technetium-tc-99m-medronate and Brain-Neoplasms

Although 201Tl chloride (Tl) SPECT has been used in the differential diagnosis between recurrence of malignant brain tumor and necrosis after treatment, it is not generally recognized as a definite modality to distinguish them. We conducted a preliminary study using Tl SPECT and 99mTc-MDP or 99mTc-HMDP (Tc) SPECT because it has been said that extraosseous accumulation was caused by calcium deposits in necrotic tissues. In our study, for the purposes of clarifying the mechanism of extraosseous uptake and the correlation between extraosseous accumulation of bone-scanning agent and tumor viability in malignant brain tumors, we compared whether Tc uptake was correlated with the histopathological findings and further performed semi-quantitative evaluation between Tc SPECT and Tl SPECT. The correlation coefficients between the ratio of tumor to normal skull count obtained from Tc SPECT (Tc-T/N) and those of tumor to normal brain count (T/N) and to normal scalp count (T/S) both obtained from Tl SPECT were calculated. Using contrast enhanced CT (CE-CT) or contrast enhanced MRI (CE-MRI), 8 of 10 cases showed intensely ring-enhanced tumor with necrotic lesion. Histopathologically, 7 of 8 cases whose tumor had been resected before treatment had necrosis with increased vascularity or bleeding. Of the remaining 2 cases one case, malignant lymphoma had only hypervascularity by biopsy, while the other one was excluded for resection after treatment. Three of these 8 cases whose CE-CT or CE-MRI showed necrotic lesions exhibited Tc and Tl accumulations in the area corresponding to necrosis. In contrast, 2 showed no Tc nor Tl uptake. Tc-T/N had no significant correlation with any of early-, delayed-T/N or T/S. In conclusion, there was no significant correlation between Tc and Tl uptakes by malignant brain tumors in semi-quantitative evaluation.

Topics: Aged; Bone and Bones; Brain Neoplasms; Female; Humans; Male; Middle Aged; Necrosis; Organotechnetium Compounds; Pilot Projects; Radionuclide Imaging; Radiopharmaceuticals; Statistics as Topic; Technetium Tc 99m Medronate; Tissue Distribution

In this study, we investigated prospectively the diagnostic role of 99Tcm-MIBI for staging and for predicting the therapeutic response of stage IV neuroblastoma compared with 131I-MIBG imaging and 99Tcm-MDP bone scintigraphy. Nine patients (4 girls and 5 boys aged 1-7 years) with suspected or proven stage IV neuroblastoma were studied with 99Tcm-MIBI at initial diagnosis and after 12-18 months of multidrug therapy. After the injection of 80 MBq.kg-1 99Tcm-MIBI, early (10 min) and delayed (1 h) images were obtained. The data were correlated with 131I-MIBG scans, bone scintigraphy, ultrasound, computed tomography and/or magnetic resonance imaging, and bone marrow biopsy. Eight of nine primary tumours and 41 metastatic lesions were detected by 131I-MIBG scintigraphy. None of the primary lesions demonstrated significant 99Tcm-MIBI accumulation. Sestamibi was positive in 16 of 41 MIBG-avid metastatic lesions. After six courses of multidrug chemotherapy, 30 131I-MIBI-avid neuroblastoma metastases that were 99Tcm-MIBI-negative at the time of diagnosis still did not show significant sestamibi accumulation. Follow-up demonstrated that all lesions that were 99Tcm-MIBI-avid at the time of diagnosis remained negative. Of these 16 lesions, seven were positive for 131I-MIBG accumulation with no reduction in size, and nine showed resolution after therapy. New metastatic foci detected by MIBG scintigraphy did not accumulate 99Tcm-MIBI. Clinical evaluation of patients with no 99Tcm-MIBI uptake in primary and secondary sites of neuroblastoma confirmed that they were resistant to multidrug chemotherapy. All 99Tcm-MIBI-positive lesions, irrespective of clinical outcome, demonstrated significant clearance of tracer on the delayed images. We conclude that 99Tcm-MIBI has no role in the staging of neuroblastoma. Sestamibi is a well-documented transport substrate for P-glycoprotein-related multidrug resistance and serial imaging may provide prognostic information on the therapeutic value of chemotherapy.

Topics: 3-Iodobenzylguanidine; Brain Neoplasms; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Male; Neoplasm Staging; Neuroblastoma; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Whole-Body Counting

We aimed to compare the role of (18)F-fluoride PET/CT, FDG PET/CT and (99m)Tc-MDP bone scans in the detection of bone metastases in patients with lung, breast and prostate carcinoma.. This was a prospective study including patients for staging (S) and restaging (R). Seventy-two patients (23S, 49R) with infiltrating ductal breast carcinoma, 49 patients (25S, 24R) with prostate adenocarcinoma and 30 patients (17S, 13R) with non-small-cell lung carcinoma (NSCLC), without known bone metastases but with high risk/clinical suspicion for the same, underwent a (99m)Tc-MDP bone scan, FDG PET/CT and (18)F-fluoride PET/CT within 2 weeks. All scans were reviewed by two experienced nuclear medicine physicians, and the findings were correlated with MRI/thin-slice CT/skeletal survey. Histological verification was done wherever feasible.. Sensitivity and negative predictive value (NPV) of (18)F-fluoride PET/CT was 100 % in all three malignancies, while that of FDG PET/CT was 79 % and 73 % in NSCLC, 73 % and 80 % in breast cancer and 72 and 65 % in prostate cancer. Specificity and positive predictive value (PPV) of FDG PET/CT were 100 % in NSCLC and prostate and 97 % and 96 % in breast cancer. As compared to the (99m)Tc-MDP bone scan, all parameters were superior for (18)F-fluoride PET/CT in prostate and breast cancer, but sensitivity and NPV were equal in NSCLC. The MDP bone scan had superior sensitivity and NPV compared to FDG PET/CT but had low specificity and PPV.. To rule out bone metastases in cases where there is a high index of suspicion, (18)F-fluoride PET/CT is the most reliable investigation. (18)F-fluoride PET/CT has the potential to replace the (99m)Tc-MDP bone scan for the detection of bone metastases.

Topics: Adult; Aged; Brain Neoplasms; Breast Neoplasms; Female; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Multimodal Imaging; Positron-Emission Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

A 30-year-old man diagnosed with follicular thyroid carcinoma treated previously with total thyroidectomy was referred to radioiodine treatment. Post-therapy scan performed 10 days after a 150 mCi 131NaI revealed radioiodine uptake in left temporal region. To elucidate the abnormal head uptake, Tc-99m MDP bone scan and head magnetic resonance image was performed. No anomalous uptake was observed in the bone scan. Head magnetic resonance image found a well-circumscribed lesion in temporal was compatible with a vascular malformation. Angioresonance confirmed the diagnosis of cavernous angioma, a benign vascular tumor.

Topics: Adult; Brain Neoplasms; Diagnosis, Differential; Hemangioma, Cavernous; Humans; Magnetic Resonance Imaging; Male; Radionuclide Imaging; Technetium Tc 99m Medronate; Thyroid Neoplasms

Ewing's sarcoma is a highly malignant neoplasm of bones which accounts for the 10% of primary bone malignancies. Primary Ewing's sarcoma of skull vault is very rare and constitutes 1-6% of all Ewing's sarcomas. We present a case of a primary and a radiation-induced skull Ewing's sarcoma. The symptoms, neuroimaging findings and the treatment for these cases are reviewed. Both children were operated with favorable outcome.

Topics: Adolescent; Astrocytoma; Brain Neoplasms; Facial Nerve Diseases; Facial Paralysis; Humans; Immunohistochemistry; Magnetic Resonance Imaging; Male; Neoplasms, Radiation-Induced; Particle Accelerators; Petrous Bone; Radiopharmaceuticals; Sarcoma, Ewing; Skull Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Neuroblastoma is the third most common malignancy of childhood. 131I-MIBG scintigraphy must be performed in patients with neuroblastoma at the time of staging. The aim of this study is to identify the role of 131I-MIBG scintigraphy in neuroblastoma patients in correlation with other diagnostic modalities for staging of the disease.. Twenty six patients provisionally diagnosed by clinical and imaging criteria to have neuroblastoma were included. On histopathologic verification 5 of these 26 patients were rediagnosed as non-neuroblastoma. Each patient had imaging by ultrasound, CT and/or MRI. In all cases, 131I-MIBG scintigraphy was performed, among them 15 patients had additional 99mTc-MDP bone scan.. The outcome demonstrated that CT and MRI were able to detect lesions in 19 out of 21 patients; while in 2 patients no lesions were detected. 131I-MIBG showed active lesions in 16 out of the above 19 patients, while in 3 patients 131I-MIBG was negative. There were no false positive result by 131I-MBG scan. Accordingly, 131I-MIBG is able to detect neuroblastora lesions with an overall sensitivity of 84.2%, specificity of 100% and an accuracy of 85.7%. Detection of primary lesions by 131I-MIB was significantly better than 99mTc-MDP bone scanning (92.31% vs. 61.54% respectively) (P < 0.05). For skeletal metastases, 131I-MIBG scan has a higher ability to detect more lesions than 99mTc-MDP bone scan (P = 0.023).. 131I-MIBG scintigraphy has an excellent ability to discriminate between neuroblastonia and other small round cell paediatric tumours. 131I-MIBG was found to be significantly superior to conventional bone scanning in revealing both primary and metastatic osseous lesions.

Topics: 3-Iodobenzylguanidine; Adolescent; Adrenal Gland Neoplasms; Bone Marrow Neoplasms; Brain Neoplasms; Child; Child, Preschool; Female; Humans; Infant; Iodine Radioisotopes; Liver Neoplasms; Male; Mediastinal Neoplasms; Neoplasm Staging; Neuroblastoma; Radionuclide Imaging; Radiopharmaceuticals; Retroperitoneal Neoplasms; Spinal Neoplasms; Technetium Tc 99m Medronate

Topics: Bone Neoplasms; Brain Neoplasms; Glioma; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Acute Disease; Bone Neoplasms; Brain Neoplasms; Diagnosis, Differential; Humans; Infarction, Middle Cerebral Artery; Middle Cerebral Artery; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Bone scintigraphy (BS) is widely utilized for the assessment of bone metastases (BMs) of neuroblastoma (NB). Since 111In-pentetreotide scintigraphy (PS) has been used to image NB with high sensitivity, we compared the sensitivity and specificity of PS with that of BS for the detection of BMs of NB. Nine patients with NB underwent both PS and BS for staging and/or restaging of their disease. The sensitivity and specificity of both imaging approaches were compared based on the findings of histopathology, other conventional imaging methods and subsequent clinical follow-up. In five of the nine patients, both PS and BS were negative for BMs. Radiographic bone surveys (RBSs) were also negative in these patients, except in one who showed a suspicious tibial lesion, but a computed tomography-guided biopsy failed to show evidence of disease. These patients remained without clinical evidence of BMs after a median duration of more than 15 months (range, 6-19 months). In three of four remaining patients, both PS and BS were positive for BMs, whilst only PS was positive in one patient. Overall, PS showed a greater number of BMs (30 vs. 7) with greater conspicuity compared with BS. The initial experience comparing BS with PS suggests that PS may provide a better assessment of the extent of BMs of NB, and that it may be useful as an adjunct to BS at institutions in which 131I- or 123I-metaiodobenzylguanidine is not available, particularly if BS is negative. In patients with similarly positive BS, PS might still provide unique prognostic information beyond that provided by BS. Further studies are therefore warranted.

Topics: 3-Iodobenzylguanidine; Bone and Bones; Bone Neoplasms; Brain Neoplasms; Child; Child, Preschool; Female; Fluorodeoxyglucose F18; Follow-Up Studies; Humans; Male; Neuroblastoma; Pentetic Acid; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Although extraosseous accumulations of 99mTc phosphate complexes are phenomena which can often be seen, no case showing extraosseous accumulation to brain tumor on SPECT has been reported. We report here two cases of primary brain tumor showing extraosseous accumulation of 99mTc phosphate in bone SPECT. 201Tl SPECT also showed increased 201Tl uptake by the tumor. Comparing bone SPECT with 201Tl SPECT, the regions of abnormality of both SPECTs were very similar in the case of glioblastoma, but in the case of malignant lymphoma the region showing intense uptake of 99mTc-MDP was smaller than that on 201Tl SPECT. It was revealed that bone SPECT is more useful in the assessment of extraosseous accumulation to a primary brain tumor than conventional bone scintigraphy.

Topics: Aged; Brain Neoplasms; Diphosphonates; Female; Glioblastoma; Humans; Lymphoma; Male; Middle Aged; Radiopharmaceuticals; Skull; Technetium; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Topics: Arm; Bone and Bones; Bone Neoplasms; Brain Neoplasms; Humans; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Venous Thrombosis

Topics: Aged; Antibodies, Monoclonal; Brain Neoplasms; Humans; Magnetic Resonance Imaging; Male; Meningioma; Neoplasm Recurrence, Local; Prostatic Neoplasms; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate

Topics: Adult; Bone Neoplasms; Brain Neoplasms; Glioblastoma; Humans; Liver Neoplasms; Lung Neoplasms; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Adenocarcinoma; Bone Neoplasms; Brain Neoplasms; Female; Humans; Middle Aged; Pelvic Bones; Radionuclide Imaging; Radiopharmaceuticals; Ribs; Skull; Spinal Neoplasms; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate

To establish a method for localization and qualitative diagnosis of glioma.. The monoclonal antibody SZ-39 against human glioma was labelled with 131I and injected intravenously into 40 patients with intracranial occupying lesions proved by X-CT. 72 hours after 131I-McAb-SZ39 administration, cranial bone nuclide-imaging agent 99mTc-MDP was injected intravenously, and the patients were examined by SPECT scan with dual nuclide double channel tomography and special software. On radio-immuno-image, the immunocomplex formed by specific conjugation of 131I-McAb-SZ39 with target tissue was red, while the cranial bone incorporated with 99mTc-MDP was green. The location of the immunocomplex area could be identified by the superimposition of the images.. 21 patients with positive targeting diagnosis of glioma showed the accuracy rate checked by SPECT was 81%(17/21) and by X-CT 48% (10/21). Seven patients with negative targeting diagnosis showed the accuracy rate checked by SPECT was 86%(6/7) and by X-CT 14% (1/7). Pathologically, the sensitivity of targeting SPECT to glioma was 94.5%(17/18) and that of X-CT 55%(10/18).. Targeting SPECT examination could be used for localization and qualitative diagnosis of glioma and make up the inadequacy of X-CT in the qualitative diagnosis of atypical incipient and recurrent glioma, meningioma, metastatic carcinoma, and inflammatory lesions of brain.

Topics: Adolescent; Adult; Aged; Antibodies, Monoclonal; Astrocytoma; Brain Neoplasms; Child; Child, Preschool; Female; Glioblastoma; Humans; Iodine Radioisotopes; Male; Middle Aged; Radioimmunodetection; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Bone and Bones; Brain Neoplasms; Child, Preschool; Eye Neoplasms; Female; Humans; Magnetic Resonance Imaging; Neoplasms, Second Primary; Pineal Gland; Pinealoma; Retinoblastoma; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Topics: Brain Neoplasms; Combined Modality Therapy; Dura Mater; Ganglioneuroma; Humans; Infant; Male; Radionuclide Imaging; Remission Induction; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Bone scintigrams of 99mTc-phosphorous compound in 4,579 cases were reviewed concerning the intracranial accumulation. Intracranial accumulations were demonstrated in 8 cases (0.17%). The lesions with intracranial accumulation were two cases of primary brain tumor (1 meningioma and 1 astrocytoma), five cases of metastatic brain tumor (1 rectal cancer, 1 gastric cancer, 1 uterine cervical cancer and 2 lung cancers) and one case of cerebral infarction. Calcification was detected in one of eight cases on CT scans. It is important to pay attention to the intracranial accumulation on routine bone scintigram because brain tumor or infarction may be detected.

Topics: Aged; Bone and Bones; Brain; Brain Neoplasms; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

The advent of improved chemotherapy has changed the natural course of osteosarcoma. The role of bone scintigraphy in the workup of metastatic osteosarcoma is being re-evaluated. Extra-osseous osteogenic sarcoma metastases, particularly pulmonary metastases, are known to accumulate bone-avid agents. In this case, there is also uptake by noncalcified metastases to the brain and to soft tissues of the leg and arm which has not been previously reported. Correlation with computed tomography and magnetic resonance imaging is made.

Topics: Adult; Bone Neoplasms; Brain Neoplasms; Humans; Lung Neoplasms; Male; Osteosarcoma; Radionuclide Imaging; Technetium Tc 99m Medronate

Extracranial metastases of meningioma are very rare, with a reported incidence of less than one in 1000 cases of meningioma. Metastases have been reported in the lungs and pleura, in the liver, in the lymph nodes, and in bone. The appearance of osseous metastases in the bony pelvis from intracranial angioblastic meningioma is described.

Topics: Bone Neoplasms; Brain Neoplasms; Hemangiosarcoma; Humans; Male; Middle Aged; Pelvic Bones; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Brain Neoplasms; Child; Diphosphonates; Female; Humans; Infant; Male; Neuroblastoma; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Autopsy; Brain Neoplasms; Child; Diphosphonates; Humans; Male; Neuroblastoma; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

99mTc-methylene diphosphonate (MDP) bone scintigraphy demonstrated localization in an intracranial metastasis of osteogenic sarcoma. This unusual case suggests that bone scintigraphy may have diagnostic value in the early diagnosis of metastatic ossifying lesions.

Topics: Adult; Brain Neoplasms; Diphosphonates; Femoral Neoplasms; Humans; Male; Occipital Lobe; Osteosarcoma; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

The intensity of parenchymal brain lesions was compared using Tc-99m pertechnetate and Tc-99m phosphate. The following conclusions were made: 1. If the Tc-99m phosphate intensity is greater than the intensity of the Tc-99m pertechnetate scan, and the patient is evaluated within four weeks of ictus, the lesion is a CVA (P less than .001). 2. If the Tc-99m phosphate intensity is less than or equal to the intensity of the Tc-99m pertechnetate scan, and the patient is evaluated within four weeks of ictus, the parenchymal lesion is not a CVA (P less than .001). 3. If the evaluation takes place longer than six weeks after ictus, then no evaluation about the nature of the lesion can be made based upon uptake of Tc-99m phosphate and Tc-99m pertechnetate.

Topics: Adult; Brain Neoplasms; Diphosphonates; Glioblastoma; Glioma; Humans; Male; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed