technetium-tc-99m-medronate and Head-and-Neck-Neoplasms

Topics: Acquired Hyperostosis Syndrome; Bone Neoplasms; Face; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Hyperplasia; Infections; Mandibular Condyle; Maxilla; Osteitis Deformans; Periodontitis; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals; Sjogren's Syndrome; Technetium Tc 99m Medronate; Technology, Dental; Temporomandibular Joint Disorders; Tomography, X-Ray Computed

Nuclear medicine studies often play a significant role in the diagnosis and treatment of oral and maxillofacial diseases. While not commonly used in everyday dental practice, the dental provider should have a conversational knowledge of these imaging modalities and understand the indications and limitations of these studies. The purpose of this review is to discuss the nuclear medicine studies that have applications in the head and neck region as well as their indications, limitations, and diagnostic conclusions that can be drawn from these studies.

Topics: Citrates; Gallium; Head and Neck Neoplasms; Humans; Jaw Diseases; Radionuclide Imaging; Radiopharmaceuticals; Salivary Gland Diseases; Sentinel Lymph Node Biopsy; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon

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

Sentinel node scintigraphy in tumours of the head and neck region was combined with bone scintigraphy to provide anatomical landmarks in order to better locate the lymph node uptake. 99Tc(m)-nanocolloid (40 MBq) was injected in the peritumour region 1 h after the administration of bone-seeking 99Tc(m)-methylene diphosphonate (200 MBq). After 5 min, A-P and lateral projections of the head and neck region were acquired. In all the 26 patients examined, the surrounding anatomy was clearly depicted. In 23 patients, the lymphatic drainage was identified within 30 min. In these patients, all hot spots appearing outside the deposited activity could be located according to the neck region classification system of the Memorial Sloan-Kettering Hospital. No lymphatic drainage was visualized in the remaining three patients. The injection of bone-seeking activity 1 h before deposition of the radiocolloid provided images visualizing soft tissues as well as skeletal structures, thus improving the topical diagnosis. Correlation with the results of surgery was not performed. The administration of a small amount of bone-seeking activity prior to sentinel node scintigraphy of head and neck tumours improves the anatomical localization of the lymph node activity.

Topics: Adult; Aged; Aged, 80 and over; Bone and Bones; Female; Head and Neck Neoplasms; Humans; Lymph Nodes; Lymphoscintigraphy; Male; Middle Aged; Radiopharmaceuticals; Technetium Tc 99m Medronate

To assess the role of technetium-99m methoxy diphosphonate (Tc-99m MDP) single photon emission tomography (SPECT) imaging for the detection of osseous invasion in craniofacial malignancies.. The study was performed in 45 subjects using Tc-99m MDP (740 MBq). Out of 45 subjects, 30 were patients had different craniofacial malignancies, and 15 subjects who did not have any malignancy served as controls. Planar imaging was performed. Anterior, lateral and oblique lateral views of the skull were obtained. SPECT imaging was done taking 64 views of the skull in a 360 ° circular path, each 40 s with 128 × 128 matrices. Scans were visually interpreted using a score of 0, 1, and 2, representing a lesion as definitely absent, doubtful, and definitely present, respectively. Planar scans were compared with the SPECT images.. Bone SPECT detected more lesions as compared to planar bone scan and plain radiographs. SPECT was found to be superior to planar imaging and radiographs in the detection and efficient demonstration of the extent of osseous invasion of craniofacial cancer. Sensitivity was 100% for SPECT and 83.33% for planar bone scan.. SPECT imaging of the skull is a very beneficial complementary form of investigation in patients with craniofacial malignancies for the assessment of osseous invasion, particularly in tumors likely to invade the skull base.

Topics: Adult; Aged; Aged, 80 and over; Facial Bones; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Neoplasm Invasiveness; Skull Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The aim of this study was to evaluate the efficacy of fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) compared with bone scan in detecting bone metastases in patients with head and neck cancer.. A total of 319 patients with head and neck cancer were identified in our database who had undergone F-FDG PET/CT, from January 2006 until June 2007. Of them 156 patients (age range 15-100 years) met our inclusion criteria - namely, biopsy-proven head and neck cancer, and bone scan and F-FDG PET/CT within 30 days. Comparison was made on a lesion-by-lesion analysis. MRI, multidetector CT, and the clinical course of the patients were our references.. F-FDG PET/CT identified (n=213) bone lesions in 18 patients, in addition to distant metastases in solid organs such as the liver and lung, lymphadenopathy above and below the diaphragm, and adrenal glands in 12 patients. However, bone scan identified (n=198) 16 patients. Bone scan missed two patients with confirmed bone metastases by means of biopsy in one patient and radiologically in the second. F-FDG PET/CT showed true-positive results in 18 patients, whereas bone scan showed true-positive results in 16 patients. F-FDG PET/CT showed true-negative results in 138 patients, whereas bone scan showed true-negative results in 134 patients. F-FDG PET/CT showed no false-positive or false-negative results. However, bone scan had two false-positive and two false-negative results. The overall sensitivity, specificity, and accuracy was 100% for F-FDG PET/CT and 88, 98, and 96%, respectively, for bone scan.. F-FDG PET/CT is superior to Tc-methylene diphosphonate bone scan in detecting bone metastases in head and neck cancer.

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Female; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Image Enhancement; Male; Middle Aged; Positron Emission Tomography Computed Tomography; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Medronate; Young Adult

The role of 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) in identifying bone metastases in patients with head and neck cancer is not clear. We compared the ability of FDG-PET and bone scintigraphy (BS) to detect bone metastases in patients with upper aerodigestive tract (UADT) malignancies. Patients with histologically confirmed malignancies in the UADT underwent both FDG-PET and BS at initial staging or follow-up. The two methods were compared in patients and in seven skeletal regions. Maximum standard uptake value (SUVmax) on PET was calculated in each lesion and compared between true- and false-positive lesions. This study included 564 eligible patients, of whom 17 had bone metastases. The spine was the most frequently involved site, followed by the lungs and liver. Both FDG-PET and BS had high specificity, accuracy, and negative predictive values for detecting bone metastases (>95% each), and the two methods did not differ in sensitivity, specificity, and predictive values (P>0.05). Both FDG-PET (n=15) and BS (n=14) yielded a significant number of false-positive results, which could be corrected by further work-ups and follow-up imaging. Compared with true-positive lesions, the false-positive lesions on FDG-PET were usually single (86.7% vs. 12.5%, P<0.001) and had lower mean SUVmax (2.4 vs. 5.6, P<0.001). FDG-PET is not more accurate than BS for detecting bone metastasis in patients with UADT cancer. Positive findings on FDG-PET or BS require further confirmation.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Neoplasms; Child; Cohort Studies; Female; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Lymphatic Metastasis; Male; Middle Aged; Positron-Emission Tomography; Radiopharmaceuticals; Sensitivity and Specificity; Statistics, Nonparametric; Technetium Tc 99m Medronate; Whole Body Imaging; Whole-Body Counting

Whether a patient with head and neck cancer has mandibular invasion or not is important in determining the method of resection surgery. But, no modality is adequately reliable when used alone in the evaluation of mandibular invasion. Therefore, to more accurately diagnose mandibular invasion in head and neck cancer, we used a new modality, namely, 99mTc methylene diphosphonate (MDP) or 99mTc hydroxymethylene diphosphonate (HMDP) and 201Tl chloride dual isotope single photon emission computed tomography (Tc/Tl SPECT). The aim of this study is to disclose the usefulness of Tc/Tl SPECT in the assessment of mandibular invasion by head and neck cancers. 99mTc-MDP or -HMDP SPECT (Tc SPECT)s and 201Tl chloride SPECT (Tl SPECT)s were performed in 34 patients with suspected mandibular involvement of head and neck cancer. Thirty of 34 cases underwent both TcMTl SPECT and CT examination. Tc/Tl SPECT fusion images were obtained using the Automatic Registration Tool (ART, TOSHIBA, Japan) system. In the diagnosis of mandibular invasion on Tc/Tl SPECT fusion images, a problem was that the range of Tc and Tl uptake was changed by the condition of display used in the reconstruction and expression of the images. Then, prior to clinical evaluation, to reveal the most appropriate upper window level for display, a phantom study was performed. In a clinical study, the upper window level was set at 40 or 50%, which were verified to be the proper values in the preliminary study. The diagnostic accuracy obtained using Tc SPECT, TcMTl SPECT and CT was compared with the histopathological findings. Tc/Tl SPECT at 40 and 50% upper window level had higher specificity, accuracy, and positive predictive value (73.3%, 85.3%, 81.8%) than Tc SPECT alone (21.4%, 67.6%, 64.5%) and higher sensitivity and negative predictive value (94.7%, 91.7%) than CT (70.6%, 72.2%) for detecting mandibular invasion. Tc/Tl SPECT was a useful diagnostic procedure for the assessment of mandibular invasion by head and neck cancers.

Topics: Head and Neck Neoplasms; Humans; Mandibular Neoplasms; Neoplasm Invasiveness; Radiopharmaceuticals; Reproducibility of Results; Retrospective Studies; Technetium Tc 99m Medronate; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon

Bone scans showing solitary hot spots in the ribs pose diagnostic problems in patients with proved extraskeletal cancers. The authors wanted to determine the importance of solitary rib lesions and their correlation with other clinical manifestations.. The study included 199 patients with solitary rib hot spots on their bone scans. The follow-up radiographic and scintigraphic images were reviewed to determine their origin. The correlation between the occurrence of a malignant rib lesion and clinical data were determined using Pearson chi-square tests.. Ninety-three patients had an established cause of the rib hot spot. Eleven (11.8%) had a solitary malignant rib hot spot and 82 (88.2%) had a solitary benign rib hot spot. None of the hot spots at costochondral junctions were malignant. Of the 11 patients with proved metastatic rib hot spots, 1 of 11 (9.1%) had localized bone pain, 5 of 6 (83.3%) were concordant with primary tumors, 4 of 7 (57.1%) had elevated tumor markers, and 5 of 11 (45.5%) had concurrent extraskeletal metastases. For the 82 patients with benign rib hot spots, the figures were 2 of 82 (2.4%), 43 of 57 (75.4%), 26 of 69 (37.7%), and 19 of 82 (23.2%), respectively. Statistical analysis did not show a significant correlation between the incidence of metastases in solitary rib hot spots and clinical manifestations.. Most solitary rib hot spots on bone scans were benign. The interpretation of a solitary hot spot in the ribs is difficult even with the help of these clinical manifestations. Follow-up bone scintigrams or radiographs are needed for further investigation of solitary rib hot spots.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Bone Diseases; Bone Neoplasms; Breast Neoplasms; Diagnosis, Differential; Female; Follow-Up Studies; Head and Neck Neoplasms; Humans; Kidney Neoplasms; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Ribs; Statistics as Topic; Technetium Tc 99m Medronate

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

To document the varied radiological features before, during, and after treatment of non-Central Nervous System Primitive Neuroectodermal Tumours (PNETs), which are rare tumours of childhood.. Thirty-three children with PNETs have been treated at our institution between 1990 and 1999. Full radiological and clinical follow-up was obtained in 29 (17 females, 12 males). Imaging was retrospectively reviewed, with particular attention to Computed Tomography (CT) and Magnetic Resonance Imaging (MRI).. Age range at diagnosis was 0-16 years old (mean 4.4 years). There were five main sites of tumour: head and neck (n = 7), scapula/axilla (n = 2), chest (n = 11), abdomen (n = 3), and spinal/paraspinal (n = 6). Overall mortality was 62%. Tumours of the scapula or paraspinal region appear to show better survival than other sites. Of 23 patients who had Tc99m-methylene diphosphonate (MDP) bone scans at diagnosis, four patients showed widespread distant metastases, seven showed focal increased uptake in an adjacent bone only, and 12 had normal examinations. CT was performed in 25 patients and MRI in 20, both at diagnosis and follow-up. Average size of tumours at presentation was 4.5 cm in the paraspinal, head and neck and scapular regions and 7.5 cm in the chest and abdomen. Tumours were typically of soft tissue density on CT with the larger (>5 cm) masses tending to be more heterogeneous in character. The lesions were slightly higher signal than muscle on T1-weighted (T1W) MRI and all masses were heterogeneous on T2W sequences. Calcification was uncommon (n = 6) and generally sparse. Tumours tended to displace adjacent soft tissue structures such as vessels and bronchi rather than invade or encase them. Tumours rarely crossed the midline. Local or bony invasion was seen in 12 patients at diagnosis. Metastases were identified in the lung (n = 5), pleura (n = 2), brain (n = 4), bone (n = 4), lymph nodes (n = 2), liver (n = 2), subcutaneous tissues (n = 2), kidney (n = 1) and peritoneum (n = 1).. Imaging characteristics of non-CNS PNETs are described. Tumours tend to displace rather than encase adjacent structures; local invasion occurred in 43%. Tumour calcification is uncommon. Poor prognostic features included the presence of distant metastases at diagnosis (all four patients with distant metastases at diagnosis died), but even patients without metastatic disease have a relatively poor prognosis.

Topics: Abdominal Neoplasms; Adolescent; Child; Child, Preschool; Disease-Free Survival; Female; Head and Neck Neoplasms; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Male; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neuroectodermal Tumors, Primitive, Peripheral; Prognosis; Retrospective Studies; Spinal Neoplasms; Technetium Tc 99m Medronate; Thoracic Neoplasms; Tomography, X-Ray Computed

Topics: Adult; Head and Neck Neoplasms; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyosarcoma, Alveolar; Technetium Tc 99m Medronate

Skull-base invasions of head and neck tumors were examined by simultaneous bone and tumor dual-isotope SPECT (S-SPECT) with 99mTc-hydroxy-methylene-diphosphonate (99mTc-HMDP) and 201Tl-chloride. The effectiveness and reliability of tumor diagnosis by this method was the primary interest in this study.. Before S-SPECT imaging, a phantom experiment using dried skull-bone specimens was performed to establish anatomical details of the skull base with the SPECT camera. Radionuclide crosstalk, window widths and control patients were also examined prior to S-SPECT imaging. Twenty patients with suspected tumor invasion of the skull base underwent S-SPECT.. Preliminary experiments revealed that crosstalk effects could be disregarded with adequate window width and routine administrative doses of the radionuclides. S-SPECT detected bone destruction and the extent of tumor invasion for all 12 patients in whom skull-base involvement was diagnosed by CT or MRI. For the three patients in whom CT or MRI revealed no tumor invasion, the S-SPECT images did not show any abnormal accumulation in similar regions. In the remaining five patients without CT and MRI confirmation of skull-base invasion, the S-SPECT findings showed skull-base abnormalities in three. Tumor invasion was confirmed surgically or by clinical follow-up. The remaining two patients had negative S-SPECT images.. S-SPECT is an effective and reliable diagnostic technique for detecting tumor invasion in the complex bony regions of the skull base.

Topics: Adult; Aged; Female; Head and Neck Neoplasms; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Invasiveness; Phantoms, Imaging; Prognosis; Skull Neoplasms; Technetium Tc 99m Medronate; Thallium; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

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

Topics: Adolescent; Female; Head and Neck Neoplasms; Humans; Necrosis; Radionuclide Imaging; Rhabdomyosarcoma; Technetium Tc 99m Medronate; Thallium; Thallium Radioisotopes

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

Five hundred and eighty birthmarks were reviewed; 356 were hemangiomas and 224 were malformations. Bony alterations occurred in association with only 1 percent of hemangiomas, in contrast with 34 percent of patients with vascular malformations. These alterations in bone development were classified according to size, shape, and density changes. Hypertrophy and distortion were typical of lymphatic malformations. Hypoplasia and demineralization were characteristic findings in the extremity venous malformations. Destructive and intraosseous changes were more commonly noted in the arterial or high-flow lesions. Possible mechanisms of altered skeletal growth include mechanical, physiological, and developmental processes.

Topics: Adolescent; Adult; Arm; Arteriovenous Malformations; Bone and Bones; Child; Child, Preschool; Diphosphonates; Female; Head and Neck Neoplasms; Hemangioma; Humans; Infant; Leg; Male; Middle Aged; Radionuclide Imaging; Retrospective Studies; Skin Neoplasms; Technetium; Technetium Tc 99m Medronate; Terminology as Topic

Scintigraphy using both Tc-99m phosphonate and Ga-67 was performed in 55 cases of untreated primary and secondary tumors of the head and neck. In 21 patients with primary tumors of jaws, eye, tongue, or parotid gland, Ga-67 scintigraphy visualized the primary tumor in all cases and metastases in 12. Scintigraphy using Tc-99m phosphonate disclosed primary bone involvement in 12 cases and skeletal metastases in two. In eight of 13 patients with metastatic lesions of jaws and skull, bone scintigraphy showed skeletal metastases. In seven of these patients, Ga-67 scintigraphy detected the primary tumor and in 11 cases detected metastases. Bone scintigraphy disclosed skeletal metastases in six of 21 patients with malignant neck tumors. In 13 of these patients, Ga-67 scintigraphy visualized the primary tumor, whereas it showed metastases in seven. It is concluded that Ga-67 scintigraphy should be used in the investigation of untreated primary or secondary malignant tumors of the head and neck. Bone scintigraphy may be indicated as an additional study in selected cases only.

Topics: Adult; Bone and Bones; Child; Child, Preschool; Diphosphonates; Female; Gallium Radioisotopes; Head and Neck Neoplasms; Humans; Male; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Calcinosis; Diphosphonates; Female; Fibroma; Head and Neck Neoplasms; Humans; Infant, Newborn; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Diphosphonates; Head and Neck Neoplasms; Humans; Infant; Male; Neuroblastoma; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Tissue Distribution

A large family with a history of hereditary chemodectoma has been successfully screened by means of radionuclide scintiangiography. This procedure could restrict selective and more invasive roentgenangiography only to those cases in which flow patterns are abnormal. Three asymptomatic cases of chemodectoma were revealed by this method. Early therapeutic measures may now be feasible. We discuss the possibilities for surveillance of these families without causing discomfort to the group involved.

Topics: Adolescent; Adult; Aged; Carotid Arteries; Diphosphonates; Female; Head and Neck Neoplasms; Humans; Male; Methods; Middle Aged; Paraganglioma, Extra-Adrenal; Paralysis; Pedigree; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate