technetium-tc-99m-medronate and Carcinoma--Renal-Cell

Bone marrow immunoscintigraphy using a 99mTc-labelled anti-NCA-95 monoclonal antibody and conventional bone scintigraphy with 99mTc-methylene-diphosphonate were compared in the diagnosis of skeletal metastases in 58 patients with urogenital tumours. In 13 patients with metastatic disease, bone marrow immunoscintigraphy proved to be superior to bone scintigraphy, detecting 431 metastatic lesions on immunoscans as compared to 261 lesions on bone scans. However, on a patient-by-patient basis bone marrow immunoscintigraphy did not demonstrate a clinical advantage over conventional bone scanning, as in this study no patient was identified with metastatic disease still confined to the marrow space, with bone scintigraphy and bone X-ray being normal.

Topics: Adult; Aged; Aged, 80 and over; Antigens, Neoplasm; Bone and Bones; Bone Marrow; Bone Neoplasms; Carcinoma, Renal Cell; Carcinoma, Transitional Cell; Cell Adhesion Molecules; Humans; Male; Membrane Glycoproteins; Middle Aged; Prospective Studies; Radioimmunodetection; Technetium Tc 99m Medronate; Urogenital Neoplasms

The detection of occult bone metastases is a key factor in determining the management of patients with renal cell carcinoma (RCC), especially when curative surgery is considered. This prospective study assessed the sensitivity of (18)F-labelled sodium fluoride in conjunction with positron emission tomography/computed tomography ((18)F-NaF PET/CT) for detecting RCC bone metastases, compared with conventional imaging by bone scintigraphy or CT.. An adaptive two-stage trial design was utilized, which was stopped after the first stage due to statistical efficacy. Ten patients with stage IV RCC and bone metastases were imaged with (18)F-NaF PET/CT and (99m)Tc-labelled methylene diphosphonate ((99m)Tc-MDP) bone scintigraphy including pelvic single photon emission computed tomography (SPECT). Images were reported independently by experienced radiologists and nuclear medicine physicians using a 5-point scoring system.. Seventy-seven lesions were diagnosed as malignant: 100% were identified by (18)F-NaF PET/CT, 46% by CT and 29% by bone scintigraphy/SPECT. Standard-of-care imaging with CT and bone scintigraphy identified 65% of the metastases reported by (18)F-NaF PET/CT. On an individual patient basis, (18)F-NaF PET/CT detected more RCC metastases than (99m)Tc-MDP bone scintigraphy/SPECT or CT alone (P = 0.007). The metabolic volumes, mean and maximum standardized uptake values (SUV mean and SUV max) of the malignant lesions were significantly greater than those of the benign lesions (P < 0.001).. (18)F-NaF PET/CT is significantly more sensitive at detecting RCC skeletal metastases than conventional bone scintigraphy or CT. The detection of occult bone metastases could greatly alter patient management, particularly in the context when standard-of-care imaging is negative for skeletal metastases.

Topics: Aged; Bone Neoplasms; Carcinoma, Papillary; Carcinoma, Renal Cell; Female; Fluorodeoxyglucose F18; Follow-Up Studies; Humans; Kidney Neoplasms; Male; Middle Aged; Multimodal Imaging; Neoplasm Staging; Positron-Emission Tomography; Prognosis; Prospective Studies; Radionuclide Imaging; Research Design; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Bone Neoplasms; Carcinoma, Renal Cell; Fluorodeoxyglucose F18; Humans; Kidney Neoplasms; Middle Aged; Molecular Imaging; Positron-Emission Tomography; Radiopharmaceuticals; Technetium Tc 99m Medronate

We recently experienced a case of cerebral infarction incidentally found by whole body bone scintigraphy for the detection of bone metastasis from renal cell carcinoma. Additional bone SPECT and brain MR fusion images clearly demonstrated the wedge-shaped uptake of tracer corresponded to the abnormal intensity reflecting subacute cerebral infarction. Follow-up bone scan and fused images with MRI showed complete resolution of the abnormal uptake in chronic phase. A breakdown in the normal blood-brain barrier results in abnormal ionic calcium flux into the cells following altered cell membrane integrity leading to precipitation of calcium salts which eventually binds to bone imaging tracer such as (99m)Tc-methylene diphosphonate. That is, increased accumulation of bone seeking agents represents lethal cell death. The recent development of software and hardware has enabled the fusion of functional and anatomic images. Image fusion between SPECT with various tracers and MRI is expected to provide clues as to the underlying cause of diseases and to decide our treatment planning in the near future.

Topics: Bone Neoplasms; Carcinoma, Renal Cell; Cerebral Infarction; Endocarditis; Humans; Image Processing, Computer-Assisted; Incidental Findings; Magnetic Resonance Imaging; Male; Middle Aged; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

This study aims to compare the sensitivity of whole-body MRI with bone scintigraphy in the detection of bone metastases in patients with renal cancer. A prospective study was carried out in 47 patients with renal cancer (mean age 62 years, range 29-79 years). All patients had assessment of the skeleton with whole-body bone scintigraphy (with technetium-99m methylene diphosphonate) and whole-body MRI (coronal T(1) weighted and short tau inversion recovery sequences). The number and sites of bony metastases were assessed on each imaging investigation independently. Sites of extra-osseous metastasis on MRI were also noted. The imaging findings were correlated with other imaging modalities and follow-up. 15 patients (32%) had bone metastases at 34 different sites. Both scintigraphy and MRI were highly specific (94% and 97%, respectively), but the sensitivity of MRI (94%) was superior (p = 0.007) to that of scintigraphy (62%). MRI identified more metastases in the spine and appendicular skeleton, whereas scintigraphy showed more lesions in the skull/facial and thoracic bones. MRI identified extra-osseous metastases in 33 patients (70%), these were mainly lung and retroperitoneal in site. Whole-body MRI is a more sensitive method for detection of bone metastases in renal cancer than bone scintigraphy, and also allows the assessment of soft-tissue disease.

Topics: Adult; Aged; Bone Neoplasms; Carcinoma, Renal Cell; Female; Humans; Kidney Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Medronate; Whole Body Imaging

Topics: Aged; Aged, 80 and over; Bone Neoplasms; Carcinoma, Renal Cell; Choristoma; Humans; Kidney; Male; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Conventional technetium-99m methylene diphosphate whole body bone scan (bone scan) has a high sensitivity but a poor specificity to detect bone metastases. However, positron emission tomography with 18F-2-deoxyglucose (FDG-PET) can offer superior spatial resolution and improved specificity. We have attempted to evaluate the usefulness of FDG-PET for detecting bone metastases in renal cell carcinomas (RCC) and to compare FDG-PET results with bone scan findings.. Eighteen patients were selected for this study with biopsy-proven RCC. They were suspected of having bone metastases and were undergoing bone scan and FDG-PET to detect bone metastases. The final diagnoses of bone metastases were established by operative, histopathological findings or clinical follow-up longer than 1 year by additional radiographs or following FDG-PET/bone scan findings showing progressive and extensive widespread bone lesions.. A total of 52 bone lesions including 40 metastatic and 12 benign bone lesions found on either FDG-PET or bone scan were evaluated. FDG-PET could accurately diagnose all 40 metastatic and 12 benign bone lesions. Bone scan could accurately diagnose only 31 metastatic bone lesions. Diagnostic sensitivity and accuracy of FDG-PET were 100% and 100%, respectively,and bone scan were 77.5% and 59.6%, respectively.. Our data suggest that FDG-PET has a higher sensitivity and a better accuracy than that of bone scan to detect bone metastases in patients with RCC.

Topics: Aged; Bone Neoplasms; Carcinoma, Renal Cell; Female; Fluorodeoxyglucose F18; Humans; Kidney Neoplasms; Male; Middle Aged; Technetium Tc 99m Medronate; Tomography, Emission-Computed

Topics: Arthritis, Rheumatoid; Bone and Bones; Carcinoma, Renal Cell; Humans; Kidney Neoplasms; Male; Middle Aged; Neoplasm Invasiveness; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Vena Cava, Inferior

We present a case of renal cell carcinoma metastasis to the skull, appearing as a photopenic area on Tc-99m MDP bone scan and with focal uptake in the same region on Tc-99m MIBI imaging.

Topics: Carcinoma, Renal Cell; Humans; Kidney Neoplasms; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Skull Neoplasms; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi

Nephron-sparing surgery has become established as an effective treatment for localized renal cell carcinoma when preservation of renal function is necessary. The surgery usually requires temporary renal artery occlusion and may induce ischemic renal damage. In this study, we retrospectively evaluated renal activity on bone scintigraphy after nephron-sparing surgery.. Eleven patients who underwent nephron-sparing surgery for renal cell carcinoma and had a normal contralateral kidney were studied. A total of 12 bone scintigraphy images with 99mTc-labeled methylene diphosphonate were obtained within 1 y after surgery in these patients to assess skeletal metastasis. Activity in the spared renal parenchyma was compared visually with that in the contralateral normal kidney.. The tumor was successfully resected in every patient, and no clinically significant complications occurred. Activity in the spared renal parenchyma was elevated in six of seven examinations performed within 21 d after surgery. In three examinations, the increase in renal activity was heterogeneous, being relatively prominent near the surgical margin. Increased renal activity was not observed on five examinations performed 3 mo or more after surgery.. Renal retention of bone-seeking agents is elevated in the early period after nephron-sparing surgery, probably as a result of ischemic insult during the surgical procedure. Bone scintigraphy may aid in evaluating the presence and degree of ischemic damage of the spared renal parenchyma.

Topics: Adult; Bone and Bones; Bone Neoplasms; Carcinoma, Renal Cell; Female; Humans; Kidney; Kidney Neoplasms; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Technetium Tc 99m Medronate

Topics: Bone and Bones; Carcinoma, Renal Cell; Colonic Diseases; Female; Gastrointestinal Hemorrhage; Humans; Kidney Neoplasms; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Whole-Body Counting

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Alkaline Phosphatase; Bone and Bones; Carcinoma, Renal Cell; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Kidney Neoplasms; Male; Middle Aged; Neoplasm Staging; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Adult; Budd-Chiari Syndrome; Carcinoma, Renal Cell; Female; Humans; Kidney Neoplasms; Liver; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Neoplastic Cells, Circulating; Radionuclide Imaging; Renal Veins; Technetium Tc 99m Medronate; Vena Cava, Inferior

Separate imaging studies employing Tc-99m MDP, In-111 labeled leukocytes, and Tc-99m SC were performed in a patient receiving external beam radiation therapy to the mediastinum and left hemithorax. The leukocyte scan demonstrated greatly increased activity at the site of the radiation port. The bone marrow (sulfur colloid) scan was normal and the bone scan demonstrated only minimally increased activity in the irradiated region. The varying appearance of these scans may represent the difference in the early effect of radiation on bone and bone marrow elements.

Topics: Bone Marrow; Carcinoma, Renal Cell; Humans; Indium Radioisotopes; Leukocytes; Male; Mediastinal Neoplasms; Middle Aged; Radionuclide Imaging; Radiotherapy, High-Energy; Ribs; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Thoracic Neoplasms; Thoracic Vertebrae

Topics: Carcinoma, Renal Cell; Female; Humans; Kidney; Kidney Neoplasms; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Bone and Bones; Carcinoma, Renal Cell; Humans; Kidney Neoplasms; Low Back Pain; Neoplasm Recurrence, Local; Radionuclide Imaging; Technetium Tc 99m Medronate

Ninety-one radiologically confirmed osteolytic metastases in 30 patients with hypernephromas were studied with regard to their uptake of 99mTc-MDP and this was compared with the radiological findings. In 16% of the radiologically proven metastases, there was no correlation with their isotope uptake. Compared with other bone metastases whose isotope uptake has been studied and described in the literature, there appears to be a higher proportion of hypernephroma secondaries that do not show uptake of 99mTc-MDP.

Topics: Adult; Aged; Bone Neoplasms; Carcinoma, Renal Cell; Evaluation Studies as Topic; Female; Humans; Kidney Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

A case of huge renal cell carcinoma with localization of a skeletal imaging agent is presented. Two unusual scintigraphic findings of bone agent localization in the tumor were observed: a ring-like configuration, and low-intensity uptake. The large ring-like appearance of the extraosseous radioactivity may reflect a bulky tumor with central necrosis and a less active calcification process.

Topics: Aged; Bone Neoplasms; Carcinoma, Renal Cell; Humans; Kidney Neoplasms; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

Skeletal scintigraphy is useful for detecting primary renal carcinomas and associated osseous metastatic deposits. Usually, renal masses present as photon-deficient foci, and osseous metastases, as foci of increased response. A case is presented with the unusual combination of focal increased Tc-99m MDP localization to the primary renal cell carcinoma and photopenic osseous metastatic foci. Proposed mechanisms are discussed.

Topics: Adult; Bone Neoplasms; Carcinoma, Renal Cell; Humans; Kidney Neoplasms; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

Solitary lesions on bone scans obtained as part of metastatic diagnostic studies for genitourinary malignancy require identification as to whether they represent nonneoplastic or neoplastic disease and, if neoplastic, whether metastatic genitourinary cancer or another primary is present. Such definition requires at least plain film tomograms of the area as well as computerized tomography (for inaccessible lesions) and/or biopsy of lesions still in doubt after tomography. Of the 9 patients in our study 4 had true positive scans for metastatic disease, 3 had false positive scans, 1 had a true positive scan for a second bone primary and 1 is indeterminate, since a negative biopsy of a positive area on a bone scan was followed rapidly by the appearance of other widespread metastases.

Topics: Adenocarcinoma; Adult; Aged; Bone Neoplasms; Carcinoma, Renal Cell; Carcinoma, Transitional Cell; Diphosphonates; False Positive Reactions; Female; Humans; Kidney Neoplasms; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Urinary Bladder Neoplasms; Urogenital Neoplasms