technetium-tc-99m-exametazime and Bone-Neoplasms

In this article, we present a rare case of B-cell bone lymphoma in a child with multifocal asymptomatic lesions detected by bone scintigraphy and a chronic clinical history characterized by limping and fever episodes for over a year. Initially, multifocal osteomyelitis was suspected and antibiotic therapy was administered with no clinical improvement. The biopsy of the main lesion in the left distal femur along with bone marrow cytology established the final diagnosis. This rare case illustrates the utility of routinely low cost-effective nuclear medicine studies like whole body bone scan and 99mTc hexamethylpropyleneamine oxime-labeled leukocytes to orientate similar cases to a correct diagnosis.

Topics: Antineoplastic Agents; Bone Neoplasms; Child, Preschool; Diagnosis, Differential; Gait; Humans; Leukocytes; Lymphoma, B-Cell; Male; Osteomyelitis; Radionuclide Imaging; Technetium Tc 99m Exametazime; Technetium Tc 99m Medronate

Topics: Adenocarcinoma; Aged; Aged, 80 and over; Bone Neoplasms; Crohn Disease; Diagnosis, Differential; False Positive Reactions; Humans; Ileum; Inflammatory Bowel Diseases; Leukocytes; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime

Topics: Adult; Bone Neoplasms; Humans; Ilium; Leukocytes; Lymphoma, Non-Hodgkin; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime

The usefulness of bone marrow scintigraphy with 99mTc-HMPAO-labeled leukocytes (leukocyte bone marrow scintigraphy) in the diagnosis of skeletal metastases of cancers was investigated in 70 lesions in 27 patients with various types of cancer. The final diagnosis of skeletal metastases was based on one or more criteria consisting of histological confirmation, typical findings of metastases by bone radiograph, CT and MRI, or progressive swellings of the lesions with severe pain due to nerve compression. Of the 70 lesions, 55 were finally diagnosed as metastases, and 15 as benign lesions. Leukocyte bone marrow scintigraphy showed photopenic defects in 52 of the 55 metastatic lesions (sensitivity 95%), and the remaining 3 negative lesions were found positive for metastases by MRI. In contrast, MRI could evaluate only 39 of the 55 lesions because 16 lesions in the ribs, scapula and sternum were not visualized. Of these 39 lesions, MRI showed positive findings for metastases in 33 (sensitivity 85%), and negative findings in 6 with photopenic defects found by leukocyte bone marrow scintigraphy. Of the 15 benign lesions, 3 were false positive for metastases on leukocyte bone marrow scintigraphy (specificity 80%). We conclude that 99mTc-HMPAO-labeled leukocyte bone marrow scintigraphy may be useful in the diagnosis of skeletal metastases of cancers, particularly when MRI fails to evaluate the lesions.

Topics: Adult; Aged; Aged, 80 and over; Bone Marrow; Bone Neoplasms; Case-Control Studies; Diagnostic Errors; Female; Humans; Leukocytes; Magnetic Resonance Imaging; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, X-Ray Computed

Malignant cutaneous melanoma (MCM) is a very aggressive disease that becomes in a true problem of health because of the increase in the last 5 years. In the present paper, authors report the detection of the tumor, metastases and recurrences mean 99mTc HMPAO. We presented 5 cases of MCM patients and observed the radiopharmaceutical uptake in skin, nodules and recurrent tumor lesions. Because of the number of patients was limited, authors recommended the research with a lot of patients. The gammagraphic studies could be very important for the staging of the disease and early detection of metastases and recurrent lesions.

Topics: Bone Neoplasms; Brain Neoplasms; Evaluation Studies as Topic; Female; Humans; Lymphatic Metastasis; Male; Melanoma; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Pelvic Bones; Radionuclide Imaging; Skin Neoplasms; Technetium Tc 99m Exametazime; Technetium Tc 99m Pyrophosphate

A 5-year-old Arabian horse was admitted with a 5-day history of undulant pyrexia of unknown origin, inappetence, obtundation, and acute collapse. Physical examination results were unremarkable except for a grade II/VI left-sided systolic cardiac murmur and abdominal splinting. Mild chronic inflammatory changes were evident on clinicopathologic evaluation. Echocardiography revealed moderate aortic insufficiency. A solitary soft tissue opacity was found on thoracic radiography but not on ultrasonography. Palliative treatment was ineffective. Nuclear scintigraphy with WBC labeled with technetium Tc 99m hexamethylpropyleneamine oxime did not identify abnormalities, but a second nuclear scan with technetium Tc 99m hydroxymethylene diphosphate identified polyostotic disease. Examination of a biopsy specimen from an affected rib revealed disseminated adenocarcinoma. The horse was euthanatized. Necropsy and histologic examination revealed a colonic adenocarcinoma with osseous metaplasia that had disseminated to multiple parenchymal organs, muscle, and bone.

Topics: Adenocarcinoma; Animals; Bone Neoplasms; Colonic Neoplasms; Diagnosis, Differential; Horse Diseases; Horses; Male; Palliative Care; Radionuclide Imaging; Technetium Tc 99m Exametazime; Technetium Tc 99m Medronate

An 11-year-old girl presented with the clinical picture of osteomyelitis of the distal tibia. A bone scintigram, although abnormal, did not confirm the diagnosis, but a 99mTc leucocyte scan showed focal white cell uptake in the distal tibia. This was felt to confirm infection and subsequent aspiration revealed what was thought to be pus. However, histology of the aspirated material demonstrated Ewing's Sarcoma. The differential diagnosis and the place of scintigraphy in this clinical situation are discussed.

Topics: Bone Neoplasms; Child; Diagnosis, Differential; Diagnostic Errors; Female; Humans; Organotechnetium Compounds; Osteomyelitis; Oximes; Radiography; Radionuclide Imaging; Sarcoma, Ewing; Technetium Tc 99m Exametazime; Tibia

To evaluate bone metastasis from hepatocellular carcinoma (HCC), both bone and 99mTc-HM-PAO scintigraphies were performed in six patients with clinically and pathologically confirmed HCC. Two patients had a bone scintigram which revealed abnormal accumulation in the skull base, pelvic bone and thoracic spine. The 99mTc-HM-PAO scans of both these patients also showed abnormal accumulation in the same sites. The bone scintigrams in one patient revealed not only abnormal accumulation in the ribs but also photon deficient areas in the sternum, thoracic spine and femur, while 99mTc-HM-PAO scans showed abnormal accumulation in all these sites. In three patients, bone scintigraphy revealed photon deficient areas in the ribs, pelvic bone and femur, and their 99mTc-HM-PAO scintigrams showed abnormal accumulation in the same sites. Thus, it was shown that, in the detection of bone metastasis from HCC by means of bone scintigraphy, it was necessary to pay attention to hot and cold lesions, and that a combination study with 99mTc-phosphorous compounds and 99mTc-HM-PAO was useful in evaluating these lesions.

Topics: Aged; Bone and Bones; Bone Neoplasms; Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Exametazime

Bone marrow scintigrams obtained 2-6 h and/or 20-24 h after injection of 99Tcm-HMPAO-labelled leucocytes (LeuSc) in 16 patients (seven males, nine females, average age 57 years, either with benign or malignant haemopathy, or with benign or metastatic skeletal diseases) have been compared to corresponding pictures obtained 20 min after injection of 99Tcm-labelled human serum albumin nanosized colloids (NanSc, performed within a week thereafter). Overall distribution of the colloids and of the labelled leukocytes at the level of the bone marrow appeared to be the same. Fresh vertebral fractures as well as metastatic lesions of the axial skeleton appeared as cold defects in both investigations. Fractures of the ribs as well as one metastatic lesion involving one trochanter could not be identified. Although all seven lesions involving Th9 to L4 could be clearly investigated with LeuSc, only three could be recognized with NanSc. It is concluded that, in patients with cancerous diseases, LeuSc is better than NanSc in demonstrating lesions in the case of dubious conventional osseous scintigrams as well as in the case of neurological or skeletal symptoms at the level of the lumbar and/or low thoracic regions.

Topics: Bone Diseases; Bone Marrow; Bone Neoplasms; Female; Fractures, Bone; Humans; Leukocytes; Male; Middle Aged; Organotechnetium Compounds; Oximes; Radionuclide Imaging; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Exametazime

Topics: Adenocarcinoma; Aged; Bone Neoplasms; Humans; Leukocytes; Male; Organotechnetium Compounds; Oximes; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Exametazime

Forty-three patients with suspected benign, inflammatory, or infectious diseases were imaged with [99mTc]HM-PAO-labeled leukocytes and [67Ga]citrate. Technetium-99m leukocytes showed 22 true-positive, no false-positive, 19 true-negative, and two false-negative findings and [67Ga]citrate 23, 7, 12 and 1, respectively. The sensitivity, specificity, and accuracy values with 99mTc leukocytes were 92%, 100%, and 95%, and with [67Ga]citrate 96%, 63%, and 81%. Technetium-99m leukocyte scintigraphy has a promising future in comparison with [67Ga]citrate because of the ready availability of [99mTc]HM-PAO, the good image quality, more rapid results (within few hours), and the lower radiation exposure to the patient with 99mTc leukocytes. The usefulness of 99mTc leukocytes in chronic osteomyelitis needs further evaluation.

Topics: Abdomen; Abscess; Adult; Aged; Blood Vessel Prosthesis; Bone Neoplasms; Citrates; Citric Acid; Female; Hip Prosthesis; Humans; Ilium; Infections; Inflammation; Leukocytes; Lymphoma; Male; Middle Aged; Organometallic Compounds; Oximes; Radionuclide Imaging; Technetium; Technetium Tc 99m Exametazime

Topics: Amphetamines; Bone Neoplasms; Carcinoma, Hepatocellular; Humans; Iodine Radioisotopes; Iofetamine; Liver Neoplasms; Male; Middle Aged; Organometallic Compounds; Oximes; Radionuclide Imaging; Technetium; Technetium Tc 99m Exametazime

Uptake of Tc-99m Hexamethylpropylene-amine Oxine (HM-PAO) was seen in bone metastases from carcinoma of the lung. The uptake was prominent when compared to Tc-99m MDP, I-123 IMP, and Ga-67 citrate. Brain imaging with Tc-99m HM-PAO and N-isopropyl-p-[I-123] iodoamphetamine (IMP) is now frequently performed. Uptake of these agents has been reported in brain tumors and melanomas. In this report, uptake of Tc-99m HM-PAO in a metastatic lesion in bone is discussed.

Topics: Aged; Bone Neoplasms; Female; Humans; Lung Neoplasms; Organometallic Compounds; Oximes; Radionuclide Imaging; Technetium; Technetium Tc 99m Exametazime