strontium-radioisotopes and Osteitis-Deformans

Nuclear medicine techniques are currently playing an important complementary role in the evaluation, management, and follow-up of the patient who is suspected of having Paget's disease of bone. The earlier diagnoses made possible by some of the described techniques should lead to a better understanding of the basic pathophysiology and, in addition, result in improved therapeutic modalities.

Topics: Adult; Aged; Alkaline Phosphatase; Antibodies; Calcitonin; Calcium Radioisotopes; Female; Humans; Hyperparathyroidism; Male; Middle Aged; Osteitis Deformans; Phosphates; Radiography; Radionuclide Imaging; Strontium Radioisotopes; Technetium; Uric Acid

The urinary production of pyridinium collagen cross-links, pyridinoline (PYD) and deoxypyridinoline (DPD), has been correlated to increased bone resorption in patients with neoplasms. This study investigated the production of these compounds in patients with metastatic prostate carcinoma who received palliative treatment that did and did not include 89Sr-chloride therapy.. Urinary production of PYD and DPD was measured by high-performance liquid chromatography and natural flucrescence detection methods. The urine from several age-matched groups of patients was examined for these compounds including healthy controls (n = 20), patients with early-stage (Stage A-B) prostate carcinoma (n = 8), patients with metastatic prostate carcinoma treated with conventional analgesic and radiotherapeutic palliation (n = 20), patients with metastatic disease who underwent 89Sr-chloride therapy (n = 20) and patients with mild Paget's disease (n = 5). Patients were also monitored for urinary PYD and DPD production for a 6-mo interval after a palliative intervention.. Elevated PYD and DPD (p < 0.05) concentrations were measured in patients with metastatic and nonmetastatic prostate cancer and Paget's disease. The urinary production of these compounds remained unchanged for 6 mo after 89Sr-chloride therapy for symptomatic osseous metastases. However, the patients who did not undergo 89Sr-chloride therapy exhibited a two-fold increase in PYD and a four-fold increase in DPD above controls during the interval.. PYD and DPD are sensitive and specific bone resorption markers which demonstrate a slowing of bone resorption after palliative 89Sr-chloride therapy in patients with bone metastases.

Topics: Aged; Amino Acids; Bone Neoplasms; Bone Resorption; Case-Control Studies; Humans; Male; Osteitis Deformans; Palliative Care; Prostatic Neoplasms; Strontium; Strontium Radioisotopes; Time Factors

The whole-body and part-body retention of 85Sr has been measured over a period of 150 days in 12 patients with Paget's disease, seven of whom were treated with calcitonin, starting 60 days after the 85Sr administration. Retentions were compared with those in a group of seven control subjects. The retention data were analysed using multiple exponential, single and double power-law and combined power law and exponential functions. The mean retention of 85Sr over a long period was greater in the Paget's patients than in the controls, 1.9 times at two months. No significant effect of calcitonin treatment was demonstrated. Part-body measurements based on profile scanning demonstrated a significantly increased uptake of 85Sr in sites where disease was present. The longer-term rate of disappearance from such sites was faster than from unaffected bones.

Topics: Aged; Body Burden; Female; Humans; Male; Osteitis Deformans; Strontium Radioisotopes; Time Factors

Bone metabolism studies were performed in 44 subjects with and without bone disease using a calcium tracers kinetics model, the central feature of which is an expanding exchangeable calcium pool. In normal subjects the accretion rate and the exchangeable calcium pool ranged from 1.49 to 8.45 (mean 3.9 +/- 2.05) mg.d-1kg-1 and from 60 to 131 (mean 81.25 +/- 18.11) mg.kg-1, respectively. The patients with osteogenesis imperfecta. Pierre Marie's disease and one out of two cases of hypoparathyroidism had values which fell within the normal range. Both the accretion rate and the exchangeable calcium pool were significantly elevated in patients with Paget's disease and with hyperparathyroidism. Uremic patients with generalized bone lesions had accretion rates or both parameters elevated. As far as patients with successful renal transplant are concerned, the results suggest that this method is a very poor means for detecting bone disorders with only focal lesions. In contrast, the method can be very useful when persistent renal osteodystrophy or secondary hyperparathyroidism are suspected.

Topics: Adult; Aged; Bone and Bones; Bone Diseases; Calcium; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Hyperparathyroidism; Hypoparathyroidism; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Osteitis Deformans; Osteoarthropathy, Secondary Hypertrophic; Osteogenesis Imperfecta; Renal Dialysis; Strontium Radioisotopes

Close relation of non osseus facial skull portions to the skeleton cause rapidly the bone to become co-involved in presence of various diseases. Early diagnosis is of decisive importance for therapeutic measures. For localisation scintigraphy has proved particularly reliable in aids to early determination. This can be shown clearly in inflammatory diseases and tumour infiltrations with various tumour affections. Technical requirements and the use of skeletal scinitgraphy are demonstrated on hand of 6 cases.

Topics: Adult; Aged; Carcinoma, Squamous Cell; Child; Cholesterol; Female; Fluorine; Granuloma; Humans; Male; Maxillary Neoplasms; Middle Aged; Osteitis Deformans; Otorhinolaryngologic Diseases; Posture; Radioisotopes; Radionuclide Imaging; Sinusitis; Skull; Strontium Isotopes; Strontium Radioisotopes; Technetium

In primary bone tumors the possibilities of bone scans are discussed. Exact differentiation between malignant and benign disease by this method is impossible. However, scanning provides important information about extent of the disease, metastases, multiplicity of benign lesions and influence of adjoining diseases to the bone. A special indication exists in cases of cerebral meningiomas and an absolute indication for searching osteoplastic metastases, e.g. in carcinomas of the breast and the prostate gland.

Topics: Bone Diseases; Bone Neoplasms; Child; Fluorine; Granuloma; Hemangiosarcoma; Humans; Male; Meningioma; Neoplasm Metastasis; Osteitis Deformans; Osteoma; Radioisotopes; Radionuclide Imaging; Sarcoma, Ewing; Strontium; Strontium Isotopes; Strontium Radioisotopes; Technetium

Topics: Americium; Arthritis, Rheumatoid; Bone and Bones; Bone Diseases; Bone Neoplasms; Calcium Radioisotopes; Fluorine; Humans; Iodine Radioisotopes; Osteitis Deformans; Osteomalacia; Osteoporosis; Radioisotopes; Radionuclide Imaging; Spondylitis, Ankylosing; Strontium Radioisotopes; Technetium

Scanning is based on the uptake of a nuclide by the crystal lattice of bone and is related to bone blood flow. Cancer cells do not take up the tracer. Normally, the scan visualizes the highly vascular bones. Scans are useful and are indicated in metastatic bone disease, primary bone tumors, hematologic malignancies and some non-neoplastic diseases. The scan is more sensitive than x-ray in the detection of malignant diseases of the skeleton.

Topics: Adult; Bone Diseases; Bone Neoplasms; Child; Diagnosis, Differential; Evaluation Studies as Topic; Femoral Fractures; Fluorine; Humans; Lymphoma; Multiple Myeloma; Neoplasm Metastasis; Osteitis Deformans; Osteosarcoma; Pelvic Bones; Phosphates; Radiography; Radioisotopes; Radionuclide Imaging; Skull Neoplasms; Strontium Isotopes; Strontium Radioisotopes; Technetium

Topics: Adenocarcinoma; Adult; Aged; Arthritis; Bone Diseases; Bone Neoplasms; Breast Neoplasms; Colonic Neoplasms; Female; Fluorine; Hodgkin Disease; Humans; Lymphoma, Non-Hodgkin; Male; Middle Aged; Neoplasm Metastasis; Osteitis Deformans; Prostatic Neoplasms; Radiation Dosage; Radiation Monitoring; Radiography; Radioisotopes; Radionuclide Imaging; Ribs; Shoulder; Skull Neoplasms; Strontium Radioisotopes; Technetium; Thoracic Neoplasms