technetium-tc-99m-medronate and Necrosis

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

Although 201Tl chloride (Tl) SPECT has been used in the differential diagnosis between recurrence of malignant brain tumor and necrosis after treatment, it is not generally recognized as a definite modality to distinguish them. We conducted a preliminary study using Tl SPECT and 99mTc-MDP or 99mTc-HMDP (Tc) SPECT because it has been said that extraosseous accumulation was caused by calcium deposits in necrotic tissues. In our study, for the purposes of clarifying the mechanism of extraosseous uptake and the correlation between extraosseous accumulation of bone-scanning agent and tumor viability in malignant brain tumors, we compared whether Tc uptake was correlated with the histopathological findings and further performed semi-quantitative evaluation between Tc SPECT and Tl SPECT. The correlation coefficients between the ratio of tumor to normal skull count obtained from Tc SPECT (Tc-T/N) and those of tumor to normal brain count (T/N) and to normal scalp count (T/S) both obtained from Tl SPECT were calculated. Using contrast enhanced CT (CE-CT) or contrast enhanced MRI (CE-MRI), 8 of 10 cases showed intensely ring-enhanced tumor with necrotic lesion. Histopathologically, 7 of 8 cases whose tumor had been resected before treatment had necrosis with increased vascularity or bleeding. Of the remaining 2 cases one case, malignant lymphoma had only hypervascularity by biopsy, while the other one was excluded for resection after treatment. Three of these 8 cases whose CE-CT or CE-MRI showed necrotic lesions exhibited Tc and Tl accumulations in the area corresponding to necrosis. In contrast, 2 showed no Tc nor Tl uptake. Tc-T/N had no significant correlation with any of early-, delayed-T/N or T/S. In conclusion, there was no significant correlation between Tc and Tl uptakes by malignant brain tumors in semi-quantitative evaluation.

Topics: Aged; Bone and Bones; Brain Neoplasms; Female; Humans; Male; Middle Aged; Necrosis; Organotechnetium Compounds; Pilot Projects; Radionuclide Imaging; Radiopharmaceuticals; Statistics as Topic; Technetium Tc 99m Medronate; Tissue Distribution

Topics: Aged; Aged, 80 and over; Female; Humans; Ischemia; Lower Extremity; Male; Middle Aged; Muscle, Skeletal; Necrosis; Peripheral Arterial Disease; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Technetium Tc 99m Medronate; Whole Body Imaging

Necrotic pseudotumor is a complication of metal-on-metal arthroplasty that has been reported with increasing frequency in the last 5 years. It is believed to be the result of a hypersensitivity reaction to metal ions such as nickel, cobalt, or chromium that are released in large quantities from these prostheses. The imaging appearance of a necrotic pseudotumor caused by a metal-on-metal prosthesis, on (18)F-FDG PET/CT or (99m)Tc-MDP bone scan has not been previously described in the literature. Our case demonstrates that a necrotic pseudotumor can be detected incidentally in oncologic patients referred for an (18)F-FDG PET/CT or a (99m)Tc-MDP bone scan, and recognizing this process is vital in preventing further tissue necrosis and patient morbidity, as the offending prosthesis must be promptly removed. The imaging characteristics of a necrotic pseudotumor on PET/CT and bone scan may also mimic a malignant process such as a necrotic sarcoma, and can represent a potential pitfall leading to a false positive diagnosis in an oncologic patient.

Topics: Aged, 80 and over; Arthroplasty, Replacement, Hip; Diagnosis, Differential; Female; Fluorodeoxyglucose F18; Foreign-Body Reaction; Hip Prosthesis; Humans; Metals; Necrosis; Positron-Emission Tomography; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

A 37-year-old woman was admitted to our department with general fatigue, fever, and asymmetric pain in her lower legs, 2 weeks after a common cold. Dynamic skeletal scintigraphy with 780 MBq (20 mCi) Tc-99m HDP revealed increased perfusion and tracer uptake in the soft tissue of the lower legs, suggesting an inflammatory etiology. A muscle biopsy revealed a vasculitic necrotizing myopathy predominantly affecting the small vessels of the lower legs. We diagnosed it as a postinfectious immunologic reaction.

Topics: Adult; Biopsy; Common Cold; Electromyography; Female; Humans; Inflammation; Muscle, Skeletal; Muscular Diseases; Necrosis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Time Factors

A 51-year-old woman on peritoneal dialysis for chronic renal failure secondary to diabetic and nonsteroidal anti-inflammatory drug nephropathy was referred for a Tc-99m MDP bone scan to assess firm subcutaneous plaques in the sacral and gluteal regions. This showed extensive superficial tracer localization in the subcutaneous tissues as well as visceral tracer activity in the myocardium, lungs, stomach, and kidneys. These findings were typical for calciphylaxis (calcific uremic arteriolopathy), a form of metastatic calcification encountered in patients with chronic renal failure that is characterized by subcutaneous soft tissue calcification, painful ulcerations, high morbidity, and mortality. Treatment with sodium thiosulfate resulted in dramatic scintigraphic improvement.

Topics: Bone and Bones; Calcinosis; Calciphylaxis; Female; Humans; Ischemia; Kidney Failure, Chronic; Middle Aged; Necrosis; Neoplasm Metastasis; Radionuclide Imaging; Technetium Tc 99m Medronate; Thiosulfates; Tissue Distribution

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Bone Marrow Diseases; Diclofenac; Humans; Male; Necrosis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Calciphylaxis is a highly morbid syndrome of vascular calcification and skin necrosis, the pathophysiology of which remains largely elusive. We report a patient with end-stage renal disease and multiple painful skin lesions who underwent a bone scan for extremity pain. Increased tracer accumulation was seen in the subcutaneous tissues of the trunk and lower extremities. In this case, the bone scan aided in the diagnosis and treatment of calciphylaxis for a patient who experienced a relatively short hospital stay.

Topics: Aged; Bone and Bones; Calcinosis; Calciphylaxis; Female; Humans; Kidney Failure, Chronic; Necrosis; Radionuclide Imaging; Radiopharmaceuticals; Skin Ulcer; Syndrome; Technetium Tc 99m Medronate; Vascular Diseases

Bone marrow necrosis (BMN) is a relatively uncommon clinicopathologic entity with diverse etiology. We describe a case of BMN in a 11 1/2 year old male child with an underlying non Hodgkin's lymphoma T-cell type. With the help of 99m Tc-MDP (methylene diphosphonate) bone scan we were able to find out the etiologic factor in this case.

Topics: Biopsy, Needle; Bone and Bones; Bone Marrow; Child; Combined Modality Therapy; Humans; Lymphoma; Male; Necrosis; Radiography; 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

Topics: Bone and Bones; Bone Neoplasms; Humans; Liver; Liver Neoplasms; Male; Middle Aged; Necrosis; Pancreatic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

We report a retrospective study of the prognostic value of 2-phase technetium 99m bone scanning performed in 92 patients who presented to Chamonix Hospital with severe frostbite of the extremities in the past 12 years. The results of this study show that an initial bone scan (as early as day 3) has excellent specificity in evaluating the severity of frostbite injury. There was a direct correlation between the demarcation zone of uptake in the phalanges and the eventual level of amputation (positive predictive value, 0.84). A second scan on approximately day 7 was even more sensitive and informative. A strong correlation existed between positive uptake and eventual healing (negative predictive value, 0.99). This study showed that (99m)Tc bone scanning in the first few days after frostbite injury indicates the level of amputation in severe frostbite in more than 84% of cases. We propose an algorithm based on the results of this study that can be used to evaluate new medical and surgical management of frostbite injury.

Topics: Adult; Amputation, Surgical; Female; Frostbite; Hand Injuries; Humans; Male; Necrosis; Prognosis; Radionuclide Imaging; Technetium Tc 99m Medronate

Pyomyositis, although uncommon, is being reported with greater frequency in temperate climates. The presentation is similar to a number of infectious processes, and when associated with a traumatic event, the clinical picture may be confused with that of a musculoskeletal injury. This, coupled with an unfamiliarity of the disease, may result in a delay in diagnosis. Early antibiotic therapy may obviate surgery. Progression to the suppurative stage requires surgical drainage along with antibiotics. CT guided drainage may be accomplished in certain cases. In immunocompromised patients, progression to the septicemic stage is associated with high morbidity and mortality.

Topics: Ankle Injuries; Biopsy; Child; Combined Modality Therapy; Compartment Syndromes; Debridement; Decompression, Surgical; Diagnostic Errors; Disease Progression; Emergency Treatment; Female; Humans; Myositis; Nafcillin; Necrosis; Osteomyelitis; Penicillins; Staphylococcal Infections; Suppuration; Technetium Tc 99m Medronate

A report is presented of a liquefaction necrosis of mitral annular calcification in a patient with chronic renal failure and secondary hyperparathyroidism who had been managed by hemodialysis for 11 years. The mass was echogenic with an echo-lucent area inside, high density on computed tomography and low intensity on magnetic resonance imaging. The uptake of gallium-67 (67Ga)-citrate and the bone agent technetium-99m-methylene diphosphate (99mTc-MDP) was seen in the mass. These findings were compatible with liquefaction necrosis of the mitral annular calcification. After treatment with low calcium concentration hemodialysis, the size of the mass reduced with disappearance of the echo-lucent area on the echocardiography and there was no uptake of 67Ga-citrate or 99mTc-MDP. Liquefaction necrosis might be the early and reversible form of mitral annular calcification. When a tumorlike echogenic mass at the base of mitral leaflets is seen in patients with predisposing factors for mitral annular calcification, consider the possibility of this specific form of mitral annular calcification in order to avoid any unnecessary surgical intervention.

Topics: Calcinosis; Calcium; Citrates; Echocardiography; Female; Gallium; Gallium Radioisotopes; Heart Valve Diseases; Humans; Kidney Failure, Chronic; Magnetic Resonance Imaging; Middle Aged; Mitral Valve; Necrosis; Radiopharmaceuticals; Renal Dialysis; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Prominent soft-tissue uptake of 99mTc-methylene diphosphonate (MDP) within the prostate bed was found after cryoablation for prostate carcinoma. CT, MRI and sonographic studies demonstrated liquifactive necrosis of the prostate bed. The probable etiology for 99mTc-MDP uptake in this case is necrosis with subsequent neovascular hyperemia and microscopic calcium deposits. Three-phase scintigraphy with 99mTc-MDP appears to be useful for localizing the extent of soft tissue inflammation and necrosis.

Topics: Bone and Bones; Cryosurgery; Humans; Inflammation; Male; Middle Aged; Necrosis; Pelvis; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

In high-voltage electrical burn injuries (> 1000 V), it is difficult to identify the site and extent of non-viable deep tissue damage for debridement to avoid further tissue injury from wound infection and the risk of sepsis. This prospective study was designed to evaluate the usefulness of 99Tcm-methylene di-phosphonate (99Tcm-MDP) scintigraphy in detecting the extent of tissue injury and determining the level of amputation required for electrical burn patients. Over a 5 year period, 33 high-voltage electrical burn patients were studied. Blood flow and blood pool studies revealed absent perfusion in 37 limbs, all of which eventually were amputated. In addition to a routine three-phase bone scan, images were obtained at 30-60 min (early images) to evaluate whether soft tissue injury could be detected better at that time. For comparison of the detection rate from the early images and bone (delayed) images, 164 corresponding spot views of both images were reviewed. Eighty-three and 125 tissue necrotic lesions were demonstrated by the early images and bone images respectively. All of the 83 lesions found by the early images were more clearly identified by the bone images. All but one of the 125 lesions underwent surgical debridement or amputation. We concluded that the blood flow and blood pool images correlated well with the level of amputation required. The site and extent of tissue necrotic lesions can be clearly identified on 99Tcm-MDP bone scans. Because the early images were less sensitive in detecting tissue necrosis, we suggest that early imaging is not necessary.

Topics: Adolescent; Adult; Amputation, Surgical; Bone and Bones; Burns, Electric; Child; Debridement; Extremities; Female; Humans; Male; Middle Aged; Necrosis; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Regional Blood Flow; 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

A 99mTc-MDP bone scan performed on a 52-yr-old female for possible bone metastasis revealed prominent hepatic uptake. Subsequently, a 99mTc-SC scan revealed tracer uptake in the caudate lobe with diminished uptake in the remainder of the liver. Further imaging with Doppler ultrasound and hepatic venography confirmed a diagnosis of Budd-Chiari syndrome. Hepatic necrosis, demonstrated on CT imaging, was secondary to Budd-Chiari syndrome and was felt to be the cause of 99mTc-MDP hepatic uptake in this patient.

Topics: Budd-Chiari Syndrome; Female; Humans; Liver; Middle Aged; Necrosis; Radionuclide Imaging; Technetium Tc 99m Medronate

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

From June 1986 to May 1989, 17 patients who sustained high tension electric burns received preoperative 99mTc-MDP bone scan examinations. They were done to detect soft tissue and bone injury and also as a guide for debridement and amputation. From our experience, the correlation between the results of scanning and clinical findings is 88.9 per cent. They are very sensitive and reliable for decision making regarding debridement and limb amputation level when there is coagulation necrosis.

Topics: Adult; Bone and Bones; Burns, Electric; Debridement; Female; Humans; Male; Necrosis; Radionuclide Imaging; Technetium Tc 99m Medronate

Magnetic resonance imaging (MRI) is a sensitive method for the diagnosis of bone marrow abnormalities, but its usefulness in detecting active disseminated cancer in this tissue in treated patients has not been determined. We therefore examined 14 children who had been treated for disseminated bone marrow involvement by neuroblastoma (n = 6), lymphoma (n = 3), Ewing's sarcoma (n = 3), osteosarcoma (n = 1), and leukemia (n = 1). MRI studies were performed at 21 marrow sites to evaluate residual or recurrent tumor and were correlated with histologic material from the same site. T1- and T2-weighted sequences were employed in 21 and 14 studies, respectively; short tau inversion recovery (STIR) in 18; and static gadolinium diethylene triamine pentaacetic acid (Gd-DPTA)-enhanced. T1-weighted sequences in 13. All MRI studies showed an altered bone marrow signal. Technetium 99m methylene diphosphonate (99mTc-MDP) bone scintigraphy was also performed (19 studies). On histologic examination, 7 marrow specimens contained tumor, and 14 did not. Of the 7 tumor-positive lesions, all T1-weighted, 4 of 6 T2-weighted, and all 6 STIR sequences showed abnormal signal; all 5 Gd-DTPA-enhanced. T1-weighted sequences showed enhancement of the lesion. However, abnormal signals were also observed on all T1-weighted, 6 of 8 T2-weighted, 11 of 12 STIR, and 5 of 8 Gd-DTPA-enhanced, T1-weighted images of the tumor-negative sites. In this clinical setting, MRI did not consistently differentiate changes associated with treatment from malignant disease.

Topics: Biopsy; Bone Marrow; Bone Neoplasms; Child; Contrast Media; Fibrosis; Follow-Up Studies; Gadolinium; Gadolinium DTPA; Humans; Image Enhancement; Magnetic Resonance Imaging; Necrosis; Organometallic Compounds; Pentetic Acid; Radionuclide Imaging; Technetium Tc 99m Medronate

Qualitative technetium Tc 99m bone scintigraphy using phosphate compounds and gallium 67 scintigraphy were described as a helpful means in diagnosing necrotizing external otitis (NEO). They were, however, claimed to be nonspecific. Quantitative Tc 99m methylene diphosphonate bone scintigraphy and gallium 67 scintigraphy were performed in eight patients with NEO and in 20 patients with severe external otitis, in order to prove usefulness of scintigraphy in the diagnosis of NEO. Ratios of lesion to nonlesion for bone scintigraphy were 1.67 +/- 0.16 in patients with NEO and 1.08 +/- 0.09 in patients with severe external otitis, and for gallium 67 scintigraphy they were 1.35 +/- 0.24 in NEO patients and 1.05 +/- 0.03 in patients with severe external otitis. There was no difference in uptake between diabetic patients with severe external otitis and nondiabetic patients. The scintigraphic studies were also evaluated using a qualitative scoring method (scores 0 to +4), according to the intensity of the radiopharmaceutical uptake. This method was found to be inferior in the diagnosis of NEO compared with the quantitative method. We conclude that lesion-to-nonlesion ratios greater than 1.5 and 1.3 on bone and gallium 67 scintigraphy, respectively, are indicative of NEO. Quantitative bone scintigraphy, which is quicker to perform, may be used as a single imaging modality for the diagnosis of NEO.

Topics: Adult; Aged; Aged, 80 and over; Aminoglycosides; Anti-Bacterial Agents; Diabetes Mellitus; Diagnosis, Differential; Female; Gallium Radioisotopes; Granulation Tissue; Humans; Male; Middle Aged; Necrosis; Observer Variation; Otitis Externa; Prospective Studies; Pseudomonas Infections; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate; Temporal Bone

Topics: Adolescent; Adult; Bone Neoplasms; Child; Child, Preschool; Humans; Necrosis; Osteosarcoma; Preoperative Care; Radionuclide Imaging; Remission Induction; Technetium Tc 99m Medronate

Pancreatic inflammation and tumors can induce various systemic lesions of steatonecrosis. We report here the case of a 73-year-old woman presenting a painful left leg. Roentgenograms and tomograms of the left tibia were normal. Radionuclide bone scan showed diffuse increased uptake in the whole tibia and a CT scan of the same region demonstrated an unusual pattern of bone tumor. Tibial biopsy revealed intra medullary steatonecrosis and led to the discovery of a pancreatic carcinoma.

Topics: Adenocarcinoma; Aged; Bone Marrow; Fat Necrosis; Female; Humans; Necrosis; Pancreatic Neoplasms; Technetium Tc 99m Medronate; Tibia

In 20 cases of fresh cervical hip fracture, treated with primary prosthetic replacement, preoperative 99mTc-MDP scintimetry was compared with histologic findings of the extracted femoral heads. The radionuclide uptake was classified into three types according to the activity distribution; overall increase, focal decrease, and overall decrease. Histologically, the location and extent of ischemic necrosis in the femoral heads were closely related to the distribution of decreased activity.

Topics: Aged; Aged, 80 and over; Female; Femur Head; Hip Fractures; Humans; Ischemia; Male; Middle Aged; Necrosis; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Adult; Fasciitis; Female; Humans; Necrosis; Radionuclide Imaging; Technetium Tc 99m Medronate

A case of massive hepatic necrosis has been found to have intense, diffuse accumulation of Tc-99m HMDP in the liver. A review of three similar cases revealed that diffuse intense uptake of bone-scanning agents is a grave prognostic sign.

Topics: Acute Disease; Adult; Bone and Bones; Humans; Liver; Male; Necrosis; Radionuclide Imaging; Technetium Tc 99m Medronate

The usefulness of radionuclear scanning in the treatment of 18 patients with necrotizing progressive "malignant" external otitis is discussed. A Tc 99-m bone scan, a valuable test since results are positive in early cases of osteomyelitis of the temporal bone and base of skull, showed increased uptake in all 18 patients. In 6 patients, Ga-67 citrate scans were obtained at the start of therapy and at 5-6 week intervals thereafter. The serial gallium scans were useful in evaluating the effectiveness of therapy since the uptake decrease with control of infection.

Topics: Aged; Diabetes Complications; Diphosphonates; Female; Gallium Radioisotopes; Humans; Male; Middle Aged; Necrosis; Osteomyelitis; Otitis Externa; Pseudomonas Infections; Radionuclide Imaging; Skull; Technetium; Technetium Tc 99m Medronate; Temporal Bone

Many isotopic methods have been proposed recently for the investigation of normal and diseased myocardium in ischaemic heart disease. The results of myocardial scintigraphy with Technetium 99 m marked methylene diphosphonate in the supine, left lateral and 30 degrees or 45 degrees right anterior oblique incidences are reported. A preliminary study of the tracer's fixation on diseased myocardium was performed in 18 patients. Scintigraphy every 30 minutes over a five hour period showed the optimal time for investigation to be situated between the third and fourth hour after the injection of the tracer. Seventy eight patients were then investigated; 82 scintigraphies were performed, 58 in patients with acute myocardial infarctions confirmed by the usual biological and electrocardiographic changes. A 74% sensitivity and 67% specificity were obtained with the methylene diphosphonate method. These figures varied according to the type of necrosis, subendocardial or transmural and with its extent, chronicity and degree of CPK elevation. Methylene diphosphonate scintigraphy would appear to be less sensitive and more specific for diseased myocardium than other isotopic methods. It may be carried out at the bedside and could improve the diagnosis of acute myocardial infarction when the clinical history and electrocardiographic changes are difficult to interpret.

Topics: Adult; Aged; Coronary Care Units; Creatine Kinase; Diphosphonates; Female; Heart; Humans; Kinetics; Male; Middle Aged; Myocardial Infarction; Necrosis; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Forty patients, ages three days to 12 years, with neuroblastomas had bone scans with 99mtechnetium methylene diphosphonate (99mTc-MDP) as part of their pretreatment examination. Twenty-four (60%) had primary tumor uptake and 16 (40%) did not. No difference was seen between the two groups in the incidence of tumor calcification or necrosis. No relationship between the level of urinary vanillylmandelic acid (VMA) and the presence of primary tumor uptake of 99mTc-MDP was found. The possible causes for the localization of 99mTc-MDP are discussed.

Topics: Adrenal Gland Neoplasms; Bone and Bones; Calcinosis; Child; Child, Preschool; Diphosphonates; Female; Humans; Infant; Infant, Newborn; Male; Mediastinal Neoplasms; Necrosis; Neuroblastoma; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Vanilmandelic Acid