; Strontium; Technetium; Tin

Technetium-99m-labeled pyrophosphate has proved to be a useful skeletal-imaging agent. In this study, specific areas of the skeleton were imaged at times ranging from 1/2 to 6 1/2 hr after injection of 99mTc-pyrophosphate. Count ratios between abnormal and normal bone with respect to adjacent soft tissue were obtained for selected regions of interest on computer-stored scintillation camera images. The results show that image quality improves most rapidly from 1/2 to 2 hr, but further modest gain in quality does occur on views recorded between 2 and 6 hr. All lesions detected on the later images were also observed on the early ones and the ratios of uptake between abnormal and normal bone from computer-processed scintillation camera images did not change appreciably with time after the 1/2-hr images. Our results confirm the clinical impression that overall image quality is better on views obtained at least 3 hr after injection. Further delays in imaging beyond 3-4 hr after injection probably will not result in any appreciable gain in diagnostic accuracy.

Topics: Bone Neoplasms; Diagnosis, Computer-Assisted; Diphosphates; Humans; Neoplasm Metastasis; Radionuclide Imaging; Technetium; Time Factors

Localization of 99mTc-pyrophosphate in the cardiac region during routine bone scanning for metastatic tumor is discussed in two cases. Clinical information as well as electrocardiographic and serum enzyme studies did not reveal any evidence of acute myocardial injury. The cause of myocardial localization of the radiopharmaceutical is not clear in these cases.

Topics: Aged; Bone Neoplasms; Breast Neoplasms; Carcinoma; Diphosphates; Female; Humans; Lung Neoplasms; Male; Middle Aged; Myocardial Infarction; Myocardium; Neoplasm Metastasis; Radioisotopes; Technetium

99Tcm-Sn pyrophosphate bone scans of 250 patients referred for skeletal metastatic survey were analysed to determine the frequency of abnormal extra-osseous localization and the various pathological causes. Twenty-six patients demonstrated abnormal extra-osseous concentration. There were three false positives. Sixty-five per cent of the extra-osseous lesions concentrating pyrophosphate were malignant (carcinoma of lung and breast, metastatic hepatic carcinoma, chondrosarcoma) and the remainder were benign lesions, e.g. sarcoidosis, soft-tissue calcification, post-surgical and irradiation sites. An incidental finding was the unusual frequency of accumulation of pyrophosphate in various joints, especially the knees and shoulders in asymptomatic patients above 70 years of age.

Topics: Age Factors; Aged; Bone Neoplasms; Breast Neoplasms; Diphosphates; False Positive Reactions; Humans; Joints; Liver Neoplasms; Lung Neoplasms; Middle Aged; Neoplasm Metastasis; Neoplasms; Radionuclide Imaging; Sarcoidosis; Technetium; Tin

Topics: Bone Neoplasms; Diphosphates; Female; Humans; Male; Neoplasm Metastasis; Radionuclide Imaging; Technetium

Topics: Bone Neoplasms; Diphosphates; Etidronic Acid; Humans; Neoplasm Metastasis; Organophosphorus Compounds; Phosphates; Radionuclide Imaging; Technetium

Paralleled clinical studies of radioisotopic imaging or tumor metastases in the bone were undertaken with Tc99m pyrophosphate, Ga67 citrate, and Tc99m sulfur colloid. All three were capable of anticipating the bone roentgenograms. A critical analysis suggested that positive delineation with Ga67 citrate would sometimes be superior to the others. This deserves further investigation. Clinically the combined use of Tc99m pyrophosphate with Ga67 for the chest areas and extremties or with Tc99m colloid for the pelvic and abdominal areas would be more frutiful in early detection and exact localization of bone metastases.

Topics: Bone Neoplasms; Breast Neoplasms; Carcinoma, Squamous Cell; Citrates; Colloids; Diagnosis, Differential; Diphosphates; Esophageal Neoplasms; Humans; Leiomyosarcoma; Neoplasm Metastasis; Pancreatic Neoplasms; Radionuclide Imaging; Technetium

Various portions of the skeleton were examined in 125 patients both radiologically and by scanning, using 99mTc-pyrophosphate. The results are compared, particular attention being paid to errors in diagnosis. The figures show that scans represent a valuable additional form of examination for detecting tumours which have not been found radiologically. The importance of serial observations is discussed.

Topics: Bone Neoplasms; Diagnosis, Differential; Diagnostic Errors; Diphosphates; Extremities; False Negative Reactions; False Positive Reactions; Female; Humans; Male; Neoplasm Metastasis; Pelvis; Radiography; Radionuclide Imaging; Skull Neoplasms; Spinal Neoplasms; Technetium; Thoracic Neoplasms

Kinetics and clinical studies of bone scintiscanning with 99mTc-pyrophosphate in 92 patients with certified diagnosis allowed the following conclusions: 1. After i.v. injection 99mTc-pyrophosphate is distributed in 3 compartments, from which it is cleared with biological half-lives of 32.7 minutes, 5.1 hours and 22.54 hours respectively. The relative size of these compartments is 1 : 3 : 6. After application of the substance, an initially high renal excretion with a consecutive exponential drop can be observed. The optimal period for scintigraphic studies seems therefore to be from 3-6 hrs, as at this time there is still an adequate activity in bone structures, while the low background activity yields a good contrast on scintiscans. 2. The clinical results of bone scintigraphy with 99mTc-pyrophosphate with 88.6% correct diagnoses can be considered as "very good". This feature can partly be attributed to an improved correlation of radiographic and scintigraphic images by the use of a specially designed, combined radiographic-photoscanning detector system. 3. Preliminary results concerning the quantitative uptake of 99mTc-pyrophosphate in fractures of the extremities suggest, that the quantitative analyses of the registered data can provide valuable prognostic information in traumatic, inflammatory and neoplastic bone lesions.

Topics: Bone and Bones; Bone Diseases; Bone Neoplasms; Diphosphates; Fractures, Bone; Half-Life; Humans; Kinetics; Radiography; Radionuclide Imaging; Technetium

Topics: Bone and Bones; Bone Neoplasms; Diphosphates; Drug Evaluation; Humans; Neoplasm Metastasis; Radionuclide Imaging; Strontium Radioisotopes; Technetium

Topics: Bone and Bones; Bone Neoplasms; Diphosphates; Drug Evaluation; Humans; Neoplasm Metastasis; Radionuclide Imaging; Technetium

Topics: Animals; Bleomycin; Bone Neoplasms; Diphosphates; Gallium; Neoplasm Transplantation; Neoplasms, Experimental; Rabbits; Radionuclide Imaging; Strontium Radioisotopes; Technetium

Topics: Adolescent; Aged; Bone Neoplasms; Diphosphates; Female; Humans; Male; Middle Aged; Osteitis Deformans; Radionuclide Imaging; Technetium

Topics: Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Diphosphates; Female; Humans; Intestinal Neoplasms; Lung Neoplasms; Neoplasm Metastasis; Phosphates; Radiography; Radionuclide Imaging; Technetium

Topics: Bone Neoplasms; Child; Child, Preschool; Diphosphates; Extremities; Facial Bones; Facial Neoplasms; Female; Fluorine; Gallium; Head and Neck Neoplasms; Humans; Iodine Radioisotopes; Male; Neoplasm Metastasis; Neuroblastoma; Radioisotopes; Radionuclide Imaging; Rhabdomyosarcoma; Skull Neoplasms; Strontium Isotopes; Technetium; Zygoma

Topics: Bone and Bones; Bone Diseases; Bone Neoplasms; Calcium; Diphosphates; Fluorine; Humans; Methods; Phosphates; Radioisotopes; Radionuclide Imaging; Strontium Radioisotopes; Technetium

Topics: Alkanes; Bone Neoplasms; Diphosphates; Humans; Neoplasm Metastasis; Organophosphonates; Phosphates; Radionuclide Imaging; Technetium

Topics: Aged; Bone Neoplasms; Diphosphates; Evaluation Studies as Topic; Humans; Male; Middle Aged; Neoplasm Metastasis; Phosphates; Prostatic Neoplasms; Radionuclide Imaging; Technetium

Topics: Animals; Bone Neoplasms; Chromatography, Thin Layer; Diphosphates; Evaluation Studies as Topic; Femur; Hip; Humans; Hydrogen-Ion Concentration; Ilium; Iron; Lumbar Vertebrae; Rabbits; Radiation Dosage; Radionuclide Imaging; Ribs; Technetium; Thoracic Vertebrae

Topics: Bone Marrow; Bone Neoplasms; Densitometry; Diphosphates; Humans; Male; Neoplasm Metastasis; Phosphates; Prostatic Neoplasms; Radiation Dosage; Radionuclide Imaging; Strontium Radioisotopes; Technetium

Topics: Arthritis; Bone Diseases; Bone Neoplasms; Diagnosis, Differential; Diphosphates; Hodgkin Disease; Humans; Multiple Myeloma; Neoplasm Metastasis; Osteitis Deformans; Osteoarthritis; Osteolysis; Osteomalacia; Osteoporosis; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Rheumatic Diseases; Technetium; Tin

Topics: Adolescent; Adult; Aged; Bone Diseases; Bone Neoplasms; Child; Child, Preschool; Diphosphates; Female; Humans; Male; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Technetium; Whole-Body Counting

Topics: Bone Diseases; Bone Neoplasms; Diphosphates; Hodgkin Disease; Humans; Methods; Polymers; Radionuclide Imaging; Strontium Isotopes; Technetium

Topics: Animals; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Carcinoma; Diphosphates; Humans; Lung Neoplasms; Male; Melanoma; Neoplasm Metastasis; Prostatic Neoplasms; Radionuclide Imaging; Rectal Neoplasms; Sodium; Technetium; Time Factors; Urinary Bladder Neoplasms

Topics: Arthritis, Infectious; Arthritis, Rheumatoid; Bone Diseases; Bone Neoplasms; Diphosphates; Drug Combinations; Humans; Joint Diseases; Male; Neoplasm Metastasis; Pelvic Neoplasms; Phosphates; Prostatic Neoplasms; Radionuclide Imaging; Technetium

Topics: Bone Neoplasms; Diphosphates; Humans; Metabolic Clearance Rate; Methods; Neoplasm Metastasis; Osteogenesis; Radionuclide Imaging; Statistics as Topic; Technetium; Tomography, X-Ray

Topics: Bone Neoplasms; Diphosphates; Humans; Neoplasm Metastasis; Radionuclide Imaging; Remission, Spontaneous; Strontium Radioisotopes; Technetium; Tomography, X-Ray

Topics: Bone Neoplasms; Chromatography, Paper; Diphosphates; Humans; Injections, Intravenous; Isotonic Solutions; Neoplasm Metastasis; Radionuclide Imaging; Sodium; Technetium; Technology, Radiologic; Tibia

Topics: Adolescent; Adult; Age Factors; Aged; Animals; Bone Neoplasms; Carcinoma 256, Walker; Child; Child, Preschool; Diphosphates; Female; Humans; Hydroxyproline; Male; Middle Aged; Neoplasm Metastasis; Rats

Topics: Bone Neoplasms; Bone Resorption; Chromatography; Diphosphates; Fluids and Secretions; Humans; Hydroxyproline; Hyperparathyroidism; Hyperthyroidism; Osteitis Deformans; Phosphorus; Urine