technetium-tc-99m-medronate and Osteolysis

Osteolytic lesions are frequently encountered in clinical practice. Radionuclide bone scans with technetium-99m-labeled diphosphonates are often performed in the evaluation of both solitary and multiple osteolytic lesions. In this pictorial review, we critically evaluate the current role of bone scan in common osteolytic tumors including aneurysmal bone cyst, simple bone cyst, fibrous dysplasia, nonossifying fibroma, giant cell tumor, eosinophilic granuloma, enchondroma, chondrosarcoma, osteosarcoma, Ewing sarcoma, myeloma, and metastases. The merits and limitations of bone scanning are emphasized.

Topics: Aged; Aged, 80 and over; Bone Neoplasms; Child; Female; Humans; Male; Middle Aged; Osteolysis; Positron-Emission Tomography; Practice Guidelines as Topic; Practice Patterns, Physicians'; Radiopharmaceuticals; Retrospective Studies; Technetium Tc 99m Medronate

A rare case of idiopathic massive osteolysis of the skull is reported. A 49 year-old male was admitted with a diagnosis of a skull tumor. The skull film taken for evaluation of the headache, showed a large lytic lesion with irregular margin in the left parietal area. CT showed that some of the bone had been destroyed, but the underlying brain was normal. Technetium 99m-MDP bone scan showed high activity around the margin of the lytic lesion. During surgery for this bone lesion no neoplastic or inflammatory changes were revealed. However, destruction of the bone without new bone formation could be seen. Idiopathic massive osteolysis of skull bone is extremely rare and the authors could find only 6 reported cases in the literature. It is characterized by the spontaneous onset of bone resorption without known causative factors. This destructive process continues for years until eventually it ceases spontaneously. In the case of skull lesion, there seems to be no need for surgery unless both the inner and outer tables are involved. This disease must be included in the differential diagnosis of lytic skull lesion.

Topics: Bone and Bones; Humans; Male; Middle Aged; Osteolysis; Osteolysis, Essential; Radionuclide Imaging; Skull; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Familial expansile osteolysis is an exceedingly rare autosomal dominant bone dysplasia, which can have overlapping features with Paget disease and expansile skeletal hyperphosphatasia. We present a novel case of familial expansile osteolysis evaluated on 99mTc-MDP bone scan with correlative radiographs and CT.

Topics: Humans; Osteitis Deformans; Osteolysis; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

The objective of this study was to evaluate the feasibility and diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and (99m)Tc-methylenediphosphonate (MDP) whole-body bone scanning (BS) for the detection of osteolytic bone metastases.. Thirty-four patients with pathologically confirmed malignancies and suspected osteolytic bone metastases underwent 18F-FDG PET/CT and (99m)Tc-MDP whole-body BS within 30 days. The sensitivity, specificity, and accuracy with respect to the diagnosis of osteolytic bone metastases and bone lesions were compared between the two imaging methods.. The sensitivity, specificity, and accuracy of 18F-FDG PET/CT for the diagnosis of osteolytic bone metastases were 94.3% (95% confidence interval [CI], 91.6-96.2%), 83.3% (95% CI, 43.6-96.9%), and 94.2% (95% CI, 91.5-96.1%), respectively. It was found that (99m)Tc-MDP whole-body BS could discriminate between patients with 50.2% (95% CI, 45.4-55.1%) sensitivity, 50.0% (95% CI, 18.8-81.2%) specificity, and 50.2% (95% CI, 45.5-55.1%) accuracy. 18F-FDG PET/CT achieved higher sensitivity, specificity, and accuracy in detecting osteolytic bone metastases than 99mTc-MDP whole-body BS (p<0.001).. F-FDG PET/CT has a higher diagnostic value than (99m)Tc-MDP whole-body BS in the detection of osteolytic bone metastases, especially in the vertebra.

Topics: Adult; Aged; Bone Neoplasms; Feasibility Studies; Female; Fluorodeoxyglucose F18; Humans; Male; Middle Aged; Osteolysis; Positron-Emission Tomography; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Whole Body Imaging

Prostate cancer is incurable once it has metastasized to the bone. Appropriate preclinical models are lacking. The therapeutic efficacy of the multikinase inhibitor cabozantinib was assessed in an orthotopic xenograft model of castration-resistant prostate cancer (CRPC) bone metastasis using noninvasive, multimodality functional imaging.. NOD/SCID mice were injected intratibially with luciferase-expressing ERG (v-ets avian erythroblastosis virus E26 oncogene homolog) rearranged VCaP human prostate carcinoma cells. The response of VCaP xenografts (n = 7 per group) to cabozantinib was investigated using bioluminescence imaging and anatomical and diffusion weighted magnetic resonance imaging. This enabled quantitation of tumor volume and apparent diffusion coefficient (ADC). Bone uptake of technetium-methylene diphosphonate ((99m)Tc-MDP) was assessed by single-photon emission computed tomography. Ex vivo micro computed tomography was used to quantify bone volume and correlated with appropriate histopathology. Statistical significance was determined using the two-sided Mann-Whitney test or Wilcoxon signed rank test.. VCaP xenografts were predominantly osteosclerotic with some osteolytic activity. Fluorescent in situ hybridization analysis confirmed retention of ERG oncogene rearrangements. Cabozantinib induced a statistically significant 52% reduction in tumor luminance (P = .02) and stasis in tumor volume after 15 days of treatment. Tumor ADC statistically significantly increased with cabozantinib and was associated with extensive necrosis (after 10 days, mean tumor ADC ± SD = 556±43×10(-6) mm(2)/s vs pretreatment ADC = 485±43×10(-6) mm(2)/s; P = .02 ). Tumor-associated uptake of (99m)Tc-MDP was statistically significantly reduced after 3 days of treatment (P = .02), sustained over 15 days treatment, and associated with a statistically significant (P = .048) reduction in bone growth on the tibial cortex, yet a highly statistically significant (P = .001) increase in trabecular bone volume.. The intratibial VCaP model faithfully emulates clinical disease. Cabozantinib exerts potent effects on both tumor and tumor-induced bone matrix remodeling, and quantitation of ADC provides a clinically translatable imaging biomarker for early, sensitive assessment of treatment response in CRPC bone metastasis.

Topics: Aged; Anilides; Animals; Antineoplastic Agents; Biomarkers, Tumor; Bone Neoplasms; Bone Remodeling; Diffusion Magnetic Resonance Imaging; Humans; Luminescent Measurements; Male; Mice; Mice, Inbred NOD; Mice, Nude; Middle Aged; Osteolysis; Osteosclerosis; Prostatic Neoplasms, Castration-Resistant; Pyridines; Radiopharmaceuticals; Receptor Protein-Tyrosine Kinases; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tumor Burden; Xenograft Model Antitumor Assays

Sodium fluoride (NaF) is a bone-seeking positron-emitting tracer with high sensitivity and specificity for detection of osseous lesions, particularly osteolytic lesions. We believe that NaF positron emission tomography (PET)/computed tomography (CT) scans can provide a more thorough and conclusive evaluation of bone diseases than conventional Technetium-99m-methylene diphosphonate bone scans. Understanding both normal and pathologic patterns is important for the evaluation and interpretation of these studies. Thus, an atlas of NaF positron emission tomography/computed tomography bone scans demonstrating benign, pathologic, and malignant osseous lesions as well as extraosseous lesions will be invaluable in the correct interpretation and diagnosis of osseous lesions.

Topics: Aged; Bone and Bones; Female; Humans; Male; Middle Aged; Multimodal Imaging; Neoplasm Metastasis; Osteolysis; Positron-Emission Tomography; Sodium Fluoride; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Whole Body Imaging

Juvenile mandibular chronic osteomyelitis is a rare entity that predominantly affects children and adolescents, but little is known about the factors that contribute to the recurrent course and eventual resolution of this disease. Here, we describe new findings of soft tissue and mandibular nerve canal involvement.. Four patients with mandibular diffuse sclerosing osteomyelitis are presented; all were followed with CT, a few also with MRI and bone scan. We recorded imaging findings of lesion location, pattern of bone formation, presence and evolution of lytic lesions, mandibular nerve, and soft tissue involvement.. In all patients we found enlargement of the mandibular nerve canal and soft tissue changes on CT and MRI (when available). All patients had ground glass bone patterns in conjunction with lamellated/onion skin new periosteal bone formation on CT, and all patients with follow-up CT had change in lytic lesion locations.. Mandibular nerve canal enlargement, soft tissue abnormalities, and change in location of lytic lesions may represent a diagnostic pattern in mandibular diffuse sclerosing osteomyelitis (Garré) that was not previously entirely recognized as such.

Topics: Adolescent; Child; Child, Preschool; Chronic Disease; Diagnostic Imaging; Female; Follow-Up Studies; Humans; Image Enhancement; Lymph Nodes; Magnetic Resonance Imaging; Male; Mandible; Mandibular Diseases; Mandibular Nerve; Masseter Muscle; Osteogenesis; Osteolysis; Osteomyelitis; Periosteum; Radionuclide Imaging; Radiopharmaceuticals; Recurrence; Sclerosis; Technetium Tc 99m Medronate; Tomography, Spiral Computed; Whole Body Imaging

Topics: Aged; Antigens, CD34; Biomarkers, Tumor; Bone Neoplasms; Humans; Male; Osteolysis; Solitary Fibrous Tumors; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Whole Body Imaging

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

Topics: Bone and Bones; Humans; Hyperparathyroidism; Male; Middle Aged; Osteolysis; Parathyroid Glands; Parathyroid Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Whole Body Imaging

Osteolytic lesions seen on plain radiographs can be caused by various disorders of the bones such as simple bone cyst, aneurysmal bone cyst, plasmacytoma, giant cell tumor, eosinophilic granuloma and tuberculosis. We studied prospectively Tc-99m-methylene diphosphonate bone scan findings in osteolytic lesions seen radiologically and followed them to histopathology. Interestingly, the scans in these patients helped to show if the lesions were monoostotic or polyostotic and, in some cases, ruled out malignant or infective etiology.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone and Bones; Bone Neoplasms; Diagnosis, Differential; Female; Humans; Hyperparathyroidism; Male; Middle Aged; Osteitis Deformans; Osteolysis; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Tuberculosis, Osteoarticular

Gorham disease is a rare condition characterized by intraosseous neoplastic proliferation of hemangiomatous tissue with progressive, massive osteolysis. We present a pathologically proved case of Gorham disease that involved the left parietal bone in a 23-year-old man. Imaging studies including conventional radiography of the skull, CT, MR imaging, and Technetium-99 m (Tc-99 m) scintigraphy demonstrated a large skull defect without associated soft tissue mass over the left parietal skull. Contrast enhancement and increased isotope uptake along the margin of the defect were shown at gadolinium-enhanced T1-weighted MR imaging and Tc-99 m methylene diphosphate (Tc-99 m MDP) bone scintigraphy. Pathologic study revealed intraosseous angiomatosis at the periphery of the osteolytic skull lesion.

Topics: Adult; Angiomatosis; Diagnosis, Differential; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Male; Osteolysis; Osteolysis, Essential; Parietal Bone; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

A case of atypical osseous tuberculosis (TB) mimicking multiple secondary metastases on radiologic and nuclear imaging is presented.. To emphasize the contribution of nuclear bone scanning for the assessment of osseous tuberculosis in typical and atypical presentations.. Skeletal locations of TB mostly involve the dorsolumbar spine and diagnosis is often delayed. The presence of multiple TB sites can mimic secondary metastases and biopsy remains the mainstay for final diagnosis.. Clinical symptoms, lab tests, and imaging data are presented. Possible diagnoses are discussed. A review of imaging characteristics in cases of typical and atypical presentations of osseous TB is proposed.. A dorsal spine spondylitis was first diagnosed on a 56-year-old patient presenting neurologic deficit of the left arm. Fine needle aspiration identified bacterial infection but was negative for Mycobacterium tuberculosis. Whole-body bone scan allowed the identification of an asymptomatic sacroiliac lesion, which was accessible to biopsy and gave a final diagnosis.. Nuclear bone scanning should be kept in mind when assessing spinal pain in patients at high risk of TB infection or reactivation.

Topics: Africa, Northern; Arm; Back Pain; Biopsy, Fine-Needle; Diabetes Complications; Diagnosis, Differential; Epidural Abscess; False Negative Reactions; Humans; Lumbar Vertebrae; Male; Middle Aged; Mycobacterium tuberculosis; Osteolysis; Paralysis; Radionuclide Imaging; Radiopharmaceuticals; Recurrence; Sacroiliac Joint; Sacrum; Spinal Neoplasms; Spondylitis; Technetium Tc 99m Medronate; Thoracic Vertebrae; Tuberculoma; Tuberculosis, Osteoarticular

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

Cortical septic osteitis is defined as a predominant or exclusive infection of the cortex which may lead to diagnosis pitfalls. With the two cases presented here, principal radiological features allowing a correct diagnosis are recalled.

Topics: Adult; Biopsy; Child; Contrast Media; Diagnostic Imaging; Female; Femur; Gadolinium; Humans; Magnetic Resonance Imaging; Male; Osteitis; Osteolysis; Radiopharmaceuticals; Staphylococcal Infections; Streptococcal Infections; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Ultrasonography

Bone scintigraphy was performed in a 69-year-old male patient with adult T-cell leukemia suffering from right lower limb pain. Numerous sites of increased uptake were seen in the skull, left clavicle, bilateral humeri, bilateral radii and right femur and tibia. Bone radiographs showed multiple osteolytic lesions, most of which corresponded to the abnormal deposits on the bone scans with 740 MBq of 99mTc-hydroxymethylene diphosphonate. This pattern is rarely reported, but bone involvement of adult T-cell leukemia is not uncommon. Bone involvement was remarkable on the appendicular skeleton when compared with common metastatic bone tumors. Bone scintigraphy may be useful in detecting bone involvement in adult T-cell leukemia.

Topics: Aged; Bone and Bones; Humans; Leukemia, T-Cell; Male; Osteolysis; Pain; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tissue Distribution; Tomography, Emission-Computed

There have been few studies and case-reports of bone metastases from hepatocellular carcinoma. To determine the characteristics of these metastases, we retrospectively studied 22 patients in whom the diagnosis was established either on the basis of concomitant occurrence of malignant bone lesions and hepatocellular carcinoma in the absence of other detectable malignant disease (n = 15) or on the basis of histological evidence of bone metastasis from an hepatocellular carcinoma (n = 7). There were 21 males and one female. Mean age was 62.5 years. Most patients (88.2%) had chronic alcohol abuse. The bone metastases occurred as the first manifestation of the liver cancer in half the cases (11/22). Time interval between onset of bone symptoms and admission was less than one month in 6 of 11 patients; mean interval was 7.4 weeks. Hepatomegaly was found upon initial physical evaluation in 9 of 11 patients. Pain was the main symptom of bone disease (18/22). Palpable bone masses were found in 6 of 22 patients. Purely osteolytic lesions were seen on roentgenograms in every case; rupture of the cortex and spread to adjacent soft tissues were common findings. The radionuclide bone scan was normal in four of 12 patients. An advanced primary hepatic tumor was found in 84.2% of cases. Histologic examination of bone specimens established the diagnosis of metastasis from a hepatocellular carcinoma in 7 of 9 patients (77.8%). Severe bleeding occurred during one of the nine biopsy procedures. Patients were given symptomatic treatment. Systemic chemotherapy was used in five patients, unsuccessfully. Median survival was three months.

Topics: Bone Neoplasms; Carcinoma, Hepatocellular; Female; Humans; Liver Neoplasms; Male; Middle Aged; Neoplasm Invasiveness; Osteolysis; Radiography; Radionuclide Imaging; Retrospective Studies; Sensitivity and Specificity; Technetium Tc 99m Medronate

94 patients diagnosed as having sarcoidosis were studied in Galicia in order to evaluate the frequency of bone manifestations, as well as to analyse the clinical and radiological features. Bone lesions were found in 10 patients (10.6%) with a median age of 47.4 years, the predominant sex being female in this group (70%). The lesions were of two types: a) osteolytic on metacarpal (4 cases), nasal bones (1 case), sacrum (1 case), femur (1 case); b) osteosclerosis on femur and fibula (1 case), acrosclerosis (3 cases), metacarpal (1 case). The first lesions were associated to chronic types of sarcoidosis with skin and lung involvements. The second lesions were associated to a sub-acute type of Löfgren. We highlight the behaviour of both types of bone lesions and comment on the physiopathology of the sclerotic lesions.

Topics: Age Factors; Biopsy; Bone and Bones; Bone Diseases; Humans; Incidence; Osteolysis; Osteosclerosis; Radiography; Radionuclide Imaging; Sarcoidosis; Sex Factors; Spain; Technetium Tc 99m Medronate

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

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

Topics: Child; Female; Humans; Osteolysis; Osteolysis, Essential; Radionuclide Imaging; Technetium Tc 99m Medronate

Biological fixation of the Christiansen endoprosthesis takes place gradually as a result of osteogenetic activity in the endosteal wall of the femur, which is subjected to mechanical stimulation by the madreporic shank of this prosthesis. The authors were able to monitor this biological process in 9 patients with the aid of bone scintigraphy.

Topics: Aged; Calcinosis; Diphosphonates; Female; Femoral Neck Fractures; Femur; Hip Prosthesis; Humans; Male; Middle Aged; Osteolysis; Osteoporosis; Postoperative Complications; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Wound Healing