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

Osteosarcoma is a cancer characterized by formation of bone by malignant cells. Routine bone scan imaging with Tc-99m-MDP is done at diagnosis to evaluate primary tumor uptake and check for bone metastases. At time of relapse the Tc-99m-MDP bone scan also provides a specific means to assess formation of bone by malignant osteosarcoma cells and the potential for bone-seeking radiopharmaceuticals to deliver radioactivity directly into osteoblastic osteosarcoma lesions. This chapter will review and compare a bone-seeking radiopharmaceutical that emits beta-particles, samarium-153-EDTMP, with an alpha-particle emitter, radium-223. The charged alpha particles from radium-223 have far more mass and energy than beta particles (electrons) from Sm-153-EDTMP. Because radium-223 has less marrow toxicity and more radiobiological effectiveness, especially if inside the bone forming cancer cell than samarium-153-EDTMP, radium-223 may have greater potential to become widely used against osteosarcoma as a targeted therapy. Radium-223 also has more potential to be used with chemotherapy against osteosarcoma and bone metastases. Because osteosarcoma makes bone and radium-223 acts like calcium, this radiopharmaceutical could possibly become a new targeted means to achieve safe and effective reduction of tumor burden as well as facilitate better surgery and/or radiotherapy for difficult to resect large, or metastatic tumors.

Topics: Antineoplastic Agents; Bone Neoplasms; Humans; Lung Neoplasms; Molecular Targeted Therapy; Organometallic Compounds; Organophosphorus Compounds; Osteosarcoma; Radionuclide Imaging; Radiopharmaceuticals; Radium; Technetium Tc 99m Medronate

Skeletal metastases are one of the major clinical problems for the oncologist. Over the last several decades bone scintigraphy has been used extensively in detecting bone involvement since it can provide information about disease location, prognosis and the effectiveness of treatment. Bone scan offers the advantage of total body examination, and images bone lesions earlier than other techniques. In this paper the main clinical problems related to the most common applications of bone scan in breast, prostate, lung cancer and other tumours are discussed. The experience carried out at the National Cancer Institute of Milan by using bone SPECT to detect single bone metastases is reported. One hundred and eighteen patients with bone metastases (from different tumour types: breast, lung, prostate, lymphomas, etc.) were studied by planar scintigraphy, SPECT and other radiological modalities (CT, MRI or X-rays). The overall performances of bone SPECT were sensitivity: 90.5% (19/21), specificity 92.8% (90/97), positive predictive value 73% (19/26), negative predictive value 97.8% (90/92), accuracy 92.4% (109/118). Considering breast cancer, the most frequent pathology in our series, and the lumbar spinal tract, the most common skeletal segment involved, the figures of merit of SPECT were: sensitivity 100% (4/4), specificity 95.3% (41/43), positive predictive value 66.7% (4/6), negative predictive value 100% (41/41), accuracy 95.7% (45/47). In conclusion bone SPECT showed very good performances, in particular improving the predictive value of planar scan in the diagnosis of vertebral metastases.

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Female; Humans; Lung Neoplasms; Male; Predictive Value of Tests; Prostatic Neoplasms; Radiopharmaceuticals; Sensitivity and Specificity; Spinal Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Bone metastases are extremely rare in patients with classical Wilms' tumor (WT). We describe the clinical and radiologic features, treatment and outcome of three patients with WT (one with favorable histology and two with anaplasia) in whom bone metastases were detected at diagnosis or relapse. Bone metastases were documented by skeletal radiographs, computed tomography and/or bone scintigraphy. The patient with favorable histology WT had no evidence of pulmonary metastases and is now free of disease following aggressive chemotherapy and radiotherapy.

Topics: Biopsy, Needle; Bone Neoplasms; Child; Child, Preschool; Humans; Infant; Kidney Neoplasms; Lung Neoplasms; Male; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Wilms Tumor

After left lower lobe lobectomy for lung carcinoma, a patient had acute respiratory failure secondary to pneumonia and pulmonary embolism requiring a ventilator. Tc-99m HMDP bone scan showed diffuse, intense hepatic uptake. Concurrent liver enzymes indicated hepatic necrosis. Two weeks later the patient died and a limited chest autopsy confirmed acute adult onset respiratory distress syndrome. Etiologic factors of massive hepatic necrosis in relation to hepatic localization of bone imaging agent and its prognostic outcome are discussed.

Topics: Aged; Bone and Bones; Humans; Hypoxia; Liver; Lung Neoplasms; Male; Necrosis; Postoperative Complications; Pulmonary Embolism; Radionuclide Imaging; Respiratory Distress Syndrome; Respiratory Insufficiency; Technetium Tc 99m Medronate

A healthy elderly white man was admitted for right inguinal herniorrhaphy. Preoperative chest x-ray revealed a large mass in the lower lobe of the left lung. CT-directed needle biopsy was nondiagnostic. Technetium-99m methylene diphosphonate (99mTc-MDP) bone scan revealed intense soft-tissue activity in the lower left hemithorax with no evidence of abnormal activity in the osseous skeleton. Because of the degree of uptake in the lesion, a presumptive diagnosis of extraosseous osteogenic sarcoma was made. The patient had a left lower lobectomy and the lesion was diagnosed as an osteosarcoma of primary pulmonary origin.

Topics: Aged; Humans; Lung Neoplasms; Male; Osteosarcoma; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Aged; Bone Neoplasms; Diphosphonates; Female; Histiocytoma, Benign Fibrous; Humans; Lung Neoplasms; Male; Radionuclide Imaging; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; 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

Bone metastases are assumed to be rare in carcinoid disease and to be associated mainly with bronchial primaries. The aim of the present study was to evaluate the occurrence of bone metastases in patients with metastatic carcinoid tumours, and the role of various nuclear medicine modalities (bone scintigraphy, (111)In-pentetreotide and (131)I-MIBG) in its detection and clinical management. Nine (2 women, 7 men, median age 65 years) out of 86 consecutive carcinoid patients treated between 1987 and 1998 developed bone metastases (10%) with a median interval of 37 months between the diagnosis of metastatic carcinoid and bone metastases. Seven of them had non-bronchial primaries. (111)In-pentetreotide scintigraphy failed to detect the bone lesions in 50% of the cases, and (131)I-meta-iodobenzylguanidine(MIBG) scintigraphy in almost 80% of cases. Standard bone scintigraphy, however, was positive in all. Pain relief of bone metastases by means of radiation therapy was obtained in 5 of 6 patients. In another patient palliation of pain symptoms was obtained with Rhenium-186-hydroxyethylidene diphosphonate. Octreotide, Interferon of MIBG were ineffective for this purpose. It is concluded that bone metastases in carcinoid patients may be missed on (131)I-MIBG and (111)In-pentetreotide scintigraphy. Bone scintigraphy is a sensitive imaging technique. Diagnostic nuclear medicine modalities may be helpful in the clinical management of carcinoid disease.

Topics: 3-Iodobenzylguanidine; Aged; Aged, 80 and over; Appendiceal Neoplasms; Bone Neoplasms; Carcinoid Tumor; False Negative Reactions; Female; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasms, Unknown Primary; Octreotide; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Rectal Neoplasms; Technetium Tc 99m Medronate

Despite advances in morphological imaging, some patients with non-small cell lung cancer (NSCLC) are found to have non-resectable disease at surgery or die of recurrence within a year of surgery. At present, metastatic bone involvement is usually assessed using conventional technetium-99m methylene diophosphate (Tc-99m MDP) whole body bone scan (bone scan), which has a high sensitivity but a poor specificity. We have attempted to evaluate the usefulness of whole body positron emission tomography with 18F-2-deoxyglucose (FDG-PET) for the detection of malignant bone metastases of NSCLC, and to compare FDG-PET results with Bone Scan findings. Forty-eight patients with biopsy-proven NSCLC and suspected to have stage IV disease underwent whole body bone scan and FDG-PET to detect bone metastases. The final diagnoses of bone metastases were established by operative, histopathological findings or clinical follow-up longer than 1 year by additional radiographs or following FDG-PET/Tc-99m MDP bone scan findings showing progressively and extensively widespread bone lesions. A total of 138 bone lesions found on either FDG-PET or Tc-99m MDP bone scan were evaluated. Among the 106 metastatic and 32 benign bone lesions, FDG-PET and Tc-99m MDP bone scan could accurately diagnose 99 and 98, as well as 30 and 2 metastatic and benign bone lesions, respectively. Diagnostic sensitivity and accuracy of FDG-PET and Tc-99m MDP bone scan were 93.4% and 92.5%, as well as 93.5% and 72.5%, respectively. In conclusion, our data suggest that FDG-PET with the same sensitivity and a better accuracy than those of Tc-99m MDP bone scan to detect metastatic bone lesions in patients with biopsy-proven NSCLC and suspected to have stage IV disease.

Topics: Adult; Aged; Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Whole-Body Irradiation

Radionuclide bone scanning (RNB) is considered to be the most practical screening technique for assessing the entire skeleton for skeletal metastases. However, RNB has been shown to be of lower sensitivity than MRI and CT in detecting osteolytic metastases. A prospective study was designed to evaluate the accuracy of planar RNB versus tomographic bone imaging with 18F-labeled NaF and PET (18F PET) in detecting osteolytic and osteoblastic metastases and its dependency on their anatomic localization.. Forty-four patients with known prostate, lung or thyroid carcinoma were examined with both planar RNB and 18F PET. A panel of reference methods including MRI of the spine, 1311 scintigraphy, conventional radiography and spiral CT was used as the gold standard. RNB and 18F PET were compared by a lesion-by-lesion analysis using a five-point score for receiver operating characteristic (ROC) curve analysis.. 18F PET showed 96 metastases (67 of prostate carcinoma and 29 of lung or thyroid cancer), whereas RNB revealed 46 metastases (33 of prostate carcinoma and 13 of lung or thyroid cancer). All lesions found with RNB were also detected with 18F PET. Compared with 18F PET and the reference methods, RNB had a sensitivity of 82.8% in detecting malignant and benign osseous lesions in the skull, thorax and extremities and a sensitivity of 40% in the spine and pelvis. The area under the ROC curve was 0.99 for 18F PET and 0.64 for RNB.. 18F PET is more sensitive than RNB in detecting osseous lesions. With RNB, sensitivity in detecting osseous metastases is highly dependent on anatomic localization of these lesions, whereas detection rates of osteoblastic and osteolytic metastases are similar. Higher detection rates and more accurate differentiation between benign and malignant lesions with 18F PET suggest the use of 18F PET when possible.

Topics: Bone Neoplasms; False Negative Reactions; Fluorine Radioisotopes; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Male; Prospective Studies; Prostatic Neoplasms; Radiopharmaceuticals; Sodium Fluoride; Technetium Tc 99m Medronate; Thyroid Neoplasms; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

201Tl-Chloride scintigraphy (early and delayed images) was performed in 40 patients with suspected metastatic bone lesions. The sensitivity and specificity of 201Tl scanning for detecting metastatic bone lesions were 66.7% and 77.4%, respectively. The uptake ratio of 201Tl per voxel of the lesions to the normal site was significantly different between the metastatic bone lesion and benign lesions. In 20 sites of 15 patients, 201Tl-Chloride scintigraphy was performed before and after radio- or radiothermotherapy. There was a significant difference in the mean uptake ratios in the early and delayed scans between before and after therapy. The mechanism of intracellular uptake of 201Tl is considered to be one of active transport, which might make 201Tl an accurate indicator of the viability of tumor cells and metabolic activity as long as there is sufficient blood flow to prompty transport 201Tl to tumor cells. Thus it would seem that decreased uptake of 201Tl and change in retention index after therapy depends partially on tumor blood flow. In conclusion, 201Tl-Chloride scintigraphy is very useful not only for clinically detecting metastatic bone lesions but also for assessing the therapeutic effects.

Topics: Aged; Aged, 80 and over; Bone and Bones; Bone Neoplasms; Diagnosis, Differential; Humans; Lung Neoplasms; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Medronate; Thallium; Thallium Radioisotopes

This was a prospective multicenter clinical trial (NCT03689439). Patients with cT1N0 subsolid nodules who were candidates for surgical resection were consecutively enrolled into the study. BS was performed preoperatively. The surgical plan could be changed if a positive result was detected. The primary endpoint was the incidence rate of the surgical plan being changed because of positive BS results. The secondary endpoint was the rate of positive BS findings and the rate of related complications.. From November 2018 to July 2019, 691 patients were enrolled into the study. None of the patients had positive BS results and no surgical plans were changed by BS findings. There were 222 male and 469 female patients. The average age was 54.8 ± 3.7 years old. The average tumor diameter was 14.9 ± 4.2 mm. There were 282 patients with pure GGO nodules and 409 with part-solid nodules. A total of 470 patients had a single nodule, while 221 patients had multifocal lesions. The number of patients whose pathological diagnosis was invasive adenocarcinoma, minimally invasive adenocarcinoma, adenocarcinoma in situ and mucinous adenocarcinoma was 357, 293, 32 and nine, respectively. The number of patients who underwent lobectomy, segmentectomy and wedge resection was 234, 199 and 258, respectively.. SIGNIFICANT FINDINGS OF THE STUDY: In this prospective study of 691 patients with cT1N0 subsolid lung cancer, no surgical plans were affected by positive bone scan findings.. We suggest physicians consider canceling BS from preoperative workup for cT1 subsolid lung cancer patients. Clinical trial registry number: NCT03689439.

Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Lung Neoplasms; Male; Middle Aged; Preoperative Period; Prospective Studies; Technetium Tc 99m Medronate

Radionuclide bone scintigraphy with technetium-99m-methylene diphosphonate is the commonest procedure in nuclear medicine. It is an effective diagnostic tool in staging of primary bone tumours since long. It is not only helpful to confirm the radiologic features of malignant bone tumours but also demonstrates skeletal metastasis and soft tissue involvement. Computed tomography (CT) combined with single-photon emission computed tomography (SPECT/CT) give better insight to localize and categorize the lesions. We describe an interesting image of chondrosarcoma showing anatomical extent of primary tumour and multifocal uptake in the chest conforming to underlying widespread partially calcified pulmonary metastases.

Topics: Bone Neoplasms; Chondrosarcoma; Female; Humans; Lung Neoplasms; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Single Photon Emission Computed Tomography Computed Tomography; Technetium Tc 99m Medronate

A 39-year-old woman with a history of pulmonary neuroendocrine carcinoma segmental palliative resection underwent a Tc-MDP bone scintigraphy to evaluate possible osseous metastases. The static images revealed diffuse elevated activity in the left hemithorax, more prominent in the lower thorax, which is suggestive of malignant pleural effusion. However, SPECT/CT images showed that the elevated activity was from pleura-based soft tissue masses, which were confirmed as recurrent tumor pathologically after biopsy.

Topics: Adult; Carcinoma, Neuroendocrine; Female; Humans; Lung Neoplasms; Pleural Neoplasms; Radiopharmaceuticals; Technetium Tc 99m Medronate

A 63-year-old woman initially presented with progressive left foot pain for 3 months, not responding to conservative management. MRI of the left foot showed a suspicious lesion in calcaneus. An open biopsy was consistent with metastatic lung adenocarcinoma. Tc-MDP total-body bone scintigraphy was ordered for possible other bony lesions, and only left calcaneus lesion was identified on bone scan. CT scan of the chest revealed a soft tissue mass in the superior aspect of the right lower lobe. Staging FDG PET/CT showed hypermetabolic right lung mass and left calcaneus lesion. She received chemotherapy and local radiation to the left calcaneus metastatic lesion.

Topics: Adenocarcinoma; Adenocarcinoma of Lung; Bone Neoplasms; Calcaneus; Female; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Middle Aged; Multimodal Imaging; Pain; Positron-Emission Tomography; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

A 6-year-old castrated Goldendoodle dog was presented for left-sided lameness of 3 weeks' duration. Focal, moderate to marked increased

Topics: Animals; Bone Neoplasms; Dog Diseases; Dogs; Fatal Outcome; Femur; Hair Diseases; Lameness, Animal; Lung Neoplasms; Male; Pilomatrixoma; Radionuclide Imaging; Scapula; Skin Neoplasms; Technetium Tc 99m Medronate

A 49-year-old man was admitted to a hospital with chest pain and polyarthralgia. Chest radiography showed abnormal findings, and chest computed tomography showed a mass in the right lung. A transbronchial lung biopsy led to a diagnosis of anaplastic lymphoma kinase (ALK)-positive adenocarcinoma. Bone scintigraphy revealed bilateral symmetrical accumulations of (99m)Technetium complexes in the long bones, suggesting co-existing hypertrophic pulmonary osteoarthropathy (HPO). The patient underwent four courses of chemotherapy with cisplatin plus pemetrexed, which led to decreased (99m)Technetium accumulations in the long bones. To the best of our knowledge, this is the first reported case of HPO associated with ALK-positive lung cancer.

Topics: Adenocarcinoma; Anaplastic Lymphoma Kinase; Bone and Bones; Chest Pain; Humans; Lung Neoplasms; Male; Middle Aged; Osteoarthropathy, Secondary Hypertrophic; Positron-Emission Tomography; Receptor Protein-Tyrosine Kinases; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Treatment Outcome

99mTc-3PRGD2, a promising tracer targeting integrin receptor, may serve as a novel tumor-specific agent for single photon emission computed tomography (SPECT). A multi-center study was prospectively designed to evaluate the diagnostic accuracy of 99mTc-3PRGD2 imaging for bone metastasis in patients with lung cancer in comparison with the conventional 99mTc-MDP bone scan.. The patients underwent whole-body scan and chest tomography successively at both 1 h and 4 h after intravenous injection of 11.1 MBq/Kg 99mTc-3PRGD2. 99mTc-MDP whole-body bone scan was routinely performed within 1 week for comparison. Three experienced nuclear medicine physicians blindly read the 99mTc-3PRGD2 and 99mTc-MDP images. The final diagnosis was established based on the comprehensive assessment of all available data.. A total of 44 patients (29 male, 59±10 years old) with suspected lung cancer were recruited from 4 centers. Eighty-nine bone lesions in 18 patients were diagnosed as metastases and 23 bone lesions in 9 patients were benign. In a lesion-based analysis, 99mTc-3PRGD2 imaging demonstrated a sensitivity, specificity, and accuracy of 92.1%, 91.3%, and 92.0%, respectively. The corresponding diagnostic values for 99mTc-MDP bone scan were 87.6%, 60.9%, and 82.1%, respectively in the same patients. 99mTc-MDP bone scan had better contrast in most lesions, whereas the 99mTc-3PRGD2 imaging seemed to be more effective to exclude pseudo-positive lesions and detect bone metastases without osteogenesis.. 99mTc-3PRGD2 is a novel tumor-specific agent based on SPECT technology with a promising value in diagnosis of bone metastasis in patients with lung cancer.. ClinicalTrials.gov NCT01737112.

Topics: Aged; Bone Neoplasms; Female; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Peptides, Cyclic; Technetium Tc 99m Medronate; Time Factors; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

We present a case of a 15-year-old boy with osteoblastic osteosarcoma of the left distal femur. The patient was referred to bone scan for initial staging. On planar bone scan, there is increased uptake of 99mTc-MDP (99mTc-methylene diphosphonate) in the left distal femur. There are also multiple sites of abnormal tracer uptake projecting to the thoracic cage, initially assumed to be localized in the ribs. SPECT/CT correctly identified them as pulmonary metastases. This case illustrates the potential advantages and utility of SPECT/CT imaging of skeletal bone scan in order to decide on the optimal treatment.

Topics: Adolescent; Diagnosis, Differential; Femur; Humans; Lung Neoplasms; Male; Osteosarcoma; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Whole Body Imaging

Bone extraction and division can enhance the accuracy of diagnoses based on whole-body bone SPECT data. This study developed a method for using conventional SPECT for automatic recognition of the vertebral column. A novel feature of the proposed approach is a novel "bone graph" image description method that represents the connectivity between these image regions to facilitate manipulation of morphological relationships in the skeleton before surgery. By tracking the paths shown on the bone graph, skeletal structures can be identified by performing morphological operations. The performance of the method was evaluated quantitatively and qualitatively by two experienced nuclear medicine physicians. Datasets for whole-body bone SPECT scans in 46 lung cancer patients with bone metastasis were obtained with Tc-99m MDP. The algorithm successfully segmented vertebrae in the thoracolumbar spine. The quantitative assessment shows that the segmentation method achieved an average TP, FP, and FN rates of 95.1%, 9.1%, and 4.9%. The qualitative evaluation shows an average acceptance rate of 83%, where the data for the acceptable and unacceptable groups had a Cronbach's alpha value of 0.718, which indicated reasonable internal consistency and reliability.

Topics: Algorithms; Bone and Bones; Bone Neoplasms; Computational Biology; Humans; Lung Neoplasms; Radiographic Image Interpretation, Computer-Assisted; Radiopharmaceuticals; Spine; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Whole Body Imaging

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

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

Topics: Aged; Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Multimodal Imaging; Positron-Emission Tomography; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

The aim of this study was to compare the diagnostic ability of (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) with that of (99m)Tc-methylene diphosphonate ((99m)Tc-MDP) bone scan for bone metastasis in staging patients with small cell lung cancer (SCLC).. Ninety-five patients with SCLC who underwent both (18)F-FDG PET/CT and (99m)Tc-MDP bone scan for initial staging work-up were retrospectively enrolled. All (18)F-FDG PET/CT and bone scan images were visually assessed. Bone metastasis was confirmed by histopathological results and all available clinical information.. Of 95 patients with SCLC, metastatic bone lesions were found in 30 patients, and 84 metastatic lesions were evaluated on a lesion-basis analysis. The sensitivity of (18)F-FDG PET/CT was 100 % on a per-patient basis and 87 % on a per-lesion basis, and there was no false-positive lesion on PET/CT images. In contrast, the sensitivity of the bone scan was 37 % on a per-patient basis and 29 % on a per-lesion basis. The bone scan showed 11 false-positive lesions. The bone scan detected two metastatic lesions that were not detected by PET/CT, which were outside the region scanned by PET/CT. On follow-up bone scan, 21 lesions that were not detected by the initial bone scan but were detected by PET/CT were newly detected.. In patients with SCLC, (18)F-FDG PET/CT showed higher detection rate of bone metastasis than (99m)Tc-MDP bone scan. Thus, (18)F-FDG PET/CT can replace bone scan in staging patients with SCLC.

Topics: Aged; Bone and Bones; Bone Neoplasms; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Multimodal Imaging; Neoplasm Staging; Positron-Emission Tomography; Retrospective Studies; Sensitivity and Specificity; Small Cell Lung Carcinoma; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

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

Topics: Chondroma; Female; Humans; Lung Neoplasms; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Whole Body Imaging

At present, metastatic bone involvement is usually assessed using bone scintigraphy, which has a high sensitivity but a poor specificity. The objective of our study was to compare the sensibility of the 2-deoxy-2-[18F] fluoro-d-glucose positron emission tomography/computed tomography (F-18 FDG PET/CT) for the detection of bone metastasis in patients with non-small-cell lung cancer (NSCLC) whose technetium 99m methylenediphosphonate (Tc-99m MDP) bone scans were absolutely normal.. This study based on the retrospective analysis of 95 consecutive patients with histologically proven NSCLC who underwent F-18 FDG PET/CT and Tc-99m MDP bone scan at the Eskişehir Osmangazi University School of Medicine, Department of Nuclear Medicine between November 2006 and October 2008. Nineteen patients (19 of 95, 20%) with absolutely normal Tc-99m bone scan versus multiple high-grade F-18 FDG avid bony metastases on F-18 FDG PET/CT were selected for the review. Their ages ranged from 46 to 73 years (15 males and four females; mean: 57.2 years).. Nine patients had squamous cell carcinoma, six had adenocarcinoma, three had large cell carcinoma and one had adenosquamous cell carcinoma. Tc-99m MDP bone scan that did not reveal bony abnormalities or radiotracer uptake was characteristic of benign disease (defined as absolutely normal) in these patients. Whereas, F-18 FDG PET/CT not only showed extremely disseminated heterogeneous nest-like high-grade FDG avid metastatic foci within the marrow cavity of the upper and lower thoracic spine, lumbar spine, pelvis, rib cages and bilateral proximal long bones, but also showed disseminated osteolytic bony metastases in these areas.. Discordant findings of skeletal metastasis between Tc-99m MDP bone scans and F-18 FDG PET/CT imaging may be seen in 20% of the patients with NSCLC. F-18 FDG PET/CT could detect metastatic bone involvement more accurately than bone scintigraphy. Bone scans are insensitive to early bone marrow neoplastic infiltration. Assessment of glucose metabolism with FDG PET/CT can represent a more powerful tool to detect early bone metastases in lung cancer than with traditional bone scans.

Topics: Aged; Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; False Negative Reactions; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Positron-Emission Tomography; Radiopharmaceuticals; Retrospective Studies; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

To explore the image characteristics of bone metastasis of primary lung carcinoma.. Whole-body bone imaging ((99)Tc(m)-MDP) was performed in 258 patients with pathologically proven lung carcinoma. The rate of bone metastasis, distribution of the metastatic lesions and their characteristics were analyzed.. Among the 258 cases, 142 patients developed bone metastasis. The overall rate of bone metastasis was 55.0%. The metastases located in axial skeleton were 49.6%, appendicular skeleton 36.0%, trunk bones of the axial skeleton 48.4%, and appendicular girdle skeleton 31.4%. Ribs, thoracic vertebrae, ilium and lumbar vertebrae had a higher rate of bone metastasis, higher than 20%, respectively. 1252 lesions were detected including 406 at the left side of the body, 387 in the axial skeleton and 459 at the right side of the body. There was no significant difference in terms of number of lesions between left side and right side (chi(2) = 3.3, P = 0.072). 1224 bone metastatic foci (97.8%) were presented as strong radioactive, 26 (2.1%) mixed lesion, and 2 (0.2%) low radioactive. According to the shape of the lesions, there were 810 punctate lesions (71.5%), 159 (14.0%) lump form, 108 (9.5%) strip form and 56 (4.9%) lamellar form. The accumulative bone metastasis rate was 28.7% for the patients with one to three lesions. The metastasis rate decreased gradually with the increasing number of metastatic lesions.. Bone metastasis is very common in patients with lung cancer. Most bone metastases are characterized by strong radioactive and earlier punctate form, often occurs in the trunk bones of axial skeleton or appendicular girdles. The distribution of earlier metastases has not obvious regularity, and advanced bone metastases are often concurrent, multiple and multiform, widely and randomly distributed in the body.

Topics: Adenocarcinoma; Adenocarcinoma of Lung; Adult; Aged; Aged, 80 and over; Bone and Bones; Bone Neoplasms; Female; Humans; Lung Neoplasms; Male; Middle Aged; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Whole Body Imaging

Non-small cell lung carcinomas (NSCLCs) of the superior sulcus are considered to be the most challenging type of malignant thoracic disease. In this disease, neoplasms originating mostly from the extreme apex of the lung expand to the chest wall and thoracic inlet structures. Multiple imaging procedures have been applied to identify tumors and to stage and predict tumor resectability in surgical operations. Clinical examinations to localize pain complaints in shoulders and down the arms, and to screen for Horner's syndrome and abnormalities seen in paraclinical assessments, have been applied extensively for differential diagnosis of superior sulcus tumors. Although several types of imaging have been utilized for diagnosing and staging Pancoast tumors, there have been almost no reports on the efficiency of whole-body bone scans (WBBS) for detecting the level of abnormality in cases of superior sulcus tumors.. We describe a case of Pancoast tumor in which technetium-99m methylene diphosphonate (Tc-99m MDP) bone single-photon emission-computed tomography (SPECT) was able to accurately detect multiple areas of abnormality in the vertebrae and ribs. In describing this case, we stress the clinical and diagnostic points, in the hope of stimulating a higher degree of suspicion and thereby facilitating appropriate diagnosis and treatment. From the results of this study, further clinical trials to evaluate the potential of SPECT as an efficient imaging tool for the work-up on cases of Pancoast tumor are recommended.

Topics: Aged; Carcinoma, Non-Small-Cell Lung; Humans; Lung Neoplasms; Male; Pancoast Syndrome; Radiopharmaceuticals; Spine; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Bone metastasis is one of the most common clinical phenomena of late stage lung cancer. A major impediment to understanding the pathogenesis of bone metastasis has been the lack of an appropriate animal and cell model. This study aims to establish human lung adenocarcinoma cell line with highly bone metastases potency with (99m)Tc-MDP bone scintigraphy.. The human lung adenocarcinoma cancer cells SPC-A-1 were injected into the left cardiac ventricle of NIH-Beige-Nude-XID (NIH-BNX) immunodeficient mice. The metastatic lesions of tumor-bearing mice were imaged with (99m)Tc-MDP bone scintigraphy on a Siemens multi-single photon emission computed tomography. Pinhole images were acquired on a GZ-B conventional gamma camera with a self-designed pinhole collimator. The mice with bone metastasis were sacrificed under deep anesthesia, and the lesions were resected. Bone metastatic cancer cells in the resected lesions were subjected for culture and then reinoculated into the NIH-BNX mice through left cardiac ventricle. The process was repeated for eight cycles to obtain a novel cell subline SPC-A-1BM. Real-time polymerase chain reaction (PCR) was used to compare the gene expression differences in the parental and SPC-A-1BM cells.. The bone metastasis sites were successfully revealed by bone scintigraphy. The established bone metastasis cell line SPC-A-1BM had a high potential to metastasize in bone, including mandible, humerus, thoracic vertebra, lumbar, femur, patella, ilium and cartilage rib. The expression level of vascular endothelial growth factor gene family, Bcl-2 and cell adhesion-related genes ECM1, ESM1, AF1Q, SERPINE2 and FN1 were examined. Gene expression difference was found between parental and bone-seeking metastasis cell SPC-A-1BM, which indicates SPC-A-1BM has metastatic capacity vs. its parental cells.. SPC-A-1BM is a bone-seeking metastasis human lung adenocarcinoma cell line. Bone scintigraphy may be used as an accurate, sensitive, noninvasive tool to detect experimental bone metastases in intact live NIH-BNX mice.

Topics: Adenocarcinoma; Animals; Bone and Bones; Bone Neoplasms; Cell Line, Tumor; Humans; Lung Neoplasms; Mice; Polymerase Chain Reaction; Technetium Tc 99m Medronate; Time Factors; Tomography, Emission-Computed, Single-Photon; Whole Body Imaging

Bone scan (BS) and serum alkaline phosphatase (ALP) concentration are used to detect bone metastasis in malignancy, although whole-body fluoro-D-glucose positron emission tomography computed tomography (FDG PET/CT) is being used increasingly. But BS is still used for the detection of metastatic bone lesion. So we compared the usefulness of PET/CT, BS, and serum ALP in detecting bone metastases in patients with newly diagnosed lung cancer. The medical record database was queried to identify all patients with a new diagnosis of lung cancer between January 2004 and December 2005, who had a PET/CT, BS, and serum ALP before treatment. We retrospectively reviewed all patients' records and radiological reports. One hundred eighty-two patients met the inclusion criteria. Bone metastases were confirmed in 30 patients. The sensitivity values were 93.3% for PET/CT, 93.3% for BS, 26.7% for serum ALP concentration, and 26.7% for BS complemented with serum ALP concentration. The respective specificity values were 94.1%, 44.1%, 94.1%, and 97.3%. The kappa statistic suggested a poor agreement among the three modalities. FDG PET/CT and BS had similar sensitivity, but PET/CT had better specificity and accuracy than BS. PET/CT is more useful than BS for evaluating bone metastasis. However, in the advanced stage, because of its high specificity, BS complemented with serum ALP is a cost-effective modality to avoid having to use PET/CT.

Topics: Aged; Alkaline Phosphatase; Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Medical Records; Middle Aged; Neoplasm Staging; Positron-Emission Tomography; Radiopharmaceuticals; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Whole Body Imaging

The aim of the study was to compare the diagnostic accuracy of (18)F-fluorodeoxyglucose (FDG) PET/CT versus standard planar bone scintigraphy (BS) and (18)F-labelled NaF ((18)F) PET for the detection of bone metastases (BM) in non-small cell lung cancer (NSCLC).. (18)F-FDG PET/CT was performed in 126 patients with NSCLC. Within 7 days BS (n = 58) or (18)F PET (n = 68) was performed. (18)F-FDG PET/CT, BS and (18)F PET were evaluated by two experienced readers. Lesions were graded on a scale from 1 (definite BM) to 5 (degenerative lesion), and equivocal lesions were determined as indifferent (grade 3).. A total of 92 patients showed degenerative lesions (grade 4/5) on PET/CT, BS or (18)F PET. In 34 patients (27%) BM lesions were diagnosed (grades 1 and 2). In 13 of 18 patients BM were concordantly diagnosed with PET/CT and (18)F PET. PET/CT showed more BM compared to (18)F PET (53 vs 40). In one patient one osteolytic BM was false-negative on (18)F PET. However, (18)F PET identified four patients with BM compared to negative findings on PET/CT. Of 16 patients, 11 had concordant findings of BM on PET/CT and BS. In three patients BS was false-negative and in two patients BM were diagnosed as indifferent.. Integrated (18)F-FDG PET/CT is superior to BS in the detection of osteolytic BM in NSCLC. Thus, PET/CT may obviate the need to perform additional BS or (18)F PET in the staging of NSCLC, which significantly reduces costs.

Topics: Bone and Bones; Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Fluorides; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Positron-Emission Tomography; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

We present a 73-year-old man with a new diagnosis of right upper lung adenocarcinoma. Right elbow x-ray and Tc-99m MDP whole body bone scan were performed due to a reddish, swollen, and painful right forearm for 1 week. X-ray, performed on March 25, 2008, showed an osteolytic lesion in the proximal right radius with surrounding soft tissue swelling. Tc-99m whole body bone scan, performed on March 19, 2008, had shown a single area of intense tracer uptake in the proximal right radius and no other bony lesion was identified. Infectious processes were considered initially, but the clinical symptoms and signs didn't improve after antibiotic treatment for 10 days. Incisional biopsy of the proximal right forearm was performed for diagnosis. Histopathologic examination confirmed a bone metastasis in the proximal right radius.

Topics: Adenocarcinoma; Aged; Bone Neoplasms; Humans; Lung Neoplasms; Male; Radiography; Radionuclide Imaging; Radius; Technetium Tc 99m Medronate; Whole Body Imaging

Topics: Bone Neoplasms; Female; Gated Blood-Pool Imaging; Humans; Incidental Findings; Lung Neoplasms; Middle Aged; Pulmonary Circulation; Radiopharmaceuticals; Small Cell Lung Carcinoma; Technetium Tc 99m Medronate

Topics: Aged; Bone Neoplasms; Diagnosis, Differential; Female; Humans; Lung Neoplasms; Osteoarthropathy, Secondary Hypertrophic; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

The aim of the study was to evaluate the value of the single photon emission computed tomography/computed tomography (SPECT/CT) fusion imaging in the diagnosis of benign and malignant lesions in bones.. One hundred and forty one bone lesions of 125 cancer patients, for whom the natures of the lesions were not able to be determined by the 99Tc(m)-MDP whole-body bone scan, were examined by the SPECT, CT and SPECT/CT fusion imaging simultaneously. All of the images were blindly interpreted independently by two experienced nuclear medicine physicians. The natures of the lesions were eventually confirmed by MRI, pathology or follow-up diagnosis six months later.. The diagnostic sensitivity of SPECT, SPECT+CT and SPECT/CT for the 141 bone lesions was 82.5%, 93.7%, and 98.4% respectively. The specificity was 66.7%, 80.8%, and 93.6% respectively. The accuracy was 73.8%, 86.5%, and 95.7% respectively. The specificity and accuracy of SPECT/CT for diagnosing bone lesions were significantly higher than those of SPECT and SPECT+CT (P<0.05).. SPECT/CT can effectively differentiate benign and malignant bone lesions.

Topics: Adult; Aged; Aged, 80 and over; Bone Neoplasms; Breast Neoplasms; Female; Humans; Lung Neoplasms; Male; Middle Aged; Prostatic Neoplasms; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Bone Neoplasms; Humans; Lung Neoplasms; Male; Metatarsal Bones; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Adenocarcinoma; Calcinosis; Chronic Disease; Female; Humans; Hypercalcemia; Hyperparathyroidism; Kidney Failure, Chronic; Lung; Lung Neoplasms; Middle Aged; Ossification, Heterotopic; Peritoneal Dialysis, Continuous Ambulatory; Radiopharmaceuticals; Respiratory Function Tests; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Whole Body Imaging

Traditionally, Tc 99m methyl diphosphate (MDP) bone scintigraphy provides high-sensitivity detection of skeletal metastasis from breast and lung cancers in regular follow-up. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), based on the glucose metabolism of malignant cells, plays a role in describing tumor growth, proliferation of neoplasm and the extent of metastasis. In general, concordant findings of skeletal metastasis are seen on both types of image, especially in cases of breast and lung cancer. However, there were extremely discordant findings of skeletal metastasis between bone scans and F 18 FDG PET/CT imaging in two cases among 300 consecutive F 18 FDG PET/CT follow-up exams of patients with malignancies, during the past year, in our center. Both cases, one of breast cancer and one of lung cancer, had negative bone scintigraphic findings, but a diffusely high grade of F 18 FDG avid marrow infiltration in the axial spine, leading to the diagnosis of stage IV disease in both cases. Owing to variant genetic aberrance of malignance, F 18 FDG PET/CT reveals direct evidence of diffuse, rapid neoplasm metabolism in the bone marrow of the spine, but not of secondary osteoblastic reactions in vivo . F 18 FDG PET/CT should always be employed in the follow-up of patients with malignancies.

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Positron-Emission Tomography; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Extraosseous uptake of Tc-99m MDP has been reported in various pathologic conditions. Because of the opportunity of make an additional diagnosis, extraskeletal distribution of tracer should be inspected in every case. Malignant peripheral nerve sheath tumor (MPNST) is a rare type of neurogenic tumor. Its main clinical manifestation is a mass with or without pain. MPNST can be seen in all 4 extremities, the trunk, head and neck regions, but most commonly occur in the thigh, buttocks, and supraclavicular regions. Presented here is a rare case of MPNST in which Tc-99m MDP uptake by the primary lesion and metastases were clearly demonstrated on bone scintigraphy.

Topics: Humans; Lung Neoplasms; Male; Middle Aged; Muscle Neoplasms; Muscle, Skeletal; Nerve Sheath Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Retroperitoneal Neoplasms; Technetium Tc 99m Medronate

Topics: Bone Neoplasms; Humans; Lung Neoplasms; Male; Middle Aged; Osteolysis; Osteosarcoma; Pleural Effusion, Malignant; Radionuclide Imaging; Radiopharmaceuticals; Ribs; Technetium Tc 99m Medronate

Initial staging of lung cancer is essential to determine the appropriate therapeutic strategy. 18F-FDG PET is currently considered to be the gold standard. 99mTc bisphonate bone scintigraphy has long been indicated to search for bone metastases but it is not know whether this exploration adds further information after an 18F-FDG PET scan. In order to answer this question, two observers unaware of the clinical situation reread PET scans and bone scintigraphies and results compared with other imaging findings. Between February 2001 and March 2004, 39 patients (13F, 26M, 62 +/- 11 yr) underwent 18FFDG PET and bone scintigraphy (mean interval 17 +/- 17 d). When the two explorations agreed for the diagnosis of bone extension, we considered that bone scintigraphy added nothing. When the two explorations were in disagreement, the other imaging examinations, the clinical features and laboratory results during the five-month minimal follow-up were used to establish the reference diagnosis. 18F-FDG PET and bone scintigraphy were in agreement in 29 patients (74%) with positive results in 12 (31%) and negative results in 17 (43%). The two explorations were in disagreement in 10 patients (26%). Among the five disagreement cases with positive bone scintigraphy and no bone anomaly on the 18F-FDG PET, the anomalies were benign and explained by clinical features (3 patients) or were not confirmed by the clinical course and laboratory results (2 patients). Among the 5 cases with a bone anomaly on the 18F FDG PET, no metastasis could be identified during clinical follow-up. Bone scintigraphy does not enable identification of any bone metastases which were not recognized on the PET scan and therefore should not be performed systematically. Using a computed tomography scan with the 18F-FDG PET could further limit the contribution of bone scintigraphy by providing more precision concerning foci identified on the PET scan.

Topics: Aged; Bone Neoplasms; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Observer Variation; Positron-Emission Tomography; Radiopharmaceuticals; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Medronate

A 25-year-old patient with osteosarcoma of the right distal femur underwent a bone scintigraphy with Tc-99m methylene diphosphonate (MDP). Whole-body bone scan revealed extensive metastatic disease in the abdominal region. Abdominal computerized tomography confirmed the presence of ascites and calcified masses on the greater omentum and peritoneal surfaces. Here we describe a case of unusual metastatic pattern of an osteosarcoma showing extensive intraabdominal metastases without prominent lung involvement after intensive chemotherapy.

Topics: Abdominal Neoplasms; Adult; Female; Femoral Neoplasms; Humans; Lung Neoplasms; Osteosarcoma; Radionuclide Imaging; Radiopharmaceuticals; Rare Diseases; Technetium Tc 99m Medronate

Accumulation of bone seeking radiopharmaceuticals in soft tissue of the chest has many causes. We report two cases of 99m-Tc-HMDP uptake respectively in the lung, in a patient with localized amyloidosis, and on diaphragmatic metastasis of a PNET. Mechanisms of such uptake are discussed.

Topics: Adult; Amyloidosis; Bone and Bones; Diaphragm; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Neuroectodermal Tumors, Primitive; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Bone Neoplasms; Humans; Lung Neoplasms; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Solitary Pulmonary Nodule; Somatostatin; Technetium Tc 99m Medronate; Whole-Body Counting

Topics: Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; False Negative Reactions; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Middle Aged; Positron-Emission Tomography; Radiopharmaceuticals; Subtraction Technique; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Adrenal Gland Neoplasms; Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Humans; Incidental Findings; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Two cases of primary pulmonary osteosarcoma are presented. In both cases, chest computed tomography revealed a calcified pulmonary mass and technetium-99m methylene diphosphonate bone scintigraphy showed intense uptake in the pulmonary mass. Primary pulmonary osteosarcoma was suspected on the basis of these radiographic findings. Microscopic examination of tumor specimens obtained by needle biopsy revealed histologic features of osteosarcoma, and this diagnosis was confirmed by postmortem examination of a second specimen in each case. Radiographic and histopathological findings enabled us to diagnose primary pulmonary osteosarcoma, which is one of the rarest types of cancer.

Topics: Aged; Biopsy, Needle; Diagnosis, Differential; Fatal Outcome; Humans; Lung Neoplasms; Male; Osteosarcoma; Radiography, Thoracic; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

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

Diffuse metastatic visceral calcification is rare in breast cancer. We report on a 57-year-old woman with breast cancer and hypercalcemia who had diffuse metastatic visceral calcifications on lungs, myocardium, stomach, and thyroid on a (99m)Tc-methylene diphosphonate bone scan. Visceral calcifications were completely resolved 6 months after successful anticancer and zoledronic acid treatments. Bone scanning offers a useful diagnostic tool for both identifying visceral calcification and assessing the response to therapy in chemosensitive malignities with hypercalcemia such as breast cancer.

Topics: Antineoplastic Agents; Bone and Bones; Breast Neoplasms; Calcification, Physiologic; Calcium; Diphosphonates; Female; Heart Neoplasms; Humans; Imidazoles; Lung Neoplasms; Middle Aged; Neoplasm Metastasis; Stomach Neoplasms; Technetium Tc 99m Medronate; Thyroid Neoplasms; Time Factors; Zoledronic Acid

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

Topics: Fractures, Bone; Humans; Lung Neoplasms; Male; Middle Aged; Osteoarthropathy, Secondary Hypertrophic; Radionuclide Imaging; Scaphoid Bone; Technetium Tc 99m Medronate; Whole-Body Counting

Accurate staging of cancer has a critical role in optimal patient management. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) is superior to CT in the detection of local and distant metastases in patients with non-small cell lung cancer. Although Tc-99 m methylene diphosphonate (MDP) bone scanning is well established in the evaluation of bone metastases, there are conflicting reports on the use of FDG PET in the evaluation of skeletal metastases. We report on a patient with locally advanced lung carcinoma in whom FDG PET accurately identified previously unsuspected widespread asymptomatic bone metastases (bone scan and X-rays negative, confirmed on MRI). Assessment of glucose metabolism with FDG PET might represent a more powerful tool to detect bone metastases in lung cancer compared with conventional bone scans.

Topics: Bone Neoplasms; Fatal Outcome; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed

Topics: Bone and Bones; Carcinoma, Non-Small-Cell Lung; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Bone Marrow Neoplasms; Carcinoma, Small Cell; Fluorodeoxyglucose F18; Humans; Ilium; Lung Neoplasms; Predictive Value of Tests; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed

The uptake of (99m)Tc-methylene diphosphonate (MDP) in malignant pleural effusions and, rarely, in nonmalignant pleural effusions has been well documented in the literature. Although the exact mechanism of uptake in these conditions remains unclear, there have been attempts to use the bone scintigraphic features of pleural effusion to predict sensitivity and specificity for malignancy based on pleural fluid cytology. It has been suggested that activity in the chest increases with an increase in effusion volume. We report here, however, a case of malignant pleural effusion, that showed reduced hemithoracic activity in contrast to the expected increased activity. Our experience highlights the need for an open and inquisitive mind to avoid diagnostic pitfalls when confronted with a bone scintigram showing reduced uptake unilaterally or bilaterally in the chest.

Topics: Aged; Bone and Bones; Bone Neoplasms; Humans; Lung Neoplasms; Male; Pleural Effusion, Malignant; Radionuclide Imaging; Radiopharmaceuticals; 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

Bone scintigraphy performed on a patient during the middle of radiation therapy for an inoperable left lung malignancy showed diffusely increased uptake in the thoracic vertebrae and relatively increased uptake in the ribs of the left thorax. This bone scan finding is apparently a transient phenomenon that occurs in response to irradiation and eventually leads to photon deficiency or photopenia of the vertebrae. However, this transiently increased uptake of the thoracic spine, compared with uptake in the lumbar spine, mimics diffusely decreased uptake or photopenia of the lumbar vertebrae and may be misinterpreted as an effect of irradiation of the abdominal region. In the case of asymmetric uptake between the thoracic and lumbar spine, a carefully taken history of the timing and location of irradiation is necessary to avoid misinterpretation.

Topics: Aged; Artifacts; Bone Neoplasms; Diagnosis, Differential; False Positive Reactions; Humans; Lung Neoplasms; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Thoracic Vertebrae

Topics: Bone Neoplasms; Chondrosarcoma; Diagnosis, Differential; Exostoses, Multiple Hereditary; Humans; Lung Neoplasms; Male; Middle Aged; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Whole-Body Counting

A 54-year-old man with bronchogenic adenocarcinoma had features of the hypertrophic osteoarthropathy syndrome. The syndrome is treated by surgical resection of the primary tumor, with rapid remission of the symptoms within 24 hours after surgery. In the case reported here, the tumor (T3N3M0) could not be resected. Clinical and scintigraphic regression of the hypertrophic osteoarthropathy was evident after chemotherapy. Bone scintigraphy is valuable when determining a patient's response to treatment for this paraneoplastic syndrome.

Topics: Bone and Bones; Carcinoma, Bronchogenic; Humans; Lung Neoplasms; Male; Middle Aged; Osteoarthropathy, Secondary Hypertrophic; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Bone and Bones; Breast Neoplasms; Female; Humans; Lung Neoplasms; Middle Aged; Pleural Effusion, Malignant; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

A 40-year-old woman presented with a known case of osteogenic sarcoma of the right leg and underwent below-the-knee amputation. The preoperative workup was negative for distant metastases, and the patient was followed regularly. Two years later she developed dyspnea and chest pain. Computed tomography revealed diffuse left lung metastases with pleural involvement and nodular metastases in the right lung. Tc-99m methylene diphosphonate whole-body bone scanning revealed the amputated right leg with a clean stump but with widespread metastases in the right thigh involving soft tissue and bone, and the pelvis, left femur, and skull. In addition, diffuse left lung metastases involving both parietal pleura and lung parenchyma were seen. Tc-99m methylene diphosphonate uptake has been observed in the soft tissue and lungs in patients with osteogenic sarcoma but is rarely observed in practice with this degree of aggressiveness.

Topics: Adult; Bone Neoplasms; Female; Humans; Lung Neoplasms; Osteosarcoma; Pleural Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Topics: Bone Neoplasms; Diagnosis, Differential; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Prostatic Neoplasms; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed

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: 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

Topics: Carcinoma, Non-Small-Cell Lung; Cartilage; Humans; Lung Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Ribs; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Topics: Adenocarcinoma; Aged; Bone and Bones; Female; Humans; Lung Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; 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

The authors report a case of alveolar soft-part sarcoma with lung metastases demonstrated by "double imaging" with Tc-99m HDP and Tc-99m MIBI. The tumor originated in the soft tissue with direct invasion to the right scapula, which was hypoactive on bone scan and hyperactive on Tc-99m MIBI images. A focus of dense accumulation of Tc-99m MIBI in the lungs, suggesting metastasis was also demonstrated.

Topics: Bone Neoplasms; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Sarcoma, Alveolar Soft Part; Scapula; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi

Topics: Adult; Female; Femoral Neoplasms; Humans; Lung Neoplasms; Osteosarcoma; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

A 63-year-old woman with previously treated stage I lung cancer was reexamined 5 years later for recurrence. A conventional work-up using computed tomographic scanning and transbronchial biopsy showed nothing abnormal. A Tc-99m depreotide scan, however, led to a noninvasive diagnosis of lung cancer recurrence with metastases, and it directed a noninvasive tissue diagnosis.

Topics: Adenocarcinoma; Bone Neoplasms; Female; Humans; Leg; Lung Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Scapula; Soft Tissue Neoplasms; Somatostatin; Technetium Tc 99m Medronate; Thoracic Vertebrae; Whole-Body Counting

The bone scan flare phenomenon, defined as an increase in the number or intensity of bone lesions with subsequent improvement while the patient is receiving chemotherapy, has been described in solid tumors including breast cancers and small-cell lung cancers. The purpose of this study was to verify the existence of the bone scintigraphic flare phenomenon in patients with non-small-cell lung cancer (NSCLC) during chemotherapy and thus determine the utility of bone scintigraphy in the follow-up of these patients.. Thirty-three patients with NSCLC with bone metastases and who had been treated with chemotherapy were included in the study. The outcome of bone scintigraphy was compared with that in other neoplastic sites.. The flare phenomenon was considered likely in 8 of the 33 patients. It was confirmed in two patients, invalidated in four, and remained doubtful in two.. The bone flare phenomenon occurs in NSCLC. It renders bone scintigraphy less useful in the evaluation of tumoral response in the patients in whom it is considered likely.

Topics: Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Disease Progression; False Positive Reactions; Follow-Up Studies; Humans; Lung Neoplasms; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Metastatic osteosarcoma most commonly affects the lungs and other bones. Hepatic metastasis at the time of diagnosis is extremely rare. A 14-year-old boy with synovial sarcoma of the left popliteal fossa was treated with surgical resection, radiotherapy for microscopic residual disease, and 1 year of chemotherapy (vincristine, cyclophosphamide, dactinomycin, and doxorubicin). Approximately 10 years after the initial diagnosis, a secondary osteosarcoma developed in the left proximal tibia. Computed tomography at presentation showed bilateral pulmonary metastases and large ossified nodules in the liver that demonstrated abnormal avidity on 99mTc MDP bone scan indicating hepatic metastasis. Despite chemotherapy (cisplatin, ifosfamide, high-dose methotrexate, and dacarbazine), the patient died of progressive disease 4 months after the diagnosis of the second cancer. Hepatic metastasis was found at the time of diagnosis of a secondary osteosarcoma and manifested as ossified nodules. The risk of radiation-induced osteosarcoma should always be considered in decisions about treatment for soft-tissue sarcoma.

Topics: Adolescent; Fatal Outcome; Humans; Liver Neoplasms; Lung Neoplasms; Male; Neoplasms, Radiation-Induced; Neoplasms, Second Primary; Ossification, Heterotopic; Osteosarcoma; Radiopharmaceuticals; Radiotherapy; Sarcoma, Synovial; Technetium Tc 99m Medronate; Tomography, Emission-Computed

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

Topics: Aged; Carcinoma, Small Cell; Humans; Lung Neoplasms; Male; Parietal Bone; Sensitivity and Specificity; Skull Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

The purpose of this study was to evaluate the radiographic findings of malignant fibrous histiocytoma (MFH) and to discuss the contribution of these findings to a differentiation of MFH from other malignant tumors of the head and neck.. Two cases of MFH of the maxillary sinus affecting the alveolar bone were evaluated radiographically and scintigraphically.. We reported the following findings, which have only seldom been described: the presence of fairly well-demarcated bone destruction in the intraoral radiograph; the relatively smooth surface, uniform density, or no necrotic area of the tumor; in computed tomograph images showing the clear separation of the tumor from surrounding soft tissues; bone scintigraphs reflecting the periosteal reaction to tumor invasion; and lymphoscintigraphy of the metastatic lymph nodes.. We evaluated the radiographic findings from 2 cases of MFH and describe findings that may aid in the differentiation of MFH. These radiographic features may help dentists differentiate MFH from other malignant tumors in the head and neck, although MFH is a rare disease and there are no radiographic findings that would indicate a specific diagnosis of MFH.

Topics: Alveolar Process; Citrates; Diagnosis, Differential; Female; Gallium; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Maxillary Neoplasms; Maxillary Sinus Neoplasms; Middle Aged; Neoplasm Invasiveness; Periosteum; Radiography, Panoramic; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Adolescent; Bone Neoplasms; Humans; Lung Neoplasms; Male; Neoplasm Recurrence, Local; Osteosarcoma; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tibia; Tomography, X-Ray Computed

Bone scintigraphy is widely used to detect bone metastasis owing to its high sensitivity, but solitary focus of increased uptake often causes diagnostic problem because of its low specificity. The purpose of this study was to assess the significance of solitary hot spot detected in patients with extraskeletal malignancies. We reviewed 1,167 consecutive bone scintigraphies of patients with history of lung, breast or prostatic cancer. There was 185 bone scans showing solitary hot spot (lung; 121, breast; 36, prostate; 28). Of the solitary hot spots, 30 (24.8%) in lung cancer, 8 (22.2%) in breast cancer, and 4 (14.3%) in prostatic cancer were a result of metastatic disease. There was no significant difference in the frequency of bone metastasis according to the site of primary tumor. It was relatively higher in the location of pelvis, scapula and thoracic spine. Clinical symptoms, particularly local bone pain, were helpful to diagnose the solitary hot spot.

Topics: Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Lung Neoplasms; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

The detection of bone metastases is important in the management of patients with lung cancer because bone metastasis has a major impact on the prognosis and choice of treatment modality. Bone scan has been widely used for early detection of bone metastases but its low specificity complicates confirmation of bone scan findings. To evaluate the effects of abnormal bone scan findings on the prognosis of patients with lung cancer, we retrospectively analyzed the effect of abnormal uptakes on the prognosis of patients with primary lung cancer. The overall survival of patients with abnormal bone uptake was not significantly different from those without abnormal uptake. However, the patients with more than two abnormal bone uptakes had significantly shorter survival than those with no abnormal uptake (P<0.05). To confirm the effect of abnormal bone uptakes on survival, we compared the survival curves of three patient groups without knowledge of bone scan findings: group A, stage I-IIIB with more than two abnormal bone uptakes (potential stage IV); group B, stage IIIB with no abnormal bone uptake (true stage IIIB); and group C, stage IV with no abnormal bone uptake. Group A revealed shorter survival than group B (P<0.05). But, there was no significant difference in survival times between group A and group C. In the Cox regression analysis, the presence of more than two abnormal bone uptakes was a significant prognostic factor (P=0.0277), together with performance status, stage, and albumin. These results suggest that one or two abnormal bone uptake at diagnosis did not affect overall survival of the patients, and that the patients with more than two abnormal bone uptakes are considered as clinical stage IV because of high probability of bone metastases.

Topics: Bone and Bones; Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Female; Humans; Lung Neoplasms; Male; Middle Aged; Prognosis; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Survival Rate; Technetium Tc 99m Medronate

The incidence of bone metastases in soft tissue sarcoma (STS) patients seems to be low but has not been studied separately. In this study, the authors aimed to determine the value of routine radionuclide bone scanning in preoperative staging of STS patients.. Preoperative bone scans were evaluated retrospectively in 109 consecutive patients (median age, 44 years; range, 1-86) with intermediate or high grade STS. Scans were scored in 3 categories: 1, metastases very likely; 2, equivocal; and 3, normal or benign lesions.. Category 1 scans were found in 8 of 109 patients (7%); in all 8 patients, bone metastases were confirmed. Six of these eight patients reported pain, and all had additional lung, bone marrow, or lymph node metastases. The highest rate (17%) was found in the rhabdomyosarcoma subgroup (n = 18). Category 2 (equivocal) scans were present in 12 of 109 patients (11%), in all of which bone metastases were excluded through additional investigations. Category 3 (normal) scans were found in 81%. Bone metastases were at least as frequent as lung metastases (4%) and were the single site of systemic disease in 4%. The rate of bone metastases was 55% in patients with bone pain versus 2% in patients without pain.. Bone metastases in primary STS patients are rare (7%) yet in this study at least as frequent as lung metastases. The low rate in asymptomatic patients versus the high rate in symptomatic patients supports the use of bone scanning in symptomatic patients only. The yield of routine bone scanning is low.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Marrow; Bone Neoplasms; Child; Child, Preschool; Female; Humans; Infant; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Pain; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Rhabdomyosarcoma; Sarcoma; Technetium Tc 99m Medronate

Considering the current need to improve cost-effectiveness in cancer patient management, a prospective study was undertaken in order to define the optimal combination of bone scan and tumour marker assays in breast and lung cancer strategies, as has been done in the case of prostate cancer. All patients with breast or lung cancer referred to the Nuclear Medicine Department of the Grenoble Teaching Hospital between December 1995 and April 1997 were included. A blood sample was drawn in each case for marker assay (CA15-3 or CEA and CYFRA 21-1) on the same day as the bone scan. Two hundred and seventy-five patients were included: 118 with lung cancer and 157 with breast cancer. With regard to lung cancer, no information useful for guiding bone scan prescription was obtained through CEA and CYFRA 21-1 assays. For breast cancer, the results suggest that in asymptomatic patients, a CA15-3 level of less than 25 U/ml (upper normal value chosen as the threshold) is strongly predictive of a negative bone scan; by contrast, high tumour marker levels are predictive of neoplastic bone involvement. When a doubtful bone scan is obtained in a patient with breast cancer, a normal marker level makes it highly probable that bone scan abnormalities are not related to malignancy.

Topics: Aged; Aged, 80 and over; Antigens, Neoplasm; Biomarkers, Tumor; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Breast Neoplasms, Male; Carcinoembryonic Antigen; Female; Humans; Keratin-19; Keratins; Lung Neoplasms; Male; Middle Aged; Mucin-1; Predictive Value of Tests; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

We present the bone scintigrams of two patients, which demonstrate diffuse extraosseous uptake of a bone agent in metastatic masses in the liver, one from a primary lung tumor and one from a primary breast tumor. The bone imaging agent did not localize in the brain metastases in these patients. CTs of the abdomen in both patients showed massive metastases in the liver with multiple areas of tumor necrosis. The CT of the abdomen of the breast cancer patient showed multiple small hepatic calcifications. Autopsy revealed massive tumor necrosis with calcifications in the enlarged liver. In routine bone scintigraphy, diffuse uptake of bone agents in the liver of a patient with a known malignancy should be considered suggestive of massive hepatic metastases.

Topics: Adenocarcinoma; Adult; Aged; Bone and Bones; Breast Neoplasms; Carcinoma, Small Cell; Female; Humans; Liver; Liver Neoplasms; Lung Neoplasms; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

We prospectively compared the ability of two techniques--bone scintigraphy with single-photon emission computed tomography (SPECT) of the chest and CT of the chest--to reveal potential osteosarcoma metastases of the lung.. Our study included 27 patients with osteosarcoma who prospectively underwent both bone scintigraphy with SPECT of the chest and CT of the chest. The imaging results were compared with outcome or pathologic analysis of any lung lesions found.. Eight (30%) of the 27 patients had pulmonary metastases. Four of these eight patients had positive results on both CT studies and bone SPECT studies, with additional lesions detected with bone SPECT in two of these four patients. The other four patients with pulmonary metastases had positive results on CT studies, whereas the results of bone SPECT studies remained negative. The results of bone SPECT studies were negative in the 19 patients without pulmonary metastases. CT, however, showed abnormalities in seven (37%) of the 19 patients, which were eventually attributed to benign conditions.. Negative results on a bone SPECT study of the chest should not be used to exclude the possibility of lung metastases. However, if the results are positive, a bone SPECT study can be used to confirm abnormalities seen on CT scans and may also reveal subtle lesions missed on CT scans.

Topics: Adolescent; Adult; Bone and Bones; Bone Neoplasms; Child; Female; Humans; Lung Neoplasms; Male; Middle Aged; Osteosarcoma; Predictive Value of Tests; Prospective Studies; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

A patient with initial complaints of leg pain and difficulty walking was found to have a large right tibial metastatic tumor and poorly differentiated adenocarcinoma of the lung. Findings from total-body bone scintigraphy include a large area of increased uptake in the proximal half of the right tibia with a photon-deficient area medially, and focal areas of uptake in a right rib, in the femoral neck and the left ileum. An irregular area of increased uptake in the left lung mass was shown by thoracic bone SPECT. This is an unusual case of a tibial metastasis as the first clinical presentation of bronchogenic adenocarcinoma.

Topics: Adenocarcinoma; Aged; Bone Neoplasms; Femoral Neoplasms; Femur Neck; Humans; Ileal Neoplasms; Ileum; Liver Neoplasms; Lung Neoplasms; Lymphatic Metastasis; Male; Radiopharmaceuticals; Ribs; Technetium Tc 99m Medronate; Tibia; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Whole-Body Counting

A case is presented of metastatic tumor causing Jacod's syndrome: total ophthalmoplegia, blindness, and trigeminal neuralgia. Abnormal soft tissue invading the orbital apex, anterior clinoid process, and cavernous sinus was difficult to assess by CT and MRI, but dual-isotope SPECT including Tc-99m HMDP bone imaging and Tl-201 tumor imaging strongly suggested that the cause of this rare syndrome was a small metastatic tumor. Although the therapeutic effect was also difficult to assess by anatomic imaging alone, dual-isotope SPECT after radiation therapy showed a decline of tumor viability.

Topics: Aged; Blindness; Carcinoma, Non-Small-Cell Lung; Cavernous Sinus; Follow-Up Studies; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Male; Ophthalmoplegia; Orbital Neoplasms; Radiopharmaceuticals; Skull Base Neoplasms; Sphenoid Bone; Syndrome; Technetium Tc 99m Medronate; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Trigeminal Neuralgia

Despite advances in morphological imaging, some patients with lung cancer are found to have non resectable disease at surgery or die of recurrence within a year of surgery. At present, metastatic bone involvement is usually assessed using bone scintigraphy, which has a high sensitivity but a poor specificity. We have attempted to evaluate the utility of the fluorine-18 deoxyglucose positron emission tomography (FDG PET) for the detection of bone metastasis. One hundred and ten consecutive patients with histological diagnosis of non-small cell lung cancer (NSCLC) who underwent both FDG PET and bone scintigraphy were selected for this review. In this group, there were 43 patients with metastatic disease (stage IV). Among these, 21 (19% of total group) had one or several bone metastases confirmed by biopsy (n = 8) or radiographic techniques (n = 13). Radionuclide bone scanning correctly identified 54 out of 89 cases without osseous involvement and 19 out of 21 osseous involvements. On the other hand, FDG PET correctly identified the absence of osseous involvement in 87 out of 89 patients and the presence of bone metastasis in 19 out of 21 patients. Thus using PET there were two false-negative and two false-positive cases. PET and bone scanning had, respectively, an accuracy of 96% and 66% in the evaluation of osseous involvement in patients with NSCLC. In conclusion, our data suggest that whole-body FDG PET may be useful in detecting bone metastases in patients with known NSCLC.

Topics: Aged; Bone and Bones; Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Female; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Predictive Value of Tests; Radiopharmaceuticals; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, Emission-Computed

This case report describes the clinical, scintigraphic, and pathologic findings in a patient with an unexpected finding of a cutaneous malignant melanoma.. Multiple imaging studies were done, as was a pathologic examination of a suspicious pigmented lesion on the patient's back.. A Tc-99m MDP bone scan showed diffuse uptake in the skeleton, lungs, kidneys, and stomach.. Metastatic calcification, as shown by isotope scintigraphy, is an unusual manifestation of metastatic cancer from a primary cutaneous melanoma.

Topics: Adult; Bone and Bones; Female; Humans; Kidney Neoplasms; Lung Neoplasms; Melanoma; Radionuclide Imaging; Radiopharmaceuticals; Renal Insufficiency; Skin Neoplasms; Stomach Neoplasms; Technetium Tc 99m Medronate

A case of a 55-year-old man was remitted to Traumatology Department to present back pain of two weeks of evolution. The results of bone scintigraphy and the patient's evolution allowed the diagnosis. This case report and a literature review showed the importance of using a routine bone scan in diagnosis of bone metastases.

Topics: Bone Neoplasms; Humans; Lung Neoplasms; Male; Middle Aged; Palliative Care; Radiography, Thoracic; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Adult; Bone Neoplasms; Humans; Lung Neoplasms; Male; Osteosarcoma; Radiopharmaceuticals; Ribs; Solitary Pulmonary Nodule; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

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

The bone-seeking radiopharmaceutical Sr-89 has been used as a palliative treatment for patients with bone pain caused by bone metastases. The authors report the results of nine patients (three with prostate cancer, four with breast cancer, one with thyroid cancer, and one with lung cancer) who underwent therapy with Sr-89 chloride for painful bone metastases, and evaluate Sr-89 imaging with bremsstrahlung. Two levels of dosage (1.5 and 2.2 MBq/kg) were used. Sr-89 imaging was performed in seven patients 1 week after injection. Abnormal uptake was seen in all and was consistent with the results of Tc-99m HMDP imaging. Six patients were assessed at 3 months and three patients toward the time they were terminal; 78% (seven of nine) derived some benefit. Two patients had a favorable clinical response and showed improvement on Tc-99m HMDP imaging.

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Female; Follow-Up Studies; Humans; Lung Neoplasms; Male; Middle Aged; Pain; Palliative Care; Prostatic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Radiotherapy Dosage; Remission Induction; Strontium Radioisotopes; Technetium Tc 99m Medronate; Terminal Care; Thyroid 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

The aim of this study was to optimise the parameters affecting the Bremsstrahlung scintigraphy of patients injected with strontium-89 chloride. The parameters considered were : (1) instrumental detection efficiency, and (2) tissue attenuation factor for 89Sr calibrated sources, which permit quantitative evaluation of the activity in a given bone lesion. Some typical examples of in vivo 89Sr imaging are presented to illustrate the clinical utility of the imaging procedure developed by us, which is implemented in our department for all patients treated with 89Sr chloride.

Topics: Bone Neoplasms; Breast Neoplasms; Calibration; Gamma Cameras; Humans; Lung Neoplasms; Male; Prostatic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Strontium Radioisotopes; Technetium Tc 99m Medronate

A malignant solitary fibrous tumor arising in the right buttock associated with metastatic parietal pleural and intrapulmonary tumors and pleural effusion was found in a 59-year-old man. A chest computed tomogram revealed three tumors attached to the parietal pleura with rib destruction, and a tumor in the left lower lung field. Histologically, the tumors of the buttock and parietal pleura were characterized by proliferation of bundles of spindle-shaped or oval cells separated by wavy hyalinized collagen tissue with no expression of cytokeratin, S-100 protein, muscle actin or epithelial membrane antigen, but these cells weakly expressed CD34 and strongly expressed vimentin.

Topics: Biomarkers, Tumor; Buttocks; Combined Modality Therapy; Extracellular Matrix Proteins; Follow-Up Studies; Humans; Immunohistochemistry; Lung Neoplasms; Male; Middle Aged; Neoplasms, Fibrous Tissue; Pleural Effusion, Malignant; Pleural Neoplasms; Radiography, Thoracic; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

We counted the lesions at the time of detection of bone metastases and calculated the rate of increase in the number of bone metastases from changes in serial bone scintigrams, and investigated the usefulness of serial scintigrams as a prognostic indicator in patients with metastatic bone tumors. Subjects were 112 patients with bone metastases from four types of primary lesion: 21 with prostate cancer, 27 breast cancer, 39 lung cancer and 25 stomach cancer. Of these, 18 (prostate), 19 (breast), nine (lung) and eight (stomach) underwent serial bone scintigrams in which bone metastases were first detected and identified as progressing. The numbers of lesions at the time of detection of bone metastases for prostate and stomach cancers were significantly greater than those for lung cancer. The rate of increase in the number of bone metastases for stomach cancer was significantly higher than that for prostate or breast cancers. There was no correlation between the survival time after the detection of bone metastases and the number of lesions at the time of detection in the four types of cancer. However, in prostate cancer, a negative correlation existed between the survival time after the detection of bone metastases and the rate of increase in the number of bone metastases. Thus, in patients with bone metastases from prostate cancer, it appears that the rate of increase in the number of bone metastases, estimated from serial bone scintigrams, was indicative of prognosis.

Topics: Adult; Aged; Aged, 80 and over; Analysis of Variance; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Disease Progression; Evaluation Studies as Topic; Female; Follow-Up Studies; Humans; Injections, Intravenous; Lung Neoplasms; Male; Middle Aged; Prognosis; Prostatic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Regression Analysis; Stomach Neoplasms; Survival Rate; Technetium Tc 99m Medronate; Whole-Body Counting

The purpose of this study was to evaluate the clinical usefulness of Tc-99m (V) DMSA in patients suspected of lung cancer and determine whether this agent may have value in differentiation between small cell (SCLC) and non-small cell (NSCLC) lung carcinoma.. Thirty-six patients with clinical and radiological suspicion of primary lung carcinoma were injected 450-600 MBq of Tc-99m (V) DMSA intravenously. Whole body and planar anterior, posterior thorax images were obtained 4-5 h after injection of the radioactive complex.. Histopathological results confirmed 23 NSCLC, 10 SCLC and 1 metastatic lung carcinoma and 2 lung abscess. Nineteen of the 23 (82%) NSCLC and all of the 10 (100%) SCLC cases showed Tc-99m (V) DMSA uptake. Single metastatic lung cancer also accumulated radiotracer. Lung abscess did not show uptake. Lesion/Nonlesion (L/N) ratio of SCLC (1.59 +/- 0.32) and NSCLC (1.43 +/- 0.19) tumour types did not show statistical difference (p > 0.05). Tc-99m (V) DMSA whole body imaging also showed bone metastases.. Tc-99m (V) DMSA is a noninvasive and cheap imaging method to detect malignant lung cancers and their bone metastases but, differentiation of SCLC and NSCLC is not possible.

Topics: Bone Neoplasms; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; Humans; Injections, Intravenous; Lung Abscess; Lung Neoplasms; Middle Aged; Neoplasm Metastasis; Neoplasm Staging; Radionuclide Imaging; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Artifacts; Breast Neoplasms; Carcinoma, Adenosquamous; Female; Humans; Lung Neoplasms; Male; Mastectomy; Middle Aged; Radiography, Thoracic; Radionuclide Imaging; Ribs; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Localization of skeletal tracer in a neuroblastoma primary is common but localization in extraskeletal metastatic sites has not received recognition. Tc-99m MDP concentration in hepatic or pulmonary metastases was noted in three of ten patients with such metastases. Lesion size appears to be important for demonstrating these metastases with Tc-99m MDP. This was particularly true for hepatic metastases, which were identified only when they were 5 cm or greater in diameter.

Topics: Bone and Bones; Calcinosis; Child; Child, Preschool; Contrast Media; Female; Follow-Up Studies; Gadolinium; Humans; Image Enhancement; Infant; Infant, Newborn; Liver Neoplasms; Lung Neoplasms; Magnetic Resonance Imaging; Male; Neoplasm Staging; Neuroblastoma; Radiography, Thoracic; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Technetium Tc 99m Medronate

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 assess the prognostic significance of hypertropic osteoarthropathy (HOA) discovered on routine staging bone scintigraphy in patients with lung cancer.. Between 1989 and 1992 all 99mTc-MDP bone scintigrams performed for the staging of bronchogenic carcinoma were reviewed. HOA was diagnosed by the observation of cortical/periosteal increased uptake in the extremities of the long bones. Follow-up and confirmation of the diagnosis was obtained by hospital computer, histology records, operative records, patient notes and radiological data where available.. 164 staging scintigrams for lung cancer were identified. Twenty-eight patients (17%) were observed to have HOA. Patients with and without HOA were well matched for age and sex. There was little difference in the distribution of cell type but the HOA groups has a greater incidence of peripheral tumours. There was no significance in survival between the two groups. Two of three long-term survivors had clinically overt HOA and one presented with arthralgia.. HOA is often seen on skeletal scintigraphy for staging of lung cancer and has no prognostic significance. The data also support current teaching that a high index of suspicion for HOA, as a cause of arthralgia may lead to early diagnosis of a potentially resectable lung carcinoma.

Topics: Aged; Aged, 80 and over; Carcinoma, Bronchogenic; Female; Follow-Up Studies; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Staging; Osteoarthropathy, Secondary Hypertrophic; Paraneoplastic Syndromes; Prognosis; Radionuclide Imaging; Survival Rate; Technetium Tc 99m Medronate

We studied the effect of anti-cancer chemotherapy including cis-platin (CDDP) on renal high uptake of 99mTc-MDP using renal accumulation index (RAI) which was defined as a ratio of the densities between kidneys and lumbar bodies. We analyzed 21 cases who received bone scintigraphy within 30 days after chemotherapy. High RAIs were observed in 15 cases (71.4%). We compared the relationship between the RAI and time interval of CDDP administration and bone scintigraphy, total dose of CDDP, BUN and age. High RAIs were inversely related to the time interval and no patient showed high RAI when bone scintigraphy were studied later than 17 days after chemotherapy. BUN level were related to RAI. But, dose of CDDP and ages were unlikely responsible for the RAI values in this study. We summarized that high renal uptake of 99mTc-MDP was likely to be due to short time interval after chemotherapy.

Topics: Adult; Aged; Antineoplastic Agents; Blood Urea Nitrogen; Bone and Bones; Cisplatin; Esophageal Neoplasms; Female; Humans; Kidney; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

Tc-99m MIBI is taken up avidly by viable tumor tissue and does not accumulate in the necrotic carcinoma. We present a patient who underwent Tc-99m MIBI and Tc-99m HMDP thoracic SPECTs: a large area of increased MIBI uptake with central photopenia (ring appearance) in the right upper lung localizes bone imaging agent and does not localize multiple areas of intense uptake in the metastatic hilar mediastinum lymph nodes. Rapid growth of tumor cells in the lung leading to central necrosis/ischemia accounts for bone imaging agent localization in the tumor, as well as the ring-appearance of lung mass on Tc-99m MIBI imaging. These findings may reflect less viability of the lung tumor as compared with intense MIBI uptake in hilar/mediastinal lymph node uptake without bone agent localization.

Topics: Bone Neoplasms; Carcinoma, Small Cell; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Thorax; Tomography, Emission-Computed, Single-Photon

The aims of this study were to determine the incidence of hypertrophic pulmonary osteoarthropathy (HPO) in nasopharyngeal carcinoma (NPC) and assess its clinical significance. Altogether, 407 NPC patients were reviewed retrospectively. HPO was identified by 99Tcm-methylene diphosphonate bone scans and related clinical and radiographic evidence. Pulmonary metastases, bony metastases and titre of anti-Epstein Barr virus (EBV) immunoglobulin were assessed in patients with and without HPO. The patients had a mean (+/- S.D.) age of 50.4 +/- 12.4 (range 17-73) years. HPO was found in 27 of the 407 (6.6%) NPC patients, among whom 13 (48%) had pulmonary metastases. HPO preceded lung metastases by 7-22 months (14.4 +/- 6 months) in 7 (52%) patients. Six patients had overt lung metastases at the time of the bone scan. No significant difference was found in anti-EBV immunoglobulins between the patients with or without HPO, nor in the incidence of bony metastases between these two groups of patients. HPO should be regarded as an early sign of pulmonary metastases.

Topics: Adolescent; Adult; Aged; Antibodies, Viral; Bone Diseases; Bone Neoplasms; Child; Herpesvirus 4, Human; Humans; Hypertrophy; Lung Diseases; Lung Neoplasms; Middle Aged; Nasopharyngeal Neoplasms; Osteoarthropathy, Secondary Hypertrophic; Radionuclide Imaging; Reproducibility of Results; Retrospective Studies; Technetium Tc 99m Medronate

Determining the etiology of a focal lesion seen on bone scan in patients with primary tumors usually requires the use of other imaging procedures or biopsy. Single positron emission computed tomography (SPECT) with high resolution multidetector systems can localize the specific site of a vertebral lesion and in this way potentially differentiate between benign and metastatic disease. SPECT images of the lower thoracic and lumbar spine were reviewed for lesion location and intensity by two experienced interpreters. Follow-up data were adequate to ascertain the cause of 71 lesions seen on SPECT in 29 patients. Twenty-six of these lesions were not seen on planar images. Of the 71 lesions, 44 were benign and 27 metastatic. Of the 15 lesions where the pedicle was involved, 11 were found to metastatic. There were a total of 14 facet lesions, 9 of which were present in vertebra with no lesions at sites other than the facets. All 9 of these isolated facet lesions turned out to be benign. Lesion intensity did not distinguish benign from malignant disease. We conclude that SPECT imaging is useful in determining the etiology of focal lesions seen on bone scan in patients with a known primary tumor referred for evaluation of metastatic disease.

Topics: Colonic Neoplasms; Diagnosis, Differential; Diagnostic Imaging; Follow-Up Studies; Humans; Image Enhancement; Lumbar Vertebrae; Lung Neoplasms; Male; Osteoarthritis; Prostatic Neoplasms; Sensitivity and Specificity; Spinal Diseases; Spinal Neoplasms; Technetium Tc 99m Medronate; Thoracic Vertebrae; Tomography, Emission-Computed, Single-Photon

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

A total of 75 prostate cancer and 67 lung cancer patients with positive bone scintigrams were studied. The patterns of spread of tumors to various bones were different between the 2 groups. The differences in the distribution of bony metastases between the prostate and lung are explained by the role of Batson's vertebral venous plexus.

Topics: Bone and Bones; Humans; Lung Neoplasms; Male; Neoplastic Cells, Circulating; Prostatic Neoplasms; Radionuclide Imaging; Spinal Neoplasms; Spine; Technetium Tc 99m Medronate; Veins

A 52-year-old man with metastatic poorly differentiated bronchogenic carcinoma and serum calcium levels as high as 14.6 had intense Tc-99m MDP uptake found throughout the stomach wall on SPECT imaging. FDG uptake assessed by PET imaging was not elevated in the stomach, whereas multiple hyper-metabolic tumor foci could be found throughout the body. Three months later, when calcium levels normalized, no Tc-99m MDP uptake was found in the stomach despite persistence of neoplastic lesions elsewhere. This case study indicates that gastric MDP uptake in patients with malignancy related hypercalcemia can be reversible and not necessarily indicative of neoplastic infiltration.

Topics: Bone Neoplasms; Carcinoma, Bronchogenic; Deoxyglucose; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Humans; Hypercalcemia; Lung Neoplasms; Male; Middle Aged; Stomach; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon

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

Intracerebral uptake of methylene diphosphonate (MDP) was unexpectedly found in metastatic work-up of lung cancer. The history of the 52-year-old patient revealed a sudden onset of weakness of right limbs 10 days ago. Technetium-99m diethylenetriamine pentaacetate (Tc-99m DTPA) brain scan and Tc-99m hexamethyl propylene amine oxime (HMPAO) brain single photon emission computed tomography (SPECT) were done, and both showed abnormality in the left temporoparietooccipital region corresponding to the territory of left middle cerebral artery. A repeated bone scan four months later showed complete resolution of the intracerebral Tc-99m MDP uptake. We present this case to emphasize the importance of complementary and enhanced radionuclide images.

Topics: Brain; Cerebral Infarction; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Oximes; Technetium Tc 99m Exametazime; Technetium Tc 99m Medronate; Technetium Tc 99m Pentetate; Tomography, Emission-Computed, Single-Photon

The importance of evaluating nonfunctional adrenal masses in the right clinical setting is discussed. A 60-year-old man was initially diagnosed of having a localized lung carcinoma. Metastatic work-up showed an adrenal mass that was not deemed to be related to the lung primary. Although biochemical testing revealed that the adrenal mass was nonfunctional, adrenal scintigraphy was not performed. On resection, the lung neoplasm was shown to be a poorly differentiated adenocarcinoma. Radiologic follow-up of the adrenal finding was recommended. A year later, the patient presented with an abdominal mass that was visualized by bone scintigraphy and, on resection, proved to be adrenocortical carcinoma. In retrospect, the lung mass was a metastasis of an adrenocortical carcinoma.

Topics: Adenocarcinoma; Adrenal Cortex Neoplasms; Bone and Bones; Bone Neoplasms; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

Iliac crest bone marrow biopsy (BMB) has often been used as the gold standard for the detection of bone marrow metastases in small cell lung cancer (SCLC). However, it is likely to lead to numerous false-negative results. For this reason, we compared the results of bone scintigraphy (BS), magnetic resonance imaging (MRI), and BMB in 48 sequential patients affected with pathologically confirmed SCLC (47 were evaluable; mean age, 58.4 years). The three procedures were carried out within 1 week, no treatment being performed during this period. Whole-body scans and spot views were obtained in the anterior and posterior projections. For MRI, only the thoracolumbar spine, the sternum and the pelvis were scanned, using spin-echo T1-weighted sequences, resulting in an acquisition time of less than 45 min. Only five BMBs were rated as positive. In these cases, both BS and MRI were also positive. The other 42 biopsies were negative. Among them, in ten cases both BS and MRI were positive. In 21 cases, both BS and MRI were negative. In five cases MRI was positive while BS was negative. Finally, in six cases MRI was negative whilst BS was positive. In most cases in which either BS or MRI was positive, follow-up scans confirmed the initial findings. This study suggests that BMB is more invasive and less sensitive than BS or MRI in detecting bone metastases. MRI seems to be more sensitive than BS in detecting small spinal or pelvic metastases. Whole-body bone scintigraphy is more sensitive in detecting skull, costal or peripheral metastases.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Biopsy; Bone and Bones; Bone Marrow; Bone Neoplasms; Carcinoma, Small Cell; Female; Humans; Ilium; Lung Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate

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

Topics: Adult; Breast Neoplasms; Female; Humans; Lung Neoplasms; Phyllodes Tumor; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Tumor scintigraphy with 67Ga-citrate, 99mTc(V)-DMSA and 99mTc-MDP were performed on a patient with rare primary pulmonary leiomyosarcoma. While 67Ga-citrate accumulation to the tumor was not recognized, 99mTc(V)-DMSA and 99mTc-MDP scintigraphy showed relatively intense localization of the tracers in the lesion, and were very useful in suggesting the characteristics of the tumor.

Topics: Citrates; Citric Acid; Female; Gallium; Humans; Leiomyosarcoma; Lung Neoplasms; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; 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

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

Glucose phosphate (GP) labelled with 99mTc was used to obtain scintigraphic images of bone lesions in one group of patients (n = 28) and of lung tumors in another (n = 35). All bone lesions detected by 99mTc-MDP were also demonstrated by 99mTc-GP; all lung tumors except 4 were detected by 99mTc-GP, the failure rate being about the same as that for 67Ga. The use of 99mTc-GP is preferable to that of 99mTc-MDP because the former does not accumulate in normal bone; the advantage of 99mTc-GP over 67Ga lies in its better physical characteristics and in the fact that the result of the study is available within a few hours rather than three days.

Topics: Adolescent; Adult; Aged; Bone Cysts; Bone Diseases; Bone Neoplasms; Child; Child, Preschool; Female; Glucosephosphates; Humans; Hyperparathyroidism; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Osteitis Deformans; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate

In a double-blind, prospective study, the authors analyzed bone scintigrams and magnetic resonance (MR) images of the spine in 71 patients with histologically proved skeletal metastases. Bone scintigrams and MR images were separately reviewed by four independent observers. Bone scintigraphy permitted identification of 499 abnormal vertebrae and MR imaging, 818 abnormal vertebrae. MR imaging depicted additional abnormal vertebrae in 49 patients. The authors conclude that MR imaging is more sensitive than bone scintigraphy in detection of vertebral metastases.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Bone Marrow; Breast Neoplasms; Double-Blind Method; Female; Gamma Cameras; Humans; Lung Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Observer Variation; Prospective Studies; Radionuclide Imaging; Sensitivity and Specificity; Spinal Neoplasms; Technetium Tc 99m Medronate

Topics: Aged; Bone and Bones; Carcinoma, Small Cell; Humans; Lung Neoplasms; Male; Radionuclide Imaging; Technetium Tc 99m Medronate; Whole-Body Counting

Topics: Adult; Bone and Bones; Bone Neoplasms; Carcinoma, Small Cell; Diagnosis, Differential; Humans; Indium Radioisotopes; Leukocytes; Lung Neoplasms; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Adolescent; Bone and Bones; Bone Neoplasms; Diagnosis, Differential; Female; Humans; Lung; Lung Neoplasms; Middle Aged; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Tomography, X-Ray Computed

Topics: Adult; Aged; Female; Humans; Lung Neoplasms; Male; Middle Aged; Pulmonary Fibrosis; Radiation Injuries; Radionuclide Imaging; Radiotherapy; Technetium Tc 99m Medronate

Bone scintigraphy was performed as part of an initial diagnostic evaluation of 70 dogs admitted with primary bone tumors during a 2-year period. Tumors involved major long bones of the appendicular skeleton and included 62 osteosarcomas, 6 fibrosarcomas, and 2 chondrosarcomas. All dogs were free of radiographically detectable pulmonary metastases. Bone scintigraphy was not of value in distinguishing among various types of primary tumors. One dog with an ulnar chondrosarcoma had a scintigraphically detectable occult osseous metastasis or synchronous primary tumor, and 1 dog with osteosarcoma had a scintigraphically detectable lymph node metastasis. Pulmonary metastases were not detected scintigraphically. Of the 70 dogs, 44.3% had areas of increased isotope uptake associated with nonneoplastic disease processes.

Topics: Animals; Bone Neoplasms; Chondrosarcoma; Dog Diseases; Dogs; Female; Fibrosarcoma; Lung Neoplasms; Lymphatic Metastasis; Male; Osteosarcoma; Radionuclide Imaging; Technetium Tc 99m Medronate

Scintigraphic, radiologic, and clinical follow-up findings were reviewed in cases in which bone scans (n = 301) showed one or two new abnormalities in patients with malignancy but no known metastases. Metastatic disease was confirmed for 25 of 231 scans (11%) with one new abnormality and for 17 of 70 scans (24%) with two new abnormalities. The prevalence of metastases was 0.06 to 0.13 for lesions in all regions of the skeleton, except the sternum (three of six) and the pelvis (10 of 32). On follow-up scans, in the absence of an interval change in therapy, 19 of 21 metastases became more intense, whereas most benign abnormalities either remained unchanged (47%) or resolved (41%). Benign lesions in the ribs, extremities, and pelvis generally resolved within 12-24 months, while most benign skull and spine abnormalities were still apparent after 35-58 months of follow-up.

Topics: Bone Neoplasms; Breast Neoplasms; Female; Humans; Lung Neoplasms; Radionuclide Imaging; Ribs; Skull Neoplasms; Spinal Neoplasms; Technetium Tc 99m Medronate

Carpal bone is an uncommon location for metastases, and diagnostic problems can occur when a solitary metastasis mimics acute arthritis or osteomyelitis clinically as well as radiologically.

Topics: Bone Neoplasms; Carcinoma, Bronchogenic; Carpal Bones; Humans; Lung Neoplasms; Male; Middle Aged; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

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

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

The distribution of skeletal metastases in prostatic and lung cancer was examined to test the hypothesis that prostatic carcinoma spreads by a unique hematogenous route. Abnormal technetium-99m methylene diphosphonate bone scans were retrospectively reviewed in 71 patients with prostatic carcinoma and 41 patients with lung cancer comparing patterns of osseous involvement. Differences in the distribution of lesions were not significant. It is concluded that prostatic carcinoma does not metastasize to specific skeletal sites by a singular hematogenous pathway.

Topics: Bone Neoplasms; Humans; Lung Neoplasms; Male; Prostatic Neoplasms; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Medronate

Topics: Adrenal Gland Neoplasms; Carcinoma, Small Cell; Humans; Lung Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Aged; Bone and Bones; Female; Humans; Lumbosacral Region; Lung Neoplasms; Osteosarcoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Of 628 patients with extra-osseous malignancies diagnosed by surgery and/or pathology, 207 (33.0%) were identified as having skeletal metastasis by bone imaging. There was statistical significant difference in the incidence of metastasis in in different malignancies (P less than 0.02). The metastatic rates of nasopharyngeal, lung, prostate and breast cancers were higher than gastrointestinal, kidney, and other malignancies. There was significant differences in the different sites of skeletal metastasis (P less than 0.01). They were thorax, spine, pelvis, limbs and skull in order of incidence. Solitary metastatic rate was 15.9%. Biopsy is advised for patients suspected to have metastatic disease but with only one single "hot spot" in skeletal imaging, particularly in the rib.

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Humans; Lung Neoplasms; Male; Nasopharyngeal Neoplasms; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate

Tc-99m-HMDP bone imaging was performed in 114 patients with various carcinomas. Ninety-four patients gave positive results. In 65 patients, bone imaging was compared with radiograms. The two methods were both positive in 40 patients (62%). Of these 65 patients, 17 (26.1%) had negative radiograph but positive bone imaging. Bone metastases were mainly found in the axial skeleton. It is important to differentiate bone fracture from metastasis when only one single lesion is found. The best differentiation is bone imaging follow-up.

Topics: Adolescent; Adult; Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Female; Humans; Lung Neoplasms; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Ribs; Technetium Tc 99m Medronate

Topics: Aged; Chondrosarcoma; Female; Humans; Lung Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate

Bone imaging using Tc-99m MDP was performed on a 68-year-old man with a newly diagnosed adenocarcinoma of the lung. The image unexpectedly showed increased activity in the heart area. Emergent echocardiography demonstrated impending pericardial tamponade. A malignant pericardial effusion was verified by pericardiocentesis.

Topics: Adenocarcinoma; Aged; Bone and Bones; Cardiac Tamponade; Heart Neoplasms; Humans; Lung Neoplasms; Male; Pericardial Effusion; Radionuclide Imaging; Technetium Tc 99m Medronate

Extraosseous soft tissue metastases from osteosarcoma occasionally accumulate Tc-99m MDP. The authors present a case of osteogenic sarcoma of the femur with a pulmonary metastasis detected by bone imaging with radiographic correlation including CT and magnetic resonance imaging. The implication of the detection of osseous and extraosseous metastasis in these patients by bone imaging is discussed. The changing role of bone imaging in the initial workup and follow-up of patients with osteogenic sarcoma is reviewed in light of the change in course and prognosis of the disease as a result of recent advances in adjuvant chemotherapy.

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

Topics: Giant Cell Tumors; Humans; Lung; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Carcinoma, Small Cell; Female; Humans; Liver Neoplasms; Lung Neoplasms; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

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

In searching for disease on skeletal images it is important to identify areas of increased activity and cold lesions, which are usually more difficult to identify. Focal photon-deficient lesions are due to metastatic disease in over 80% of cases. They may occur if the tumor is extremely aggressive, if there is disruption of the blood supply to the bone, or if there is significant marrow involvement, particularly in a vertebral body. Some of the common causes of a photopenic lesion are avascular necrosis, malignant bone tumors such as multiple myeloma, metastasis, radiation therapy, attenuation artifacts such as prosthesis or pacemaker, and early osteomyelitis. A case of hemangioma of the dorsal vertebra, a rare cause of photopenic lesion, is reported here.

Topics: Aged; Bone Neoplasms; Hemangioma; Humans; Lung Neoplasms; Male; Radionuclide Imaging; Spinal Neoplasms; Technetium Tc 99m Medronate; Thoracic Vertebrae

Bone scintigraphy was performed in 17 patients with previously known lung metastases of osteosarcoma. 99Tcm-MDP uptake was observed in all primary bone lesions but lung metastatic lesions were positive in only six patients (35%). 99Tcm-MDP uptake by lung metastases was significantly correlated with bone and osteoid formation in the metastatic lesions and preoperative serum ALPase values. These clinical observations were confirmed by using nude mice transplanted with human lung metastatic osteosarcoma. 99Tcm-MDP scintigraphy appears to be useful for detecting lung metastases of osteosarcoma only in a selected group of patients.

Topics: Adolescent; Adult; Animals; Bone Neoplasms; Female; Humans; Lung Neoplasms; Male; Mice; Mice, Nude; Middle Aged; Neoplasm Transplantation; Osteosarcoma; Radionuclide Imaging; Technetium Tc 99m Medronate; Transplantation, Heterologous

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Humans; Lung Neoplasms; Male; Pain; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Adult; Aged; Bone Neoplasms; Female; Gallium Radioisotopes; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

One hundred thirty patients with lung cancer were studied to determine the incidence of unilateral thoracic soft-tissue accumulation (UTS) of 99mTc methylene diphosphonate (MDP). The finding was present in 60 of 130 (46%) of the patients. Of 52 patients who had received radiation therapy to the primary tumor in the chest, 46 (88%) had UTS, while six (12%) did not. Radiation therapy to lung tumors was the most significant of the factors studied in unilateral soft-tissue uptake of bone agent in the thorax of patients with lung cancer.

Topics: Aged; Bone Neoplasms; Connective Tissue; Female; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate; Thorax

A new case report of alveolar micro-lithiasis shows the diagnostic interest of two non invasive explorations to affirm a radiologic suspicion. Technetium showed calcium in the lung. The broncho-alveolar lavage, realised with a big quantity of fluid, removed the microliths. These two technics together avoid pulmonary biopsy.

Topics: Adult; Calculi; Diagnosis, Differential; Female; Humans; Lung Diseases; Lung Neoplasms; Pulmonary Alveoli; Radionuclide Imaging; Respiratory Insufficiency; Technetium Tc 99m Medronate; Therapeutic Irrigation

Seventy-nine cases with known carcinoma of the lung or breast who underwent both bone marrow aspiration and Tc-99m MDP bone scintigraphy were reviewed. The bone images were assessed for the presence of the pattern of bone marrow expansion which is visualized by diffuse increased metaphyseal activity, particularly evident at the knees, ankles, and elbows. This pattern was found to be an insensitive marker for the presence of marrow metastases (sensitivity 15%). The specificity of the finding was 86%. When diffuse increased metaphyseal activity is present on a Tc-99m MDP bone scan in a patient with malignant disease, the possibility of bone marrow metastases should be pursued by marrow aspiration and biopsy.

Topics: Biopsy, Needle; Bone and Bones; Bone Marrow; Bone Neoplasms; Breast Neoplasms; False Positive Reactions; Humans; Lung Neoplasms; Neoplasm Metastasis; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Medronate

Hospital records of 27 children with osteogenic sarcoma were reviewed in an effort to define the usefulness of skeletal scintigraphy in the initial evaluation and follow-up of their disease. Serial bone scans as well as plain radiographs, linear tomograms, and computed tomograms were evaluated for evidence of bone or lung metastases. Eighteen patients developed lung metastases and three developed bone metastases. Seven patients demonstrated uptake of tracer in lung metastases, however, the lesions were all easily identifiable by radiographic means. All bone metastases were detected by scintigraphy, in one instance prior to radiographic abnormality. In no cases were bone metastases known to occur in the absence of lung metastases. None of the bone scans performed for routine follow-up purposes resulted in altered therapy for the patient. We propose that skeletal scintigraphy is useful in the initial metastatic work up of osteogenic sarcoma, and may be helpful in some patients with specific indications during their follow-up, but is less valuable when there is no clinical suspicion for bone metastases.

Topics: Adolescent; Bone Neoplasms; Child; Child, Preschool; Etidronic Acid; Female; Humans; Lung Neoplasms; Male; Organotechnetium Compounds; Osteosarcoma; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Medronate

Two cases are reported in which bone imaging with Tc-99m MDP showed sternal areas without tracer uptake corresponding to bone metastases compromising blood supply to the sternum itself. Radiographs were normal in both cases.

Topics: Adult; Aged; Bone Neoplasms; Breast Neoplasms; Carcinoma, Bronchogenic; Female; Humans; Lung Neoplasms; Male; Neoplasms, Multiple Primary; Radionuclide Imaging; Sternum; Technetium Tc 99m Medronate

Bone lesions with a ring-shaped appearance (the doughnut sign) have been encountered during routine reporting of bone scintigrams performed on patients with multiple myeloma. Such a ring-shaped appearance has been revealed in four (8%) of the last 50 bone scintigrams performed on patients with myeloma at the Royal Marsden Hospital. In contrast, a review of the last 300 bone scintigrams performed on patients with bone metastases failed to reveal any such ring-shaped appearance. Examination of the case notes and radiographs of the multiple myeloma patients did not reveal any correlation between the presence of the ring-shaped appearances and the histology, biochemistry, treatment, or course of the disease nor were any specific radiographic features noted. Three of the four patients have had local radiotherapy to the sites of the lesions. We conclude that the ring-shaped appearance on bone scintigrams is usually related to myelomatous bone lesions, particularly following local radiotherapy to these lesions. The reason for this appearance in three of the four scintigrams may be the stimulation of vascularity and osteoblastic activity around the periphery of the myelomatous lesions by the response of the lesions to radiotherapy.

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Lung Neoplasms; Male; Multiple Myeloma; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate

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

The prognostic significance of bone scintigraphy was investigated by following 587 consecutive patients with lung cancer, in whom this investigation had been performed, for up to 9 years, or until death. Survival was unrelated to age, sex or cell type. However, pain and abnormal bone scintigraphy were both independently associated with a significantly reduced survival compared with those who were free of pain or who had normal bone scintigraphy. These factors were cumulative. The association remained equally valid for all cell types. Claims that a single metastasis is not prognostically significant are unfounded. It is suggested that the results of some chemotherapy trials must be reconsidered in the light of present findings, because of the lack of adequate control groups; the results could be construed to show a beneficial effect only in patients with bone metastases and a poor prognosis, but little or no effect in patients with normal bone scintigraphy. As judged by clinical and radiological follow-up and post-mortem examination, skeletal scintigraphy in patients with lung cancer had a sensitivity of 0.89, a non-specificity (false positives/true negatives) of 0.00 and an accuracy of 0.78. With existing radiopharmaceuticals there is an irreducible residue of false negatives due to deposits which provoke little or no osteoblastic response. Bone scintigraphy is, thus, indicated in any patient with lung cancer with unexplained symptoms and whenever staging is required, because of the prognostic implications. It should precede other staging investigations because the high detection rate may render other tests unnecessary.

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Female; Humans; Lung Neoplasms; Male; Middle Aged; Prospective Studies; Radionuclide Imaging; Technetium Tc 99m Medronate

A case of nonsecretory multiple myeloma is presented. Radiological findings and bone marrow examination provided the diagnosis. Bone scintigraphy showed metastatic pulmonary calcification, thus demonstrating the potential superiority to any other routine diagnostic modality in detection of visceral calcification.

Topics: Adult; Biopsy; Bone Marrow; Calcinosis; Humans; Lung Neoplasms; Male; Multiple Myeloma; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

Adverse allergic reactions to radiopharmaceuticals are rare but have been documented in the literature. This report presents data consistent with a definite adverse reaction to the radiopharmaceutical [99mTc]MDP.

Topics: Bone Neoplasms; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Diphosphonates; Drug Hypersensitivity; Female; Humans; Lung Neoplasms; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Time Factors

We report a case of adult T-cell leukemia with increased uptake in both lungs which was detected by a bone scan using 99mTc-MDP. This finding is thought to have been caused by the metastatic calcification which is associated with ectopic parathormone production.

Topics: Adult; Calcinosis; Diphosphonates; Humans; Leukemia; Lung Neoplasms; Male; Radionuclide Imaging; T-Lymphocytes; Technetium; Technetium Tc 99m Medronate

Topics: Adrenal Gland Neoplasms; Diphosphonates; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

From a series of technetium-99m labelled agents based on a vicinal diphosphonic acid structure, the ligand 1,2-diphosphonoethyleneglycol (DPEG) was selected for clinical study on the basis of a biodistribution in rats which compared well with that of methylene disphonphonate (MDP). The 99Tcm-DPEG agent was assessed in ten patients in whom bone metastases had been demonstrated by 99Tcm-MDP imaging two to seven days previously. Visual comparison of the skeletal images obtained with the two agents revealed the same number of bone metastases at the same locations. Statistical analysis of the data revealed no significant differences between the two radiopharmaceuticals on the basis of lesion to soft tissue ratio and lesion to normal bone ratio, although a slightly higher lesion to soft tissue ratio was found for MDP than for DPEG (p less than 0.03). At least for the formulation tested, it is concluded that this new radiopharmaceutical based on the P-C-C-P structure does not possess diagnostic advantages over 99Tcm-MDP for the detection of bone metastases.

Topics: Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Diphosphonates; Female; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

A retrospective review of 2,851 bone scans done at a cancer center over a period of 4 yr revealed 41 patients having a single abnormality in a rib as their first abnormal scintigraphic finding. The scan findings in these cases were correlated with clinical, scintigraphic, and radiographic follow-up to ascertain their etiology and course. Four lesions (9.8%) were due to malignant disease, 16 (39%) were associated with benign fractures demonstrated on x-ray, 11 (27%) were associated with primary or postoperative radiation therapy. The remaining ten patients (24.2%) with normal x-rays and no association with radiation therapy or subsequent development of metastasis were assigned to benign etiology. This experience suggests that solitary rib lesions in cancer patients are uncommon and are most frequently (90%) associated with benign etiology.

Topics: Bone Diseases; Bone Neoplasms; Breast Neoplasms; Humans; Lung Neoplasms; Neoplasm Invasiveness; Neoplasms; Radionuclide Imaging; Radiotherapy; Retrospective Studies; Rib Fractures; Ribs; Technetium Tc 99m Medronate

One of the explanations of a cold lesion on static bone imaging is the presence of an aggressive, destructive lesion. This is the first reported case of such a lesion with an aggressive nature that was confirmed by abnormal flow and pool images.

Topics: Adenocarcinoma, Bronchiolo-Alveolar; Aged; Diphosphonates; Female; Humans; Lung Neoplasms; Radionuclide Imaging; Sacrum; Spinal Neoplasms; Technetium; Technetium Tc 99m Medronate

In 87 patients with proved diagnosis and a normal or pathologic bone scan (BS) in addition a bone marrow scan (BMS) was performed using a 99mtechnetium-labelled microcolloid. The analysis of scintigraphic findings included those obtained by other investigations shows that in these selected patients a false normal or false positive interpretation would have been resulted in 18% performing the BS only. Both methods BS and BMS were capable of diagnosing the correct stage of disease in all patients. The results indicate an augmentation of diagnostic facilities by the BMS in diseases affecting bone or bone marrow.

Topics: Adult; Bone and Bones; Bone Diseases; Bone Marrow; Bone Neoplasms; Breast Neoplasms; Diphosphonates; Female; Hodgkin Disease; Humans; Lung Neoplasms; Male; Middle Aged; Myeloproliferative Disorders; Osteomyelitis; Osteosarcoma; Plasmacytoma; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

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

Increased accumulation of radioactivity was observed in malignant pleural and ascitic effusion as to a patient with stomach cancer and in malignant pleural effusions as to 2 patients (1 with breast cancer and another with lung cancer) during the performance of routine whole-body bone scans with 99mTc methylene diphosphonate. This finding should strongly suggest malignancy.

Topics: Adult; Ascites; Bone and Bones; Breast Neoplasms; Diphosphonates; Female; Humans; Lung Neoplasms; Male; Middle Aged; Pleural Effusion; Stomach Neoplasms; Technetium; Technetium Tc 99m Medronate; Tomography, Emission-Computed

In two patients with metastatic disease more lesions were detected on scintigraphs obtained with the 'low uptake' bone-scanning agent dimethyl-amino-diphosphonate. The results in these two patients provide practical support for the suggestion that bone-scanning agents with low uptake in normal bone, but high tumour-to-normal bone ratios, will allow better delineation of focal bone abnormalities.

Topics: Aged; Bone Neoplasms; Carcinoma, Bronchogenic; Diphosphonates; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

A total of 2530 consecutive bone scans were examined to evaluate the number and the type of soft tissue neoplasms detected with bone-seeking phosphonates. Sixty-eight primary or secondary soft tissue neoplasms of 63 patients accumulated 99mTc -methylene diphosphonate and 2 accumulated 99mTc -diphosphonate, and one metastasis was seen as a nonactive 'cold' focus in the urinary bladder. The localization of tumors was: 19 in the lung, 15 in the liver, 11 in the kidney, 10 in the peritoneal cavity or ascites, 5 in the large bowel, 4 in the vascular or lymphatic system, 3 in the connective tissue or muscles, 2 in the ovary, 1 in the urinary bladder, and 1 in the brain. Our results differ in many respects from those reported in the literature. The causes of the differences are discussed.

Topics: Abdominal Neoplasms; Adenocarcinoma; Adolescent; Adult; Aged; Bone and Bones; Carcinoma, Small Cell; Colonic Neoplasms; Diphosphonates; Female; Humans; Liver Neoplasms; Lung Neoplasms; Lymphoma, Non-Hodgkin; Middle Aged; Ovarian Neoplasms; Radionuclide Imaging; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Technetium; Technetium Compounds; 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

Two hundred cancer patients with bone metastases were studied by gammagraphy employing 555 MBq of 99mTc-MDP. The results were compared with those obtained by radiology and alkaline phosphatase determination, showing that gammagraphy is positive in 93 per 100 of the cases and is more useful than the other procedures to make a pre-radiologic diagnosis of bone metastases (27 per 100).

Topics: Adult; Aged; Bone Neoplasms; Digestive System Neoplasms; Female; Genital Neoplasms, Female; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate; Urologic Neoplasms

An intratibially transplantable osteogenic sarcoma in rats, that regularly disseminates osteogenic metastases in the lung, is described. The tumor take rates exceeded 90% 30 days after transplantation. Pulmonary metastases were diagnosed in about 99% of the animals, while metastases in the kidneys (14%), lymph nodes (13%) and liver (3%) occurred less frequently. The mean survival time of untreated animals varied between 36 and 48 days, depending on the age at transplantation. Histologic and scintigraphic findings are reported.

Topics: Animals; Bone Neoplasms; Cell Line; Diphosphonates; Female; Femoral Neoplasms; Lung Neoplasms; Lymphatic Metastasis; Male; Neoplasm Transplantation; Osteosarcoma; Radiography; Radionuclide Imaging; Rats; Rats, Inbred Strains; Technetium; Technetium Tc 99m Medronate; Tibia; Time Factors

The presence of the "hot patella" sign was evaluated in a prospective study of 200 consecutive bone scans, and in a review of scans from 148 patients with various metabolic bone disorders and 61 patients with lung carcinoma. The incidence was found to be 31%, 26% and 31% respectively. This sign is an extremely common scan finding and may be seen in association with a wide variety of disorders. It is concluded that this sign cannot be considered to be of diagnostic value.

Topics: Adult; Aged; Bone and Bones; Bone Diseases, Metabolic; Carcinoma, Bronchogenic; Diphosphonates; Humans; Lung Neoplasms; Middle Aged; Patella; Prospective Studies; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Asymptomatic prostatic carcinoma presented as multiple bilateral pulmonary nodules in a patient without any evidence of skeletal involvement by normal bone image. Percutaneous biopsy provided the initial clue to diagnosis. We recommend that asymptomatic prostatic carcinoma be included in the differential diagnosis of pulmonary nodules, even when there is no evidence of skeletal metastasis.

Topics: Adenocarcinoma; Bone Neoplasms; Diphosphonates; Humans; Lung Neoplasms; Male; Middle Aged; Prostatic Neoplasms; Radiography; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Our experiences with more than 2000 bone scintigrams in 803 tumour patients underline the high ranking of skeletal scintigraphy in oncology. Among our patients--who, as a matter of fact, represented a selected material--the rate of false negative scintigraphs was less than 1%. The incidence mentioned in literature is between 1 and 3% (6, 11, 38, 41). By balanced and differentiated assessment of bone scintigrams and analogous x-ray films (plain radiographs, spot-film radiographs, if necessary x-ray tomograms), taking into consideration storage anomalies in respect of localization, form and storage intensity, false-positive results can be reduced to a minimum; as a matter of fact, we believe that in oncology patients the quota of false-positive results can be reduced to less than 3%. In tumour patients, the question as to whether there are any bone metastases, can be correctly answered with a probability of about 96% by means of skeletal scintigraphic imaging and the analogous x-ray film as a complementary examination. The bone scintigram is excellently suited for effecting malignoma staging. It is, in fact, superior to all other methods. Skeletal scintigraphic imaging enables the identification of metastases earlier than any other method. It is the most sensitive primary search method which can be utilized for on-target application of x-ray diagnostic methods. Both solitary and multiple osseous metastases can be accurately localized by scintigraphy. The early identification of skeletal metastases in skeletal regions with endangered stability, is particularly important, since an impending spontaneous fracture can be prevented by osteosynthesis or local radiation therapy. Changes in the growth of metastases under radiation and/or chemotherapy can be reliably observed by scintigraphic follow-ups, and can be assessed to determine whether there is a continued growth or a remission. If scintigram and x-ray film are employed side by side--a procedure which is imperative during first examination and later with specific courses of the disease, the low grade specificity of scintigraphy is largely compensated by the x-ray method.

Topics: Bone Neoplasms; Breast Neoplasms; Diagnosis, Differential; Diphosphonates; Female; Fractures, Spontaneous; Hodgkin Disease; Humans; Lung Neoplasms; Male; Plasmacytoma; Prostatic Neoplasms; Radionuclide Imaging; Ribs; Sarcoma; Skull Neoplasms; Spinal Neoplasms; Technetium; Technetium Tc 99m Medronate

Topics: Adenocarcinoma; Adult; Aged; Bone and Bones; Breast Neoplasms; Diphosphonates; Female; Humans; Lung Neoplasms; Male; Radionuclide Imaging; 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

Tc-99m labeled dimethyl-amino-diphosphonate (DMAD) was compared with methylene diphosphonate (MDP) in five healthy volunteers and 28 patients with a variety of bony afflictions. Although the normal bone uptake of DMAD is less than MDP, the lesion-to-normal bone ratio is significantly higher with DMAD. All 71 lesions detected with MDP were also seen with DMAD. However, 10 lesions were disclosed with DMAD that were not seen with MDP. These lesions tended to have low grade concentrations of the radiopharmaceutical and were detected with DMAD by virtue of the lower normal bone uptake rather than higher lesion uptake.

Topics: Adult; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Diphosphonates; Humans; Kidney Neoplasms; Lung Neoplasms; Middle Aged; Multiple Myeloma; Organotechnetium Compounds; Osteitis Deformans; Osteomyelitis; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Bone and Bones; Bone Neoplasms; Diphosphonates; Fibula; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Osteosarcoma; Pulmonary Embolism; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Adenocarcinoma; Bone and Bones; Breast Neoplasms; Calcinosis; Diphosphonates; Female; Humans; Lung; Lung Neoplasms; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Adenocarcinoma; Adult; Carcinoma, Small Cell; Diphosphonates; Female; Humans; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

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: Adult; Bone Neoplasms; Diphosphonates; Female; Humans; Lung Neoplasms; Lymphoma, Non-Hodgkin; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Bone and Bones; Breast Neoplasms; Diphosphonates; Evaluation Studies as Topic; Female; Humans; Lung Neoplasms; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Aged; Animals; Bone and Bones; Breast Neoplasms; Diphosphonates; Female; Humans; Lung Neoplasms; Male; Middle Aged; Prostatic Neoplasms; Rabbits; Radionuclide Imaging; Rats; Technetium; Technetium Tc 99m Medronate

Topics: Bone and Bones; Brain; Carcinoma, Bronchogenic; Diphosphonates; Humans; Liver; Lung Neoplasms; Preoperative Care; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

The results of 99mTc-methylene diphosphonate 99mTc-MDP scintigraphy in 37 osteosarcoma patients were evaluated. In 11 of 12 patients with pulmonary metastases these were demonstrated by the scintigram. In 2 of these 11 patients the lung metastases could be shown earlier by scintigraphy than by X-ray tomography. Uptake of 99mTc-MDP appeared to be correlated with the formation of osteoid by the tumor. 99mTc-MDP scintigraphy demonstrated metastases not only in the lungs and the skeleton, but also in the lymph nodes and soft tissues. 99mTc-MDP whole-body scintigraphy should be used routinely for the early detection of osteosarcoma metastases.

Topics: Adolescent; Adult; Bone Neoplasms; Child; Child, Preschool; Diphosphonates; Evaluation Studies as Topic; Female; Follow-Up Studies; Humans; Infant; Lung Neoplasms; Male; Middle Aged; Osteosarcoma; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Time Factors; Tomography, X-Ray

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

Topics: Animals; Diphosphonates; Edema; Heart Failure; Humans; Lung Neoplasms; Nephrotic Syndrome; Technetium; Technetium Tc 99m Medronate