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

This study aimed at evaluating the relevance of sentinel node detection by lymphoscintigraphy in patients diagnosed with squamous-cell carcinoma of the oral cavity in the absence of neck adenopathy.. A prospective study was carried out in 31 patients diagnosed with T1 to T3 squamous-cell carcinoma of the oral cavity without any clinically detectable neck adenopathy. A lymphoscintigraphy was performed the day before surgery. All patients underwent sentinel lymph node biopsy guided by a gamma-ray detecting probe and modified neck dissection. Pathologic evaluation of the sentinel lymph node included, in addition to the standard protocol, immunohistochemical analysis and thin sections of E stained preparations.. In 3 patients, the lymphoscintigraphy failed to detect any sentinel lymph node. In the remaining group of 28 patients, 20 patients showed a negative sentinel node concordant with a histologically negative neck dissection. In 5 patients, a positive lymph node was found although the rest of the neck dissection was negative. In 3 patients, sentinel lymph node was found to be negative but other neck nodes were positive. The overall sensitivity of lymphoscintigraphy in our study was 62%.. Surprisingly, the results of our study do not support the clinical usefulness of sentinel lymph node detection as a reliable and accurate staging method in patients with oral squamous cell carcinoma. We observed that lymphoscintigraphy was not a reliable method for detecting micrometastases in patients diagnosed with a squamous-cell carcinoma of the oral cavity without clinical evidence of neck matastases.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Humans; Lymph Nodes; Male; Middle Aged; Mouth Neoplasms; Neck; Neck Dissection; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Sentinel Lymph Node Biopsy; Technetium Tc 99m Medronate

The evaluation of the importance of the prognostic of sentinel node biopsy in head and neck cancer with N0 neck.. Prospective study included 19 patients with squamous cell carcinoma of the oral cavity, pharynx and larynx without enlarged lymph nodes in ultrasound examination (N0). The study was carried out in ENT Department of Medical University in Poznań between 2001-2004. Each patient underwent lymphoscintigraphy after administration of radionuclide Technetium 99m (Nanocol). In case of detection of sentinel node, blue dye was injected into the tumour bed and dyed lymph nodes were removed. The specimens were evaluated histologically and immunohistochemically. The patients are still followed up.. So far 19 patients were included in our study. The tumours were classified from T1 to T4. In each case sentinel nodes were located. Metastases in removed lymphnodes were found in 5 patients. In one of them regional recidive was observed after 5 month. In the other patients no changes were found in follow up examination. In 14 cases in histological examination no metastases were found in sentinel nodes. In this group in one case local recurrence was observed and in another two lymph nodes metastases were confirmed. In patients with positive sentinel node elective neck dissection was performed. So far immunohistochemical examination has not provided us with any vital information. In no case with negative sentinel node we found micrometastases with the use of cytokeratin.. Based on our preliminary observation of the patients we have found that there is certain correlation confirming the fact that sentinel node may be reliable for the whole neck lymphatic system. Further clinical observation are needed based on a larger number of patients and longer observation period.

Topics: Aged; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Laryngeal Neoplasms; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Mouth Neoplasms; Pharyngeal Neoplasms; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Sentinel Lymph Node Biopsy; Technetium Tc 99m Medronate

To establish a Chinese esophageal squamous cell carcinoma (ESCC) cell line with high bone metastasis potency using (99m)Tc-methylene diphosphonate ((99m)Tc-MDP) micro-pinhole scintigraphy, X ray and micro-positron emission tomography/computed tomography (PET/CT) for exploring the mechanism of occurrence and development in esophageal cancer.. The cells came from a BALB/c nu/nu immunodeficient mouse, and oncogenic tumor tissue was from a surgical specimen from a 61-year-old male patient with ESCC. The cell growth curve was mapped and analysis of chromosome karyotype was performed. Approximately 1 × 10⁶ oncogenic cells were injected into the left cardiac ventricle of immunodeficient mice. The bone metastatic lesions of tumor-bearing mice were detected by (99m)Tc-MDP scintigraphy, micro-PET/CT and X-ray, and were resected from the mice under deep anesthesia. The bone metastatic cells in the lesions were used for culture and for repeated intracardiac inoculation. This in vivo/in vitro experimental metastasis study was repeated for four cycles. All of the suspicious bone sites were confirmed by pathology. Real-time polymerase chain reaction was used to compare the gene expression in the parental cells and in the bone metastatic clone.. The surgical specimen was implanted subcutaneously in immunodeficient mice and the tumorigenesis rate was 100%. First-passage oncogenic cells were named CEK-Sq-1. The chromosome karyotype analysis of the cell line was hypotriploid. The bone metastasis rate went from 20% with the first-passage oncogenic cells via intracardiac inoculation to 90% after four cycles. The established bone metastasis clone named CEK-Sq-1BM had a high potential to metastasize in bone, including mandible, humerus, thoracic and lumbar vertebrae, scapula and femur. The bone metastasis lesions were successfully detected by micro-pinhole bone scintigraphy, micro-PET/CT, and X-ray. The sensitivity, specificity and accuracy of the micro-pinhole scintigraphy, X-ray, and micro-PET/CT imaging examinations were: 89.66%/32%/80%, 88.2%/100%/89.2%, and 88.75%/77.5%/87.5%, respectively. Some gene expression difference was found between parental and bone metastasis cells.. This newly established Chinese ESCC cell line and animal model may provide a useful tool for the study of the pathogenesis and development of esophageal carcinoma.

Topics: Animals; Bone Neoplasms; Carcinoma, Squamous Cell; Cell Line, Tumor; Chromosomes, Human; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Gene Expression Regulation, Neoplastic; Heterografts; Humans; Karyotyping; Male; Mice; Mice, Inbred BALB C; Mice, Nude; Middle Aged; Multimodal Imaging; Neoplasm Transplantation; Positron-Emission Tomography; Predictive Value of Tests; Radiopharmaceuticals; Technetium Tc 99m Medronate; X-Ray Microtomography

Cancers that metastasize to the cauda equina are uncommon. Only seventeen cases were reported. Those from pulmonary squamous cell carcinoma was never been published to our knowledge.. A 79-year-old male patient presented with low back pain since 1 year and severe sacral pain irradiating to the left leg, paraparesis, urinary dysfunction and leg weakness since one week.. Preoperative magnetic resonance images of the lumbar spine showed an intradural spinal mass in L2-3 with infiltration of the cauda equina; the lesion measured 13 mm craniocaudally and 11 mm anteroposteriorly, and thus occupied the majority of the intrathecal space at that level. The magnetic resonance images, surgical treatment, and related pathophysiology are reviewed.. The majority of cauda equina tumors are primary tumors, and metastases are very rare. Especially old patients with intradural mass and rapidly progressive cauda equina syndrome should be evaluated for a primary malignancy to avoid an unnecessary spinal operation.

Topics: Aged; Bone and Bones; Carcinoma, Squamous Cell; Humans; Immunohistochemistry; Lumbar Vertebrae; Lung Neoplasms; Magnetic Resonance Imaging; Male; Polyradiculopathy; Radionuclide Imaging; Radiopharmaceuticals; Spinal Neoplasms; Spinal Stenosis; Technetium Tc 99m Medronate

About 10 per cent of patients undergoing radical oesophagectomy for transmural (T3) carcinoma with lymph node involvement (N1) develop symptomatic bone metastases within 12 months of surgery. The aim of this study was to evaluate the introduction of targeted preoperative bone scintigraphy.. Of 790 patients with oesophageal carcinoma staged between December 2000 and December 2004, 189 were eligible for potentially curative treatment. (99m)Tc-labelled hydroxymethylene diphosphonate bone scintigraphy was performed in those with stage T3 N1 disease (identified by computed tomography and endoscopic ultrasonography) who were suitable for radical treatment.. A total of 115 patients had bone scintigraphy. The histological diagnosis was adenocarcinoma in 82 patients and squamous cell carcinoma in 33. Bone scintigraphy was normal or showed degenerative changes in 93 patients, and abnormal requiring further investigation in 22. Plain radiography, magnetic resonance imaging and biopsy confirmed the presence of bone metastases in 11 patients (9.6 per cent).. Bone is frequently the first site of identifiable distant metastatic spread, and bone scintigraphy is recommended to exclude metastatic disease before radical treatment of advanced oesophageal carcinoma.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Bone Neoplasms; Carcinoma, Squamous Cell; Esophageal Neoplasms; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

It is an evaluation of radionuclide bone scanning in detecting bone metastasis in the patients with nasopharyngeal carcinoma after radiotherapy.. The bone scanning was performed in 78 patients with nasopharyngeal carcinoma after radiotherapy.. Bone metastasis were detected in 47 patients out of 78, including 46 squamous cell carcinoma and 1 undifferentiated carcinoma.. Radionuclide bone imaging is useful for diagnosing, treating and prognosing of nasopharyngeal carcinoma.

Topics: Adult; Aged; Bone Neoplasms; Carcinoma; Carcinoma, Squamous Cell; Female; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Radiography; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

A 73-year-old woman with a history of squamous cell carcinoma of the lung was referred for a follow-up metastatic bone survey. Focal extraosseous accumulation of Tc-99m MDP was identified in the right, paraspinal region, along the radiation therapy port.

Topics: Aged; Carcinoma, Squamous Cell; Female; Fibrosis; Follow-Up Studies; Humans; Lung Neoplasms; Mediastinum; Neoplasm Recurrence, Local; Pneumonectomy; Radionuclide Imaging; Radiopharmaceuticals; Radiotherapy; Technetium Tc 99m Medronate

Topics: Aged; Bone Neoplasms; Carcinoma, Squamous Cell; Diagnosis, Differential; Fatal Outcome; Humans; Liver Failure; Lung Neoplasms; Male; Necrosis; Neoplasm Recurrence, Local; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Whole-Body Counting

This study was carried out to evaluate the diagnostic utility of gallium citrate Ga 67 ((67)Ga) and technetium Tc 99m bone scintigraphy as initial screening methods for distant metastasis and synchronous malignancies in patients with oral cancer.. Ga and/or bone scintigraphy was performed for 123 patients with primary squamous cell carcinoma (SCC). Abnormal accumulation sites detected with scintigraphy were reevaluated with radiography or computed tomography. Whether the accumulation sites were metastatic was determined according to the radiographic findings and the later clinical course of the patients.. Ga scintigraphy did not detect distant metastases or 4 synchronous cancers at other sites and provided no useful information on the emergence of delayed pulmonary metastases that developed in 3 cases after a few months. Ga scintigraphy showed an abnormal accumulation in 53% of primary tumors and 25% of metastatic cervical lymph nodes, and the detection of accumulation was closely related to the size of the lesion. Bone scintigraphy showed 1 case (0.9%) with distant metastasis to the vertebra; however, there were numerous false-positive cases that required additional radiographic confirmation.. These results suggested that Ga and bone scintigraphy at the initial examination of patients with primary oral SCC are ineffective for detecting distant metastasis and other malignancies because of the low incidence of these lesions and the diagnostic inaccuracy of scintigraphy.

Topics: Adult; Aged; Aged, 80 and over; Bone Neoplasms; Carcinoma, Squamous Cell; Citrates; Female; Follow-Up Studies; Gallium; Gallium Radioisotopes; Humans; Lymphatic Metastasis; Male; Middle Aged; Mouth Neoplasms; Neck; Neoplasm Staging; Neoplasms, Multiple Primary; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Carcinoma, Squamous Cell; Humans; Hypercalcemia; Laryngeal Neoplasms; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Oropharyngeal Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tissue Distribution; Viscera

We examined mandibular invasion of intraoral squamous cell carcinoma by simultaneous bone and tumor dual-isotope SPECT using (99m)Tc-hydroxymethylene diphosphonate ((99m)Tc-HMDP) and (201)Tl-chloride ((201)Tl) and by CT.. Early and delayed simultaneous bone and tumor dual-isotope SPECT and CT were performed on 39 patients suspected of having tumor invasion of the mandible by intraoral squamous cell carcinoma. SPECT images were superimposed to project tumor location from tumor SPECT onto the osseous structures shown by bone SPECT. The CT imaging protocol consisted of 5-mm contiguous axial images.. Histopathologic examination revealed invasion of the mandible in 13 patients and no tumor invasion in 26 patients. The results of delayed dual-isotope SPECT were exactly the same as those of early dual-isotope SPECT. On early and delayed dual-isotope SPECT, the sensitivity, specificity, and accuracy in detecting mandibular invasion by intraoral squamous cell carcinoma were 100% (13/13), 88.5% (23/26), and 92.3% (36/39), respectively. The corresponding values using CT were 45.5% (5/11), 94.7% (18/19), and 76.7% (23/30), respectively, when 9 patients were excluded because of dental artifacts.. Our results suggest that superimposed early bone and tumor dual-isotope SPECT images alone may be sufficient in the diagnostic evaluation of mandibular invasion by intraoral squamous cell carcinoma.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Humans; Male; Mandible; Middle Aged; Mouth Neoplasms; Neoplasm Invasiveness; Radiography; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Medronate; Thallium; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon

Topics: Bone and Bones; Bone Neoplasms; Carcinoma, Squamous Cell; Femoral Neoplasms; Head and Neck Neoplasms; Humans; Lung Neoplasms; Male; Middle Aged; Osteolysis; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Topics: Aged; Biopsy; Carcinoma, Squamous Cell; Fatal Outcome; Femoral Neoplasms; Hip Prosthesis; Humans; Male; Neoplasms, Unknown Primary; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Thallium

Topics: Bone Neoplasms; Carcinoma, Squamous Cell; False Negative Reactions; Femur; Humans; Ilium; Laryngeal Neoplasms; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi

Topics: Carcinoma, Squamous Cell; Female; Humans; Lung Neoplasms; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Superior Vena Cava Syndrome; Technetium Tc 99m Medronate; Whole-Body Counting

Plain radiographs, computed tomography (CT), and more recently magnetic resonance imaging (MRI) are used routinely to stage carcinoma of the nasopharynx. Tc-99m methylene diphosphonate (MDP) SPECT is seldom used for local staging of the disease.. Plain radiographs and CT were used to stage squamous carcinoma of the nasopharynx in a 50-year-old man with a left XII nerve palsy.. Findings of the plain radiographs were normal, whereas the CT scan revealed a nonhomogenous hyperdense mass in the nasopharynx but intact underlying bone. Given the symptoms, a Tc-99m MDP planar scan was ordered and showed no enhanced uptake, but SPECT images obtained at the same time revealed markedly increased focal radiotracer uptake in the region of the tumor, indicating osseous involvement.. Possible bony invasion with a nasopharyngeal carcinoma may be better shown with MDP SPECT than with planar isotope bone scans, plain radiographs, or CT.

Topics: Adult; Carcinoma, Squamous Cell; Cranial Nerve Diseases; Humans; Hypoglossal Nerve; Male; Nasopharyngeal Neoplasms; Radiopharmaceuticals; Skull Base Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Three-phase bone scintigraphy was undertaken to check the anastomotic patency and monitor the viability of vascularized bone grafts. Ten consecutive patients who underwent vascularized bone grafting of the mandible were reviewed. A successful clinical outcome was achieved in 8 patients. The graft failed in 2 patients. In this series, 3-phase bone scintigraphy of radiolabeled (99m)Tc-methylene-diphosphonate was performed at 7 days, and at 1, 3, 6, and 12 months after reconstruction. Assessments made using 3-phase bone images were compared with the clinical findings. The clinical outcome of the cases presented in our series correlated extremely well with 3-phase bone images. Three-phase bone scintigraphy is a useful method for the assessment of patency and viability of vascularized bone grafts. The use of this method can be very helpful in assessing the anastomotic patency and viability of a graft which for clinical reasons is suspected of being non-viable.

Topics: Aged; Anastomosis, Surgical; Bone Transplantation; Carcinoma, Squamous Cell; Female; Graft Survival; Humans; Male; Mandible; Mandibular Diseases; Middle Aged; Mouth Neoplasms; Osteoradionecrosis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Vascular Patency

Skeletal scintigraphy, a sensitive diagnostic tool used to detect changes in bone, is helpful for evaluating bone invasion by oral cancer. However, the exact sites of accumulation of 99mTc-phosphate compounds in the mandible have not yet been fully elucidated. The aim of this study was to determine the localization of 99mTc-methylene diphosphonate (MDP) in the areas of mandible that have been invaded by cancer.. Seven patients with oral cancer (lower gingiva, 4; tongue, 2; floor of the mouth, 1) who underwent surgical treatment with mandibular bone resection were included in the study. Autoradiography and contact macroradiography were used for evaluation of 99mTc-MDP accumulation.. Radioactivity reflecting accumulation of 99mTc-MDP was documented encircling the portion of the mandible with cancerous invasion, suggesting that 99mTc-MDP accumulated in immature bone. High uptake also was found in the periosteal reactive bone around the cortical bone.. The amount of increased 99mTc-MDP circumscribing carcinoma invasion varies among cases. Additionally, uptake may not correspond directly with the amount of the carcinoma invasion; that seen in periosteal bone could be attributed mistakenly to bone invasion in planar scintigraphy.

Topics: Aged; Alveolar Process; Autoradiography; Carcinoma, Adenoid Cystic; Carcinoma, Squamous Cell; Female; Gingival Neoplasms; Humans; Male; Mandibular Neoplasms; Middle Aged; Mouth Floor; Neoplasm Invasiveness; Radionuclide Imaging; Technetium Tc 99m Medronate; Tongue Neoplasms

Radioisotope bone scanning is frequently used in staging malignancies. However, false-positive results are common, and biopsy is usually required. In the absence of plain radiographic abnormalities or local symptoms, localization of the area of abnormal tracer activity at the time of open rib or sternum biopsy may be difficult. It often requires resection of a large portion of one or more ribs or the sternum to assure that biopsy of the target area was performed. In this setting, a small gamma probe underwent evaluation as an aid to precise intraoperative localization of increased tracer activity in the target bone.. Ten patients with asymptomatic suspected osseous chest metastases by radioisotope bone scanning but with normal plain radiographs underwent open biopsy of 13 ribs and 1 sternum. Six to 12 hours before operation, each received an intravenous injection of 28 mCi of technetium-99m oxidronate. The hand-held, pencil-sized gamma probe in a sterile sleeve was used to localize the area of greatest activity in the target bone, once the bone was exposed through a small incision. Biopsy of a 3-cm length of rib or portion of sternum was performed. In the first two rib biopsies, an intraoperative radiograph with a radiopaque marker on the rib confirmed that the correct rib was selected for biopsy. Intraoperative radiographs were not done on later cases.. The mean ratio of hot spot activity on the targeted rib to background counts on adjacent ribs was 1.65 +/- 0.22 (range, 1.35 to 2.05), and the difference was easily discernible intraoperatively. The ratio of hot spot activity on the sternum was somewhat lower (1.22), but the target area was still easy to detect. An abnormal diagnosis to account for the increased tracer activity was found in each of the 13 ribs and 1 sternal biopsy in all 10 patients: metastatic squamous cell carcinoma (1 rib), metastatic prostatic adenocarcinoma (1 rib), lymphoma (2 ribs), localized hypercellular marrow (1 rib), medullary fibrosis/Paget's disease of the bone (2 ribs), localized fibrosis/granulation tissue (1 rib), enchondroma (3 ribs), and chondroma (2 ribs, 1 sternum). The difference in background counts to hot spot activity was best with injection of the tracer 6 hours before operation.. The intraoperative use of gamma counting is an easy, highly accurate aid (100% sensitivity) to localize areas of abnormal radioisotope uptake in suspected asymptomatic rib and sternal metastases. Use of this technique obviates the need to obtain intraoperative localizing radiographs to confirm accurate rib identification, thereby decreasing operative time.

Topics: Adenocarcinoma; Adult; Aged; Biopsy; Bone Marrow Diseases; Bone Neoplasms; Carcinoma, Squamous Cell; Chondroma; Contrast Media; Female; Fibrosis; Gamma Cameras; Granulation Tissue; Humans; Injections, Intravenous; Intraoperative Care; Lymphoma; Male; Middle Aged; Osteitis Deformans; Primary Myelofibrosis; Prostatic Neoplasms; Radiography, Interventional; Radiology, Interventional; Radionuclide Imaging; Radiopharmaceuticals; Ribs; Sensitivity and Specificity; Sternum; Technetium Tc 99m Medronate

Topics: Aged; Biopsy; Carcinoma, Squamous Cell; Humans; Male; Muscle, Skeletal; Paraneoplastic Syndromes; Polymyositis; Radionuclide Imaging; Technetium Tc 99m Medronate; Tongue Neoplasms

Topics: Aged; Bone and Bones; Carcinoma, Squamous Cell; Humans; Lung Neoplasms; Male; Maxillary Neoplasms; Palatal Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

It is important for head and neck surgeons planning their operative approach to assess tumor infiltration to the mandible by intraoral squamous-cell carcinomas. Two- to 3-hr planar bone scintigraphy is sensitive but not specific in detecting mandibular invasion by tumor. We evaluated 3-hr SPECT bone scintigraphy, which provides better anatomical detail, to determine if it more accurately assesses tumor invasion.. Thirty consecutive patients with proven intraoral squamous-cell carcinomas were studied. Semiquantitative assessment of the mandible was performed with a three-level graded scoring system, based on comparisons of tracer uptake in the mandible to that in the upper cervical vertebrae and in an unaffected part of mandible. Lesion-to-cervical spine (L/S) count ratios and lesion-to-nonlesion (L/N) count ratios in the mandible on the 3-hr SPECT images were calculated.. All patients with proven tumor invasion showed higher tracer uptake than those with normal mandible or other dental diseases. The L/S and L/N count ratios on the SPECT images were significantly higher in patients with tumor invasion than in those without (L/S, p < 0.001; L/N, p < 0.01). L/S ratios provided better differentiation than L/N ratios.. Bone SPECT provides a reliable means of assessing tumor invasion to the mandible by intraoral squamous-cell carcinomas.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Cervical Vertebrae; Female; Humans; Male; Mandible; Mandibular Neoplasms; Middle Aged; Mouth Floor; Mouth Neoplasms; Neoplasm Invasiveness; Technetium Tc 99m Medronate; Time Factors; Tomography, Emission-Computed, Single-Photon

Topics: Carcinoma, Squamous Cell; Ear Neoplasms; Humans; Male; Middle Aged; Otitis Externa; Radionuclide Imaging; Technetium Tc 99m Medronate

Detecting osseous involvement is clinically important in the management of oral carcinoma. Thirty-one patients with osseous involvement due to oral carcinoma who underwent panoramic radiography and bone scintigraphy were evaluated retrospectively. Bone scintigraphy confirmed osseous involvement in all 31 (100%) of these patients. In 27 (87%) of 31 patients with osseous involvement, both the panoramic radiogram and bone scintigram were positive. In the remaining four patients (13%), bone scintigram was positive for mandibular or maxillary invasion, while panoramic radiogram was negative. There were no instances of an abnormal radiogram with a normal bone scintigram. These findings strongly suggest that bone scintigraphy is more sensitive than panoramic radiography in detecting osseous involvement of the mandible and maxilla due to oral carcinoma. Furthermore, bone scintigraphy was a critical pre-surgical in determining the extent of the osseous involvement.

Topics: Carcinoma, Squamous Cell; Cheek; Diagnostic Errors; Evaluation Studies as Topic; Gingival Neoplasms; Humans; Mandibular Neoplasms; Maxillary Neoplasms; Melanoma; Mouth Neoplasms; Neoplasm Invasiveness; Radiography, Panoramic; Radionuclide Imaging; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Medronate

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

The purpose of this study was to evaluate the frequency and the extent of extraosseous 99mTc-HMDP accumulation in 412 patients with primary lung cancer. CT scanning was also performed and we compared the extraosseous uptake by lung cancer with the internal structure of the tumor on CT scans. The extent of ectopic 99mTc-HMDP accumulation was classified as low, moderate or high. CT scans were used to evaluate the size and internal structure of the tumor, including calcification and necrosis. Ectopic 99mTc-HMDP accumulation in primary lung cancer was found in 32 patients (7.7%), and included 2 cases (0.5%) of high uptake, 8 cases (1.9%) of moderate uptake, and 22 cases (5%) of low uptake. No difference in uptake was observed among the histological types, but a relationship between tumor size and 99mTc-HMDP extraosseous accumulation was observed. CT scans of the 32 tumors exhibiting ectopic 99mTc-HMDP accumulation revealed 5 cases of calcification in the tumor and 18 cases of tumor necrosis. The factors promoting ectopic 99mTc-HMDP accumulation were considered to be tumor size and calcification or necrotic change. In patients with neither calcification nor necrosis, other factors such as increased calcium metabolism and altered vascular permeability may be involved.

Topics: Adenocarcinoma; Calcinosis; Carcinoma, Large Cell; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Humans; Lung Neoplasms; Necrosis; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Tomography, X-Ray Computed

To date no investigation has proven accurate and reliable for assessing mandibular invasion by carcinoma prior to surgery. This prospective study compared a new imaging modality, single photon emission computed tomography (SPECT), with clinical examination and high resolution CT scanning to evaluate the sensitivity and specificity of each method in detecting mandibular invasion by squamous cell carcinoma. Twenty-nine patients (21 men, 8 women) with an oral cavity/oropharyngeal carcinoma were studied. All underwent primary surgery and/or radiotherapy where indicated. Resected mandibles were decalcified and examined for tumour infiltration. Imaging studies were read independently by two experienced observers. Clinical examination predicted bone invasion with a sensitivity of 90% and a specificity of only 25%. CT had a sensitivity of 89% and a specificity of 57% while SPECT imaging had a sensitivity of 100% and a specificity of 29%. Using Fisher's exact test and the Kappa statistic for pairwise comparisons between each method, SPECT imaging was complementary to CT in the pre-operative assessment of mandibular invasion.

Topics: Aged; Carcinoma, Squamous Cell; Female; Humans; Male; Mandible; Mandibular Neoplasms; Mouth Neoplasms; Neoplasm Invasiveness; Oropharyngeal Neoplasms; Prospective Studies; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The decision of whether to perform continuity-sparing or resecting surgery of the jaw in cases of malignant oral tumors is often difficult.. To aid in this decision, bone scintigraphy was evaluated retrospectively in 304 patients with a squamous cell carcinoma.. One hundred forty-five patients showed no accumulation of the radionuclide, and none of them had infiltration by tumor histologically.. It was concluded that a bone-sparing resection of tumors close to the jaw may be justified when there is a negative bone scan.

Topics: Adenocarcinoma; Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma, Adenoid Cystic; Carcinoma, Squamous Cell; Cheek; Child; Diphosphonates; False Negative Reactions; Female; Humans; Jaw Neoplasms; Lip Neoplasms; Male; Middle Aged; Mouth Floor; Mouth Neoplasms; Organotechnetium Compounds; Patient Care Planning; Predictive Value of Tests; Radiography; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Medronate; Tongue Neoplasms

Hypertrophic osteoarthropathy was detected in a 55-yr-old man with pulmonary squamous-cell cancer by bone scintigraphy using 99mTc-hydroxy methylene diphosphonate (HMDP). Intense symmetrical uptake was demonstrated in the distal portions of the long bones as was the parallel tract sign, accompanied by markedly elevated serum growth hormone levels. After chemoradiotherapy for pulmonary cancer, the arthralgia disappeared and scintigraphic findings and serum growth hormone levels improved, suggesting that ectopic production of growth hormone in the pulmonary tumor had been associated with hypertrophic osteoarthropathy. These findings indicate that bone scintigraphy is useful for detecting hypertrophic osteoarthropathy, and assessing alterations in hypertrophic osteoarthropathy activity post-treatment.

Topics: Bone and Bones; Carcinoma, Squamous Cell; Growth Hormone; Hormones, Ectopic; Humans; Lung Neoplasms; Male; Middle Aged; Osteoarthropathy, Secondary Hypertrophic; Radionuclide Imaging; Technetium Tc 99m Medronate

We examined clinical characteristics of patients with primary lung cancer associated with clubbing of the fingers or pulmonary hypertrophic osteoarthropathy. Clubbing was observed in 12.5% of patients with lung cancer. Squamous cell carcinoma was frequently associated with clubbing. Clubbing was found in all clinical stages. PaO2 and PaCO2 were normal in patients with lung cancer, which suggests that neither hypoxemia nor hypercapnia caused the clubbing in these patients. Pulmonary hypertrophic osteoarthropathy was found in three patients with lung cancer (two men and one woman, mean age 49 years). The incidence was 2.9% among lung cancer patients with clubbing, 0.22% in all lung cancer patients, and was apparently lower than those in reports from outside Japan. One of these patients has stage IIIA squamous cell carcinoma, one had stage IV large cell carcinoma, and one had stage IV adenocarcinoma. In all cases bone scans were useful for diagnosis and for following the clinical course.

Topics: Adenocarcinoma; Aged; Carcinoma, Large Cell; Carcinoma, Squamous Cell; Female; Humans; Lung Neoplasms; Male; Middle Aged; Osteoarthropathy, Secondary Hypertrophic; Radionuclide Imaging; Technetium Tc 99m Medronate

After establishing the diagnosis of carcinoma in the head and neck, routine examinations comprise chest x-ray, bone scan and abdominal ultrasound and are often initiated to exclude or confirm metastatic disease. Data are few on the frequency of metastases at the time of initial diagnosis and reliability of bone scanning and sonography to detect metastases. The aim of the present retrospective study was to define criteria for the use of these latter two methods of examination. The medical records of 382 patients with squamous cell carcinoma who were examined for the first time were analyzed during a four-year period. Bone scanning was performed on 360 patients, but suspect scintigraphic evidence of bone metastasis could be confirmed in only one patient. Only three of 367 patients undergoing abdominal ultrasound were found to have hepatic metastases. Reasons for a practical use of these two methods of examination are discussed.

Topics: Bone Neoplasms; Carcinoma, Squamous Cell; Diagnosis, Differential; Diagnostic Imaging; Head and Neck Neoplasms; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Neoplasm Staging; Otorhinolaryngologic Neoplasms; Prognosis; Technetium Tc 99m Medronate; Ultrasonography

A 36-yr-old male with a past history of invasive squamous-cell carcinoma of the larynx underwent 99mTc-MDP scintigraphy for the evaluation of lower back pain. The scan findings were unremarkable except for markedly and uniformly increased tracer uptake in the region of the thyroid cartilage, suggesting calcification and/or tumor invasion. Confirmation of significant pathology was obtained on tissue examination from a subsequent total laryngectomy demonstrating inflammatory infiltration and perichondrial invasion of the thyroid cartilage by carcinoma.

Topics: Adult; Carcinoma, Squamous Cell; Humans; Laryngeal Neoplasms; Male; Neoplasm Invasiveness; Radionuclide Imaging; Technetium Tc 99m Medronate; Thyroid Cartilage

Topics: Aged; Carcinoma, Squamous Cell; Hamartoma; Humans; Lung Neoplasms; Male; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

Fifty patients (43 male, 7 female, age 31-77 years) with single solid masses in their lungs based on the findings of a chest X-radiograph [40 malignancies: 5 small cell carcinoma (Ca), 17 epidermoid Ca, 12 adeno Ca, 6 undifferentiated large cell Ca] and 10 benign lesions underwent technetium-99m (V) dimercaptosuccinic acid [99m-(V)DMSA] scans to evaluate the usefulness of 99mTc-(V)DMSA in the detection of lung Ca with different cell types and benign lesions. Only 43% (17/40) of the malignancies in the lungs were detected by 99mTc-(V)DMSA, including 29% (5/17) epidermoid Ca, 50% (6/12) adeno Ca and 17% (1/6) undifferentiated large cell Ca of the lungs. However, all 5 cases of small cell Ca and 11 cases combined with bone metastasis were revealed by 99mTc-(V)DMSA. In addition, 3 of the 10 benign lesions (2 organizing pneumonias, 1 benign tumor) presented with an uptake of 99mTc-(V)DMSA. The diagnostic sensitivity, specificity and accuracy were 43%, 70% and 48%, respectively, in differentiating malignant from benign lesions for the single solid mass in the lungs. In conclusion, 99mTc-(V)DMSA is of little or no use in the differentiation of lung Ca from single solid masses in the lungs.

Topics: Adenocarcinoma; Adult; Aged; Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Diagnosis, Differential; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sensitivity and Specificity; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate

Etidronate disodium (EHDP) therapy is often instituted emergently for treatment of hypercalcemia associated with malignancy, and a staging bone scan is part of the evaluation of the patient with extensive metastatic disease. In these patients in whom high dose EHDP therapy has been instituted, uptake of the bone scan agent is markedly diminished. The case presented illustrates this finding: a breast cancer patient who had received two 500-mg intravenous doses of EHDP prior to bone scan staging. No skeletal visualization was present at 3 hr after 99mTc-MDP injection. Blood-pool activity and uptake in large metastatic sites were observed.

Topics: Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Carcinoma, Squamous Cell; Drug Interactions; Etidronic Acid; Female; Humans; Hypercalcemia; Radionuclide Imaging; Technetium Tc 99m Medronate

We discuss three cases irradiated to their bone metastases. 99mTc-MDP bone scan before irradiation showed normal uptake in the lesions. In all the cases, the irradiation therapy was effective, but focal increased uptake area corresponding to the site of bone metastasis was revealed by the follow-up bone scan one to three months after irradiation. We concluded that the change of tracer uptake was so-called flare in formerly false negative lesion. The cause of this phenomenon was considered either elevation of osteoblastic activity with control of tumor or progression of osteolysis until tumor got well-controlled.

Topics: Aged; Bone and Bones; Bone Neoplasms; Bone Resorption; Breast Neoplasms; Carcinoma, Squamous Cell; Esophageal Neoplasms; False Negative Reactions; Female; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

Photopenic osseous lesions are a well-recognized but unusual manifestation of metastatic disease on bone scintigraphy. Common primary tumors giving rise to such lesions include lung, breast, renal, and thyroid. This case report illustrates multiple "cold" osseous metastases from aggressive penile squamous cell carcinoma without radiographic destruction.

Topics: Bone Neoplasms; Carcinoma, Squamous Cell; Humans; Male; Middle Aged; Penile Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate

Several imaging techniques, such as conventional radiography, sonography, computed tomography, isotope scanning and magnetic resonance tomography are used for evaluation of malignant tumors in the region of the floor of the mouth and the tongue. At present, conventional radiography, as well as computed tomography and isotope scanning are the techniques preferred for examination of the mandible. In this study, the results of conventional radiographic examination, computed tomography, ultrasound and Tc scanning in detecting tumor invasion of the mandibular bone, are documented and correlated to surgical and histological findings. The results suggest that ultrasound--our primary diagnostic imaging technique for evaluation of tumors of the floor of the mouth and the tongue--not only provides excellent imaging of tumor extension in soft tissue but also allows accurate diagnosis of osteodestructions of the mandible. In most regions ultrasound had the same accuracy in detecting tumor invasion of the mandible. In the alveolar process, however, sonography was superior to other imaging techniques. The lingual surface of the mandibular ramus can not be screened by the extraoral sonography.

Topics: Carcinoma, Squamous Cell; Diagnostic Imaging; Female; Humans; Male; Mandibular Diseases; Mandibular Neoplasms; Middle Aged; Mouth Neoplasms; Neoplasm Invasiveness; Osteolysis; Radiography, Panoramic; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Ultrasonography

Topics: Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Male; Mandible; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate; Tonsillar Neoplasms

There is given a report about first clinical experiences in the partial cryodevitalization of the mandible. 3 tumor-bearing patients were treated. The resection of the mandible was not necessary. The process of revitalisation was observed by bone scanning.

Topics: Bone Regeneration; Carcinoma, Squamous Cell; Cryosurgery; Follow-Up Studies; Humans; Mandible; Mandibular Neoplasms; Osteosarcoma; Radionuclide Imaging; Technetium Tc 99m Medronate

A five year review of 224 Tc-99m methylene diphosphonate (MDP) scintiscans of 194 patients with proven nasopharyngeal carcinoma revealed evidence of craniofacial asymmetry in 73.7 per cent. In virtually all instances tracer accumulation corresponded to the side of the primary lesion, cervical node enlargement and or cranial nerve dysfunction. It was concluded that the high frequency of asymmetric ipsilateral MDP accumulation about the face may be attributed to one or all of the following; tumour extension into contiguous structures, localised inflammatory or necrotic changes or even tracer uptake by the tumour itself.

Topics: Bone Neoplasms; Carcinoma, Squamous Cell; Facial Bones; Humans; Nasopharyngeal Neoplasms; Radionuclide Imaging; Skull; Technetium Tc 99m Medronate

Topics: Carcinoma, Squamous Cell; Humans; Lung Neoplasms; Male; Middle Aged; Muscles; Paraneoplastic Syndromes; Radionuclide Imaging; Technetium Tc 99m Medronate

A rare case of squamous cell carcinoma of the pleura in association with tuberculosis is described. Concentration of 99mTc-methylenediphosphonate was demonstrated in the calcified pleural tumoral tissue. To the best of our knowledge, such concentration has not been previously reported. The possible etiological factors of this disease and findings are briefly discussed.

Topics: Carcinoma, Squamous Cell; Empyema, Tuberculous; Female; Humans; Middle Aged; Pleura; Pleural Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate; Tuberculosis, Pleural

Topics: Adult; Aged; Carcinoma, Squamous Cell; Female; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Prognosis; Skull Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed

Although skeletal metastases from malignant neoplasms are common, the spread of cancer to the distal phalanx of the hand is quite rare. We have presented two cases with a distal phalangeal metastasis which could be definitely detected by radionuclide imaging.

Topics: Bone Neoplasms; Carcinoma, Squamous Cell; Esophageal Neoplasms; Female; Fingers; Gallium Radioisotopes; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Carcinoma, Squamous Cell; Humans; Male; Mandibular Neoplasms; Mastoiditis; Methods; Middle Aged; Radionuclide Imaging; Skull; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

A patient with squamous cell carcinoma of the lung had splenic uptake of Tc-99m MDP on two consecutive bone scans, but not on a third. There was no intervening therapy. At autopsy the spleen was grossly and microscopically normal.

Topics: Bone and Bones; Carcinoma, Bronchogenic; Carcinoma, Squamous Cell; Diphosphonates; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Spleen; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

A retrospective analysis of 104 chest radionuclide angiography (CRNA) studies establishes the utility of this procedure in the evaluation of pulmonary malignancies and benign masses. Remarkable abnormalities in the perfusion of the lungs were identified in 36 (58%) of 62 cases that were not predictably normal or predictably abnormal form the clinical setting. While 60 of these 62 cases involved malignancy being evaluated for metastases, only 21 (34%) had metastases identified by radionuclide bone or liver-spleen scintigraphy. In addition to diagnosis of superior vena cava obstruction, the CRNA may have a more frequent application as an adjunct to routine scintigraphic studies directed to the identification of metastatic disease.

Topics: Adenocarcinoma; Aged; Carcinoma, Squamous Cell; Diphosphonates; Female; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Vena Cava, Superior

Topics: Carcinoma, Squamous Cell; Diphosphonates; Humans; Hypopharyngeal Neoplasms; Male; Middle Aged; Muscular Diseases; Pharyngeal Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

When abnormally increased radioactivity is seen in a rib or ribs by bone imaging in a patient with suspected or known malignancy, it frequently is difficult to differentiate fracture from metastatic disease. Histological examination of the lesion is crucial for diagnosis, staging, and planning of therapy. To assess the value of external localization of the site or sites of abnormal uptake in a rib as a guide for open rib biopsy, 10 patients (7 men, 3 women; age range, 34 to 68 years) with known or suspected malignancy were studied. With reference to the oscilloscope image, a cobalt 57 marker was placed on the skin overlying the focus of increased uptake, and the area of increased activity was marked on the skin as a guide to surgical resection. Of ten resected ribs, four showed metastatic disease and five had fractures. (One patient underwent two external marking procedures and two surgical procedures.) Rib biopsy was not performed in 1 patient because prior to the surgical procedure, a small subcutaneous nodule adjacent to the skin marker was excised and confirmed to be carcinoma. Appropriate courses of management (operation, irradiation, chemotherapy) were taken after the biopsies. The surgeon responsible for the biopsy should be present during the skin-marking procedure, and the area beneath the scapula and the region adjacent to the spine should be avoided. Our results indicate that the technique is a very useful aid for approaching open rib biopsies more precisely.

Topics: Adenocarcinoma; Adult; Aged; Biopsy; Bone Neoplasms; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Diagnosis, Differential; Diphosphonates; Evaluation Studies as Topic; Female; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Rib Fractures; Ribs; Technetium; Technetium Tc 99m Medronate

Topics: Adenocarcinoma; Adult; Aged; Bone and Bones; Bone Neoplasms; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Diphosphonates; Etidronic Acid; Female; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Aged; Bone Neoplasms; Carcinoma, Squamous Cell; Diphosphonates; Female; Fibrosarcoma; Humans; Male; Middle Aged; Technetium; Technetium Tc 99m Medronate; Thermography; Tomography, X-Ray Computed

Topics: Adenoma; Adult; Aged; Bone and Bones; Bone Neoplasms; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Diphosphonates; Female; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Adult; Aged; Carcinoma, Squamous Cell; Child, Preschool; Diphosphonates; Female; Histiocytoma, Benign Fibrous; Humans; Liposarcoma; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Radionuclide Imaging; Rectal Neoplasms; Rhabdomyosarcoma; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Thigh

Topics: Carcinoma, Squamous Cell; Diphosphonates; Humans; Kidney Neoplasms; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

A case is described in which Tc-99m methylene diphosphonate concentrated in a hepatic metastasis from esophageal squamous cell carcinoma. We observed radiopharmaceutical concentration in the hepatic metastases, which was probably related to the presence of necrosis with calcification.

Topics: Bone and Bones; Calcium; Carcinoma, Squamous Cell; Diphosphonates; Esophageal Neoplasms; Humans; Liver; Liver Neoplasms; Male; Middle Aged; Spleen; Technetium; Technetium Tc 99m Medronate; Tomography, Emission-Computed