technetium-tc-99m-medronate and Carcinoma

Topics: Adult; Artifacts; Axilla; Biopsy; Breast Diseases; Breast Neoplasms; Carcinoma; Carcinoma, Ductal, Breast; Chemotherapy, Adjuvant; Drug Resistance, Multiple; Drug Resistance, Neoplasm; False Positive Reactions; Female; Forecasting; Humans; Lymphatic Metastasis; Magnetic Resonance Imaging; Mammography; Middle Aged; Multicenter Studies as Topic; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Organophosphorus Compounds; Organotechnetium Compounds; Patient Selection; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Thallium Radioisotopes; Ultrasonography

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Carcinoma; Diphosphates; Diphosphonates; Fractures, Bone; Humans; Lung Neoplasms; Male; Osteomyelitis; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

To compare the diagnostic and prognostic value of [(18)F] fluorodeoxyglucose positron emission tomography (FDG-PET) and bone scans (BS) in the assessment of osseous lesions in patients with progressing prostate cancer.. In a prospective imaging trial, 43 patients underwent FDG-PET and BS prior to experimental therapies. Bone scan index (BSI) and standardized uptake value (SUV) on FDG-PET were recorded. Patients were followed until death (n = 36) or at least 5 years (n = 7). Imaging findings were correlated with survival.. Osseous lesions were detected in 39 patients on BS and 32 on FDG-PET (P = 0.01). Follow-up was available for 105 FDG-positive lesions, and 84 (80%) became positive on subsequent BS. Prognosis correlated inversely with SUV (median survival 14.4 versus 32.8 months if SUVmax > 6.10 versus ≤ 6.10; P = 0.002) and BSI (14.7 versus 28.2 months if BSI > 1.27 versus < 1.27; P = 0.004). Only SUV was an independent factor in multivariate analysis.. This study of progressive prostate cancer confirms earlier work that BSI is a strong prognostic factor. Most FDG-only lesions at baseline become detectable on follow-up BS, suggesting their strong clinical relevance. FDG SUV is an independent prognostic factor and provides complementary prognostic information.

Topics: Aged; Aged, 80 and over; Bone and Bones; Bone Neoplasms; Carcinoma; Fluorodeoxyglucose F18; Follow-Up Studies; Humans; Male; Middle Aged; Positron-Emission Tomography; Predictive Value of Tests; Prognosis; Prostatic Neoplasms; Survival Analysis; Technetium Tc 99m Medronate

Because of the discrepant findings on regional bone mineral density (BMD) in stage IV patients with bone metastases due to prostate cancer, we decided to evaluate BMD of lumbar spines in 30 prostate cancer patients with lumbar spine metastases. These measurements of BMD in lumbar spines were compared with 30 stage IV prostate cancer patients without lumbar spine metastases.. Before BMD measurements, the bone scan with technetium-99m labeled diphosphonate was carried out in all of the men to evaluate lumbar spine metastases. Dual energy x-ray absorptiometry was used to measure BMD in the lumbar spines.. There was no difference of age, height, weight, and body mass index between the two group patients. However, significantly higher BMD of the lumbar spines in the 30 patients of prostate cancers with lumbar spine metastases was found (p value <0.05).. Our results show that patients of prostate cancers with lumbar spine metastases demonstrated by Tc-99m MDP bone scan have increased BMD in the lumbar spines, possibly because of a predominance of osteoblastic over osteolytic metastases demonstrated by Tc-99m MDP bone scan.

Topics: Absorptiometry, Photon; Aged; Bone Density; Bone Neoplasms; Carcinoma; Humans; Lumbar Vertebrae; Male; Prostatic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Spinal Neoplasms; Technetium Tc 99m Medronate

A 60-year-old man with back pain underwent 99m Tc-MDP to evaluate bone metastases from newly esophageal carcinoma. No bone metastasis was found on the whole-body bone scan. Unexpectedly, subcutaneous metastasis revealed increased 99m Tc-MDP activity.

Topics: Bone Neoplasms; Carcinoma; Esophageal Neoplasms; Humans; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Accurate staging is crucial to determine the type of treatment for patients with bladder cancer (BCa), especially in high-risk cases. We aimed to assess the role of bone scan in the initial staging of muscle-invasive bladder carcinoma (MIBC).. Forty-five patients with MIBC were referred to our tertiary clinic to perform a technetium 99m-methyl diphosphonate (Tc99m-MDP) bone scan from January 2019 to March 2020. The patients underwent bone scintigraphy with pelvic SPECT/CT before radical cystectomy. Whole-body scanning was performed 4 hours after Tc99m-MDP injection in both anterior and posterior views. Since the most common bone involvement site in these patients is the pelvic bones and the spine, pelvic SPECT/CT was performed in all patients.. Frequency of skeletal metastasis was 26.7%. Only 19% of the metastases were detected by previous pelvic CT/MRI images performed for routine staging. All the reported skeletal metastases by previous anatomical imaging methods were detected in the bone scan. There was no statistically significant correlation between bone metastasis and the patient's age, lymph nodes metastasis (LNM), hydronephrosis, and muscle-invasive type. The mean serum calcium level was 8.7 ± 0.57 in patients with bone metastasis and 8.87 ± 0.99 in patients without bone metastasis, which was not statistically significant.. Bone scan has higher diagnostic performance than conventional imaging methods for detecting bone metastases. It changed the management plan in 8.8% of our patients, so we conclude that performing a whole-body bone scan in the initial staging of MIBC would be helpful.

Topics: Bone Neoplasms; Carcinoma; Diphosphonates; Female; Humans; Male; Muscles; Neoplasm Staging; Radiopharmaceuticals; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Urinary Bladder; Urinary Bladder Neoplasms

Metastatic calcification relates to abnormal calcification resulting from hypercalcaemia in otherwise normal tissues. Hypercalcaemia can occur secondary to chronic renal failure, hyperparathyroidism, hypervitaminosis D, and metastatic neoplasms. Specific symptoms are often lacking, but calcification may be a marker of disease severity and its chronicity. We present cases with different patterns of soft tissue calcification on Tc99m MDP bone scan.

Topics: Aged; Bone Neoplasms; Breast Neoplasms; Calcinosis; Carcinoma; Female; Humans; Hypercalcemia; Kidney Failure, Chronic; Lung; Male; Middle Aged; Neoplasm Metastasis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Thoracic Wall

An abnormally increased uptake of the bone-seeking agent is rarely observed in structures other than the bone and urinary track on bone scintigraphy. The general etiologies of soft tissue uptake can be explained by heterotopic ossification or dystrophic and metastatic calcification. We report a case of serendipitous visualization of the entire colon on bone scintigraphy. Diffuse colonic uptake was detected on the whole-body bone scan in a patient with biopsy-proven sigmoid colon cancer. Additional imaging studies clearly showed direct bladder invasion of the sigmoid colon cancer. Imaging findings with a brief review of the literature are presented in this article.

Topics: Aged; Bone and Bones; Carcinoma; Fluorodeoxyglucose F18; Humans; Incidental Findings; Intestinal Fistula; Male; Multimodal Imaging; Positron-Emission Tomography; Radiopharmaceuticals; Sigmoid Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Urinary Bladder Fistula; Whole Body Imaging

Bone metastasis occurs frequently in nasopharyngeal carcinoma (NPC) patients. The aim of this study was to compare the clinical value of 18F-FDG PET/CT with that of 99mTc-MDP planar bone scintigraphy (PBS) for detecting bone metastasis in NPC patients.. Thirty-five histologically proven NPC patients were enrolled in this retrospective study. They underwent both 18F-FDG PET/CT and PBS within 7 days in our department. In a lesion-based analysis, the skeletal system, excluding the head, was divided into four regions: the spine, the pelvis, the thorax, and the appendix. Bone metastasis was considered to be present by either biopsy or clinical follow-up for at least 6 months. PET/CT and PBS were compared by McNemar's paired-sample test.. A total of 50 lesions were confirmed to be malignant (spine 27, thorax 11, pelvis 8 and appendix 4). Although PET/CT was found to be more sensitive on lesion level than PBS (sensitivity 70.0 versus 42.0%; P=0.044), there were still 14 metastatic (28.0%) lesions that could be detected by PBS while negative in PET/CT imaging. In a patient-based analysis, fifteen (42.9%) of 35 eligible patients were found to have bone metastasis. The sensitivity, specificity and accuracy of PET/CT was 60.0% (9/15), 100% (20/20) and 82.9% (29/35); as for PBS, it was 66.7% (10/15), 85.0% (17/20) and 77.1% (27/35), respectively. There was no statistical difference between PET/CT and PBS (P>0.05).. PBS, as a conventional imaging, should be used as an important complement for detecting bone metastasis in NPC patients.

Topics: Adult; Aged; Bone Neoplasms; Carcinoma; Female; Fluorodeoxyglucose F18; Humans; Image Interpretation, Computer-Assisted; Male; Middle Aged; Multimodal Imaging; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Positron-Emission Tomography; Reproducibility of Results; Retrospective Studies; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Young Adult

The aim of this study was to compare bone scintigraphy (BS) and positron emission tomography/computed tomography (PET/CT) for the detection of bone metastases from breast cancer.. Twenty patients with breast cancer and bone pain were submitted to both bone scintigraphy and 18-F-fluorodeoxyglucose PET/CT imaging between July 2012 and June 2013. Scintigraphy was performed following an intravenous injection of technetium-99m-methylene diphosphonate (99mTc-MDP) around 10 days before the PET/CT scan, performed using an intravenous injection of 18-F-fluorodeoxyglucose followed by whole-body computed tomography (CT) to characterize metastases by both methods. Student's t-test for paired samples was used in the comparative data analysis, with significance at p<0.05.. CT identified 429 metastatic implants in the 20 patients, with scintigraphy showing 244 of these lesions (57%) and PET/CT showing 307 (72%); however, there was no statistically significant difference between the mean number of lesions detected per patient with the two imaging modalities (p=0.367).. In the present study, no difference was found between PET/CT and bone scintigraphy in the detection of bone metastases from breast cancer.

Topics: Bone Neoplasms; Breast Neoplasms; Carcinoma; Female; Fluorodeoxyglucose F18; Humans; Middle Aged; Multimodal Imaging; Positron-Emission Tomography; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Interpretation of abnormal foci with high tracer uptake may require morphological correlation. Fusion of functional images obtained by single photon emission computed tomography (SPECT) and anatomical images obtained by computed tomography (CT) or magnetic resonance (RM) allows an integrated comprehension of complementary information.. To demonstrate that SPECT/CT fusion with external markers is useful in clinical practice to clarify the location and pathological meaning of questionable foci.. Thirty four pairs of images from separate equipments (31 SPECT/CT and 3 SPECT/RM) pertaining to 29 patients, were fused. Fifty one foci of abnormal tracer uptake of uncertain pathological meaning were analyzed. These were classified before and after the fusion as probably malignant or probably benign.. Seventy percent of patients had a differentiated thyroid carcinoma. The fusion localized 100% of foci. Nine percent had a normal and 26% an abnormal anatomy. Before fusion 82% of foci were classified as potentially malignant. This figure changed to 59% after the fusion (p <0.01). Therefore the suspicion of malignancy was presumptively confirmed in 72% of foci and fusion results would have reached a 27% of incremental diagnostic value in 14 cases that changed of category (11 with differentiated thyroid carcinoma, one with colorectal cancer, one with a nasal Ewing sarcoma and one with a brain tumor).. The fusion of SPECT and CT is useful in selected patients, specially those with differentiated thyroid carcinoma. The fusion of SPECT and RM is also feasible.

Topics: Adolescent; Adult; Aged; Carcinoma; Child; Child, Preschool; Female; Humans; Image Enhancement; Iodine Radioisotopes; Magnetic Resonance Imaging; Male; Middle Aged; Radiopharmaceuticals; Retrospective Studies; Sensitivity and Specificity; Subtraction Technique; Technetium Tc 99m Medronate; Thyroid Neoplasms; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The lack of anatomical details in standard (131)Iodine whole body scanning ((131)I WBS) interferes with the proper localization of metastatic differentiated thyroid carcinoma (DTC) lesions. In addition, nearby or overlapping variable physiological distribution of (131)I may affect the specificity of (131)I uptake, giving indeterminate results. The aim of this study was to demonstrate the clinical usefulness of simultaneous co-registration of (99m)Tc MDP bone scanning as an anatomical landmark with (131)I scanning in the evaluation of metastatic DTC.. Twenty-five patients (16 females and 9 males, mean age +/- SD = 52 +/- 13 years) with metastatic DTC (17 papillary, 8 follicular), were included. Whole body scanning using a 256 x 1024 matrix and an 8 cm/min scan rate were obtained 48 hours after oral administration of 185-370 MBq 131I and 2 hours after IV administration of 185-370 MBq (99m)Tc MDP using a dual head gamma camera equipped with high energy parallel hole collimators. Occasionally, additional simultaneous co-registration of localised detailed images was also performed using a 256 x 256 matrix size. The two planar images were fused with optional fusion of SPECT images. The data from standard (131)I scanning and fused (131)I/ (99m)Tc-MDP scanning were separately assessed by two nuclear medicine physicians. Fusion images were considered to improve image interpretation in comparison with standard (131)I scanning when they provided better localization of lesions.. All lesions in the present study were validated by radiological images and clinical follow up for at least 12 months. Forty-eight metastatic lesions were confirmed as follows: 2 in the skull, 10 in the neck, 20 in the thorax, 12 in the pelvic-abdominal region and 4 in the extremities. Standard (131)I WBS showed 54 extra-thyroidal foci with 8 false positive lesions of which 2 were located in the scalp and 6 in the pelvic-abdominal region extra-skeleton (i.e. sensitivity 100%, specificity 86%). Out of the 48 validated lesions, 16 were indeterminately localized: 10 in the thorax (3 mediastinal nodal lesions, 5 vertebral lesions and 2 ribs) and 6 in the pelvic-abdominal region (2 upper sacral, 2 sacroiliac region and 2 ischial bone). Fusion images confirmed the precise localization of the pathological uptake in the validated 48 lesions (sensitivity 100%, specificity 100%). There were 2 (4%) indeterminate lesions in fused planar imaging that were clearly localized via fused SPECT images.. Fusion images using simultaneous co-registration of (131)I and (99m)Tc MDP scanning is a simple and feasible technique that improves the anatomically limited interpretation of scintigraphy using (131)I alone in patients with metastatic differentiated thyroid carcinoma. The diagnostic advantage of this technique seems to be more apparent in the thoracic and pelvic- abdominal regions in contrast to the neck and extremities.

Topics: Carcinoma; Female; Humans; Image Enhancement; Iodine Radioisotopes; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Subtraction Technique; Technetium Tc 99m Medronate; Thyroid Neoplasms; Whole Body Imaging

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

Topics: Bone Neoplasms; Carcinoma; Diagnosis, Differential; Dyspnea; Humans; Incidental Findings; Lung Neoplasms; Male; Middle Aged; Pulmonary Atelectasis; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi

The aim of this study is to specify the precise role of bone scintigraphy and serum CEA and CA 15-3 assays in the monitoring of breast cancers in order to optimize their use and to determine whether it is possible to guide the prescription of bone scan by the use of CEA and CA 15-3 assays in the monitoring of breast cancer.. For this purpose, from November 1997 to May 2002, 98 consecutive female breast cancer patients (median age, 52 years; range 35-77 years) underwent bone scintigraphy during follow-up. In these patients values of tumor markers were compared with the results of bone scintigraphy. Some of the patients with bone metastasis were checked repeatedly at intervals of 6 to 12 months, resulting in 49 patients with bone metastasis and 74 patients without bone metastasis being included in the study.. In patients with bone metastasis, serum CEA levels were abnormal in 23/49 cases and CA 15-3 serum concentrations were elevated above the cut-off in 33/49 cases. Among patients without bone metastasis, CEA and CA 15-3 serum concentrations were normal in 50/74 and 55/74 cases respectively. The combination of the two markers improved the diagnostic sensitivity.. Although serial tumor marker measurements are an efficient and cost effective method of monitoring disease progression, it does not allow prediction of the bone scan results; so it is not justifiable to reject a bone scintigraphy on the basis of these markers.

Topics: Adult; Aged; Biomarkers, Tumor; Bone Neoplasms; Breast Neoplasms; Carcinoembryonic Antigen; Carcinoma; Female; Humans; Middle Aged; Mucin-1; Radionuclide Imaging; Radiopharmaceuticals; Statistics as Topic; Technetium Tc 99m Medronate

Topics: Aged; Breast Neoplasms; Carcinoma; Female; Humans; Ligamentum Flavum; Ossification, Heterotopic; Paraparesis; Sensitivity and Specificity; Spinal Cord Compression; Technetium Tc 99m Medronate; Thoracic Vertebrae; Tomography, Emission-Computed, Single-Photon

The authors report an unusual presentation of a solitary bone metastasis in the left midtibial shaft with no other skeletal involvement in a patient with breast carcinoma. The incidence of solitary bone metastasis below the knees is rare. Clinically, the lesion was tender when palpated. A bone scan revealed increased blood flow and blood pool activity, with intense midtibial bony uptake in delayed images. These findings are similar to those of acute osteomyelitis. Biopsy revealed bony metastasis from the patient's breast carcinoma.

Topics: Acute Disease; Biopsy; Bone Neoplasms; Breast Neoplasms; Carcinoma; Diagnosis, Differential; Female; Humans; Middle Aged; Osteomyelitis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tibia; Whole-Body Irradiation

Topics: Carcinoma; Female; Humans; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Skull; Skull Neoplasms; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Thyroid Neoplasms; Tomography, X-Ray Computed; Ultrasonography

Topics: Aged; Carcinoma; Dissection; Edema; Female; Humans; Inguinal Canal; Leg; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Radiotherapy Dosage; Technetium Tc 99m Medronate; Vulvar Neoplasms; Whole-Body Counting

Topics: Adult; Carcinoma; Enteral Nutrition; Heart; Humans; Lung; Male; Nasopharyngeal Neoplasms; Nutrition Disorders; Radionuclide Imaging; Radiopharmaceuticals; Stomach; Technetium Tc 99m Medronate; Thyroid Gland; Tissue Distribution; Uremia

Topics: Bone and Bones; Bone Neoplasms; Carcinoma; Diaphragm; Female; Humans; Middle Aged; Pelvis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Uterine Neoplasms

Topics: Aged; Aged, 80 and over; Breast Neoplasms; Carcinoma; Female; Humans; Radionuclide Imaging; Radiopharmaceuticals; Skull Neoplasms; Technetium Tc 99m Medronate; Temporal Bone

Topics: Breast Neoplasms; Carcinoma; Chronic Disease; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Mastoid; Mastoiditis; Middle Aged; Radiopharmaceuticals; Skull Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Parathyroid carcinoma is a rare cause of hyperparathyroidism and metabolic osteopathy. The authors report a patient with parathyroid carcinoma who underwent 99mTc-Sestamibi parathyroid and 99mTc-MDP bone scanning. These techniques showed the parathyroid lesion and typical features of severe metabolic osteopathy respectively. The bone scan performed at only four months after surgery showed near complete resolution.

Topics: Bone and Bones; Bone Diseases, Metabolic; Carcinoma; Contrast Media; Follow-Up Studies; Humans; Hyperparathyroidism, Secondary; Male; Middle Aged; Parathyroid Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Time Factors

The aim of this study was to evaluate the diagnostic role of bone scan in patients with breast carcinoma. With this purpose, we have studied 591 patients (4 males). In 261 of them, we were able to establish the stage of disease: 33 in stage I, 137 in stage II, 71 in stage III y 20 in stage IV. Metastatic lesions were detected in 6% of patients in stage I, 8.8% in stage II, 12.7% in stage III y 50% in stage IV. Altogether, 71 from 591 patients (12%) had metastatic lesions. In 4 patients (5.3%) we obtained a false positive result. The bone lesions found in the scintigraphic studies were classified as not metastatic lesions in 236 patients (39.9%) but 26 of them were malignant (11%). Another 193 patients (32.6%) presented scintigraphic studies considered as equivocal for metastasis and 33 of them were also malignant (17%). In 150 patients scintigraphic studies did not present lesions during the follow up. In other 156 patients isolated lesions were detected and 24 of them (15.4%) were malignant. Only 4 <> lesions were detected and not any <> image was observed in this study.

Topics: Adult; Aged; Aged, 80 and over; Bone Neoplasms; Breast Neoplasms; Breast Neoplasms, Male; Carcinoma; Evaluation Studies as Topic; False Positive Reactions; Female; Humans; Male; Middle Aged; Neoplasm Staging; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Biopsy; Bone Marrow; Breast Neoplasms; Carcinoma; Female; Humans; Middle Aged; Myocardial Ischemia; Primary Myelofibrosis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi

An unusual case of multiple brown tumors due to parathyroid carcinoma is reported. The patient presented with lower leg pain. Plain radiographs demonstrated multiple lytic lesions of the lower legs and a Tc-99m MDP bone scan depicted multiple areas of increased uptake suggesting skeletal metastases. Tc-99m sestamibi tumor scintigraphy showed multiple sites of tumor uptake in bones and a large area of increased uptake with a cystic component in the right lower pole of the thyroid gland. An open biopsy from the right tibial lesion revealed a brown tumor. A large parathyroid carcinoma with a necrotic cyst was removed. After parathyroidectomy and right thyroid lobectomy, the patient became free of bone pain and serum PTH levels normalized. A 9-month follow-up Tc-99m MDP bone scan demonstrated less intense uptake in the pelvis, tibia, and fibulae. Nine-month follow-up tumor imaging with Tc-99m MIBI revealed disappearance of the preoperative uptake of multiple brown tumor.

Topics: Adult; Bone Diseases; Bone Neoplasms; Carcinoma; Female; Follow-Up Studies; Granuloma, Giant Cell; Humans; Hyperparathyroidism; Leg; Osteitis Fibrosa Cystica; Parathyroid Hormone; Parathyroid Neoplasms; Parathyroidectomy; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Thyroid Gland; Thyroidectomy; Whole-Body Counting

We present 131I scintigraphic findings in a patient with insular carcinoma of the thyroid showing diffuse abnormal uptake throughout the skeleton. The scintigraphy closely resembled the pattern of [131I]MIBG distribution in children with bone marrow metastases of neuroblastoma. The extent of involvement was underestimated by bone scintigraphy and radiography. Insular carcinoma of the thyroid in the bone marrow was subsequently demonstrated by biopsy. The patient was treated with 242 mCi 131I given in two courses, which led to severe myelosuppression and died as a result of progressive disease and severe pancytopenia 10 mo after initial therapy.

Topics: Biopsy; Bone and Bones; Bone Marrow; Bone Marrow Neoplasms; Carcinoma; Female; Humans; Iodine Radioisotopes; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate; Thyroid Neoplasms

A 59-yr-old man with chronic renal failure was admitted for evaluation of generalized skeletal pain and frontal bone mass, which was lytic on radiography. Bone scintigraphy demonstrated several foci of moderately increased uptake, without involvement of the skull mass. Radiographs of these lesions were compatible with brown tumors. Serum parathormone level was elevated and CT demonstrated a lower right cervical mass, consistent with parathyroid tumor. Following the removal of the mass and decrease in parathormone levels, the patient suffered from a prolonged period of hypocalcemia and his bone pain worsened. Repeat bone scintigraphy showed an increase in the number and intensity of the areas of focal uptake, consistent with hungry bone syndrome. This flare-up phenomenon is due to an increase in bone metabolism and is an uncommon finding following parathyroidectomy for primary hyperparathyroidism.

Topics: Bone and Bones; Bone Diseases, Metabolic; Carcinoma; Humans; Hyperparathyroidism; Hypocalcemia; Kidney Failure, Chronic; Male; Middle Aged; Parathyroid Neoplasms; Parathyroidectomy; Radionuclide Imaging; Technetium Tc 99m Medronate

We describe herein a case of parathyroid carcinoma accompanied with metastatic calcification identified by technetium-99m methylene diphosphonate (Tc-99m MDP) scintigraphy in the lungs, kidneys and stomach. Parathyroid carcinoma remains a rare disorder despite the increased prevalence of primary hyperparathyroidism. Metastatic calcification is noted infrequently even in primary hyperparathyroidism and it may cause respiratory failure. Tc-99m MDP scintigraphy three months after surgery showed a complete disappearance of Tc-99m uptake in the stomach and an obvious reduction in the kidneys but no significant change in the lungs, indicating metastatic calcification can be reversibly reabsorbed. This case indicates that the adequate excision of parathyroid carcinoma as well as the early detection of metastatic calcification by Tc-99m MDP are obligatory.

Topics: Calcinosis; Carcinoma; Female; Humans; Hypercalcemia; Kidney Neoplasms; Lung Diseases; Middle Aged; Neoplasm Invasiveness; Parathyroid Neoplasms; Radionuclide Imaging; Respiratory Insufficiency; Stomach Diseases; Technetium Tc 99m Medronate

46 patients with recently diagnosed carcinoma of the breast were included in a prospective comparative study of MRI and bone marrow scintigraphy. The aim of the study was to compare these procedures within a histologically unified patient collective. It was shown that MRI was superior to bone marrow scintigraphy in respect of sensitivity (92% vs 58%) and specificity (97% vs. 85%), although only about three quarters of the marrow spaces are examined by MRI screening. Bone marrow scintigraphy suffered particularly from a relatively high number of false positive findings (haemangiomas, degenerative changes). MRI remains the method of choice for investigating the bone marrow.

Topics: Bone Marrow; Bone Neoplasms; Breast Neoplasms; Carcinoma; Evaluation Studies as Topic; False Negative Reactions; False Positive Reactions; Female; Humans; Magnetic Resonance Imaging; Neoplasm Staging; Prospective Studies; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate; Whole-Body Counting

Insular carcinoma of the thyroid appears to represent an entity situated morphologically and biologically in an intermediate position between the well-differentiated and undifferentiated (anaplastic) tumors. The retention of I-131 concentrating ability by this variant, unlike anaplastic, is very encouraging and amenable to detection and therapy by radioiodine after initial aggressive surgery. A 46-year-old man with a histologic label of anaplastic thyroid carcinoma has had an unusually prolonged disease-free survival and histopathologic review confirmed insular carcinoma. Postoperative radioiodine evaluation revealed avid concentration of tracer in the thyroid bed. Thus, it is possible to ablate with radioiodine. The insular carcinoma should be considered as a distinct clinicopathologic entity and widespread awareness of this variant of tumor may help pathologists, surgeons, and nuclear medicine practitioners to aggressively treat the condition after initial diagnosis.

Topics: Carcinoma; Humans; Iodine Radioisotopes; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate; Thyroid Neoplasms

Topics: Bone Neoplasms; Carcinoma; Hormones; Humans; Longitudinal Studies; Male; Prostatic Neoplasms; Radionuclide Imaging; Remission Induction; Technetium Tc 99m Medronate; Treatment Outcome

SPECT of the skull was performed on twelve patients with histologically proven nasopharyngeal carcinoma using newly developed three detectors SPECT system (Toshiba GCA 9300A) mounted with fan-beam collimators, for the purpose of early detection of skull base involvement of the disease. This SPECT system has extremely improved resolution with FWHM of 8 mm in the center, and it provides clear tomographic images of the skull which has anatomically complex structure. SPECT image was taken 3 hours after injection of 740 MBq (20 mCi) of 99mTc-MDP following whole body skeletal survey. In twelve patients with confirmed nasopharyngeal carcinoma, 8 patients showed positive findings on SPECT. Three of SPECT positive patients also showed destructive findings on CT. Other five positive patients did not show destructive findings on CT at their initial examinations, but in three of them CT findings turned to positive later. SPECT was superior to CT in early detection of skull base involvement. We believe that SPECT of the skull is a diagnostic tool for early detection of skull base involvement of nasopharyngeal carcinoma.

Topics: Adult; Aged; Carcinoma; Female; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Neoplasm Invasiveness; Skull; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

One hundred thirty-two new patients with nasopharyngeal carcinoma and no evidence of distant metastases were evaluated for bone metastases with bone scanning. Forty-four patients had abnormal hypercaptation. These abnormal findings were considered related to benign diseases in 39 patients after correlating clinical examinations and skeletal radiographs. The remaining five patients had positive bone scanning which was suggestive of bone metastasis. There were 13 patients who developed symptomatic bone metastases over a follow-up period of 0.2-41 months. In three of these, the bone metastases corresponded to the sites of abnormal hypercaptation in the initial positive bone scanning. In view of the low sensitivity and specificity of bone scanning in this setting, routine bone scanning for staging nasopharyngeal carcinoma is not recommended. But in the research setting, baseline scanning is useful to make subsequent scanning more valuable, and it reduces false-positive results.

Topics: Bone and Bones; Bone Neoplasms; Carcinoma; Evaluation Studies as Topic; Female; Hong Kong; Humans; Incidence; Male; Middle Aged; Nasopharyngeal Neoplasms; Prospective Studies; Radionuclide Imaging; Technetium Tc 99m Medronate; Time Factors

This is a report for an unusual case of oxyphilic cell adenocarcinoma originating from anterior mediastinum in a 36-year-old male who complained of his neck lymphoadenopathy. 201Tl whole body scanning showed increased uptake of the left supraclavicular and upper mediastinal regions. There was no history of prior operation nor irradiation to the thyroid or neck region. Chest CT scanning also demonstrated the tumor in the superior mediastinum, but the mass has no increased 67Ga uptake. No tumor in the thyroid lobes was apparent on thyroid scintiscanning, ultrasonography and neck CT. The mediastinal tumor resection, the right and left thyroid lobectomy and the neck lymphonodectomy were completed. Serial sectioning of the resected thyroid lobes failed to show any tumorous tissue. The light microscopic features of a Hurthle-cell tumor arising in the mediastinal ectopic thyroid and diagnosed by neck lymph node biopsy were presented. The tumor was clinically malignant, having metastasized to the bone and the neck lymph nodes. Non surgical treatment including radioactive iodine (131I) therapy and combination chemotherapy were disappointing. The patient deteriorated progressively and died 16 months after thyroidectomy. We describe here an unusual case of a papillary growing and thyroglobulin producing tumor in the superior mediastinal region without evidence of a primary thyroid gland tumor.

Topics: Adult; Bone and Bones; Carcinoma; Combined Modality Therapy; Humans; Lymph Nodes; Lymphatic Metastasis; Male; Mediastinal Neoplasms; Mediastinum; Radionuclide Imaging; Technetium Tc 99m Medronate; Thallium

A 99mTc-MDP scan was done on a patient with liver metastases from a medullary thyroid carcinoma who, in addition, had a familial history of multiple endocrine neoplasm, type 2. The scan revealed accumulation in several areas of calcified liver metastases.

Topics: Adult; Calcinosis; Carcinoma; Female; Humans; Liver Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate; Thyroid Neoplasms

For an evaluation of the clinical utility of prostate-specific antigen (PSA), 32 prostatic carcinoma patients (ages 54-76) and 13 nonprostatic carcinoma patients (ages 60-70) underwent PSA measurements and bone imaging. At the time of bone imaging, each patient's PSA value was measured by a monoclonal immunoradiometric assay. All 13 nonprostatic carcinoma patients (11 bronchogenic, 1 colon, and 1 urinary bladder) gave normal PSA values, although 6 had metastatic bone disease. The 32 prostatic cancer patients were divided into 2 groups of 16 each; PSA levels in Group 1 were abnormal (greater than or equal to ng/ml): PSA levels in Group 2 were normal (less than 4 ng/ml). In Group 1, bone images of 14 patients showed bone metastases; 6 of the 14 showed progression of metastases in a 6- to 12-month period. Two patients in Group 1 were negative for skeletal metastases. Twelve patients in Group 2 were negative for skeletal metastases; bone imaging in 1 showed regression of skeletal metastases; and 3 patients had unchanged bone lesion(s). The data indicate that PSA measurements may enhance bone imaging interpretation and provide valuable clinical monitoring of prostatic carcinoma. In the case of a patient with positive bone imaging and an unknown primary, PSA measurements may definitively determine if metastases originated from prostatic carcinoma.

Topics: Aged; Antigens, Neoplasm; Biomarkers, Tumor; Bone Neoplasms; Carcinoma; Humans; Male; Middle Aged; Prospective Studies; Prostate-Specific Antigen; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate

Nine patients with histologically proven medullary carcinoma of the thyroid (MCT) were imaged using pentavalent [99mTc]dimercaptosuccinic acid [(V)DMSA], [131I] metaiodobenzylguanidine (MIBG) and [99mTc]methylene diphosphonate (MDP). Technetium-99m (V)DMSA demonstrated most of the tumor sites in eight patients with proven metastases, with an overall sensitivity of 95% in lesion detection. Iodine-131 MIBG showed definite uptake in some of the tumor sites in three of the nine patients imaged, with equivocal uptake seen in a further one patient, with sensitivity of only 11% for lesion detection. Technetium-99m MDP demonstrated bony metastases only, in four of the patients imaged yielding a sensitivity of 61%. Technetium-99m (V)DMSA has been demonstrated in this study to be a useful imaging agent in patients with MCT, showing uptake in significantly more lesions and with better imaging qualities than [131I]MIBG, and with the ability to detect soft tissue as well as bony metastases.

Topics: 3-Iodobenzylguanidine; Bone Neoplasms; Carcinoma; Humans; Iodine Radioisotopes; Iodobenzenes; Organometallic Compounds; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate; Thyroid Neoplasms

Bone scintigraphy was performed in 16 men with newly diagnosed prostatic carcinoma before orchiectomy as well as 2 weeks and 2 months after operation. The uptake in the lower thoracic and lumbar vertebrae was registered up to 240 min after injection of 99mTc-MDP and was then calculated for each patient and vertebra. The relative standard deviation in measured uptake due to measuring technique was estimated to be +/- 7%. In eight patients, who had normal bone scintigraphies before orchiectomy, there were no changes in the uptake values after operation. The remaining eight patients had widespread metastatic involvement prior to treatment. Six of these patients showed a so called "flare phenomenon" in the abnormal vertebrae which means an initial increase in uptake after operation followed by a decreased uptake in response to therapy. One patient had a continuously increased uptake in all the abnormal vertebrae which correlated well with the clinical progression of the disease, while in another patient both reactions were seen. Thus, repeated quantitative bone scintigraphies using 99mTc-MDP can be made in a reproducible way and can be a useful tool to follow a patient's response to treatment.

Topics: Aged; Bone and Bones; Bone Neoplasms; Carcinoma; Follow-Up Studies; Humans; Male; Orchiectomy; Postoperative Care; Preoperative Care; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate; Time Factors

Topics: Aged; Aged, 80 and over; Bone Neoplasms; Carcinoma; Humans; Kidney; Male; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate

A 37-year-old woman presented with a neck mass that proved to be medullary thyroid carcinoma by histologic and immunoperoxidase examinations. Serum calcitonin values were greatly elevated (over 100,000 pg/ml). There were widespread metastases in bone and liver. As the peripheral lesions showed only slight response to chemotherapy and local radiation therapy, potential use of radioiodine was studied. The bone lesions showed uptake of both Tc-99m MDP and radioiodide (I-131). Metastatic lesions were similar to the primary tumor in terms of histology, presence of calcitonin, and absence of thyroglobulin. Hence, the patient had a medullary thyroid carcinoma that took up radioiodide in its metastases. Two large oral doses of radioiodide (over 100 mCi each) did not significantly alter the serum calcitonin values, although there was a slight response in the activity of bone lesions. The whole body turnover of radioiodide was rapid (T 1/2 = 0.7 days). Upon oral administration of lithium carbonate, whole-body radioiodide turnover slowed slightly (T 1/2 = 1 day). If this effect were reflected in greater tumor retention of radioiodide (slower release), then agents that block radioiodide egress might have a role to play in therapy.

Topics: Adult; Bone Neoplasms; Calcitonin; Carcinoma; Combined Modality Therapy; Diphosphonates; Female; Humans; Iodine Radioisotopes; Lithium; Lithium Carbonate; Liver Neoplasms; Radionuclide Imaging; Sodium Iodide; Technetium; Technetium Tc 99m Medronate; Thyroid Neoplasms

Topics: Adult; Carcinoma; Colloids; Colonic Neoplasms; Diphosphonates; Female; Humans; Liver Neoplasms; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed

Topics: Aged; Carcinoma; Coronary Disease; Diphosphonates; Etidronic Acid; Follow-Up Studies; Heart; Heart Failure; Humans; Male; Organotechnetium Compounds; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Bone Neoplasms; Carcinoma; Diphosphonates; Humans; Male; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Adult; Carcinoma; Diphosphates; Diphosphonates; Etidronic Acid; Female; Humans; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate; Thyroid Neoplasms

Staging bone scans or skeletal surveys were obtained of 97 patients with endometrial carcinoma. Of the 77 patients with Stage I or II disease, no metastases were identified at staging. Three patients in the entire series demonstrated bony metastases; all of these metastases were detectable by radionuclide bone scan and radiographic bone survey. Eighty-nine patients were examined with radionuclide liver/spleen scanning at the time of staging. Four of the 89 initial scans were interpreted as demonstrating hepatocellular disease, and all four patients had abnormal liver function studies. Only one patient demonstrated a possible hepatic metastasis at initial diagnosis. This patient also had abnormal liver function studies. Based on these results, bone surveys and radionuclide bone scans are not indicated as screening procedures in endometrial carcinoma. It is suggested that screening for liver metastases in patients with endometrial carcinoma is not warranted in patients with normal liver function studies.

Topics: Bone Neoplasms; Carcinoma; Diphosphates; Diphosphonates; Female; Humans; Liver Neoplasms; Neoplasm Staging; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Uterine Neoplasms

Technetium-99m-sodium medronate is commonly used for skeletal imaging. Renal excretion allows evaluation of the kidneys. Renal masses present as areas of diminished activity. In the cases described, a renal carcinoma showed increased radionuclide accumulation, probably because of extensive tumor calcification.

Topics: Carcinoma; Diphosphonates; Female; Humans; Kidney Neoplasms; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate