technetium-tc-99m-medronate and Osteosclerosis

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

Topics: Bone and Bones; Erdheim-Chester Disease; Fatal Outcome; Hepatomegaly; Humans; Male; Middle Aged; Osteosclerosis; Radionuclide Imaging; Splenomegaly; Technetium Tc 99m Medronate

Topics: Child; Citrates; Elbow Joint; Erdheim-Chester Disease; Facial Bones; Female; Gallium; Humans; Knee Joint; Osteosclerosis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Plain X-ray is an imprecise tool for monitoring the subchondral bony changes associated with the development of knee osteoarthritis (OA). Our objective was to develop and validate a technique for assessing tibial subchondral bone density (BMD) in knee OA using dual energy X-ray absorptiometry (DXA).. Patients with OA of at least one knee underwent DXA scanning of both knees. Regions of interest (ROI) were placed in the lateral and medial compartments of tibial subchondral bone. Weight-bearing plain X-rays and Te (99m) scintiscans of both knees were obtained and scored.. One hundred and twelve patients (223 knees) underwent DXA and radiography. Intra-observer CV% was 2.4% and 1.0% for the medial and lateral ROI respectively. Definite OA (Kellgren and Lawrence Grade 2, 3 or 4) was correlated with age-related preservation of subchondral BMD compared to radiographically normal knees. Raised BMD was also associated with subchondral sclerosis, and positive scintigraphy.. DXA may provide a safe, rapid and reliable means of assessing knee OA. Cross-sectional age-related subchondral tibial BMD loss is attenuated by knee OA.

Topics: Absorptiometry, Photon; Age Factors; Aged; Bone Density; Cohort Studies; Confidence Intervals; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Knee Joint; Male; Middle Aged; Observer Variation; Osteoarthritis, Knee; Osteosclerosis; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sex Factors; Single-Blind Method; Technetium Tc 99m Medronate; Tibia

A case of osteoid osteoma (OO) in the mandible of 26-year-old female is presented. Her main complaint was intermittent pain during a 3 year period. The panoramic radiograph of the mandible showed diffuse sclerosis including an ill-defined circular radiopacity in the molar region. Computed tomography (CT) revealed an osseous lesion of 10 mm diameter that was located in the cortical bone of the mandible. Bone scintigraphy showed a localized region of high uptake of 99mTc HMDP. The lesion was diagnosed as an OO by histopathological examination of the surgical specimen and CT findings. Since radiological appearance has very significant meaning in the differentiation of an OO from other bone forming tumors, CT is the method of choice when the main symptom is pain and the conventional radiography was not informative.

Topics: Adult; Biopsy; Female; Follow-Up Studies; Humans; Mandibular Neoplasms; Osteoma, Osteoid; Osteosclerosis; Radiography, Panoramic; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

To describe a 55-year-old male with Erdheim-Chester disease with bilateral orbital infiltration and visual loss who was successfully treated with interferon-alpha.. Interventional case report.. The patient was treated with interferon-alpha and had an improvement in his clinical signs, including his visual acuity, after 4 weeks of interferon therapy.. Interferon-alpha can be effective in the treatment of orbital infiltration secondary to Erdheim-Chester disease.

Topics: Exophthalmos; Granuloma; Histiocytosis, Non-Langerhans-Cell; Humans; Interferon-alpha; Magnetic Resonance Imaging; Male; Middle Aged; Orbital Diseases; Osteosclerosis; Radionuclide Imaging; Technetium Tc 99m Medronate; Visual Acuity; Xanthomatosis

A 22-year-old woman had a Tc-99m MDP whole-body scan for low back pain. A focal area of increased activity was seen in the skull base in the region of the sella turcica. A computed tomographic examination showed ground-glass opacification of the sphenoid sinus and bony sclerosis along its walls, characteristic of fibrous dysplasia. Monostotic fibrous dysplasia, the more common form compared with the polyostotic variety, occurs in 70% to 80% of all patients with fibrous dysplasia. Monostotic lesions usually involve the ribs, femur, tibia, cranium, maxilla, and mandible. The frontal and sphenoid bones are the cranial bones most commonly involved.

Topics: Adult; Female; Fibrous Dysplasia, Monostotic; Humans; Low Back Pain; Osteosclerosis; Paranasal Sinus Diseases; Radionuclide Imaging; Radiopharmaceuticals; Sella Turcica; Skull Base; Sphenoid Sinus; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

This study describes the clinical presentation and the course of Ribbing disease in six patients and illustrates imaging features on plain radiography, conventional and computed tomography, and 99mTc-methylene diphosphonate bone scans.. Between 1982 and 1990, six female patients presented with painful bony lesions that were believed to be Ribbing disease. Ten bones were affected: both tibiae in three patients, a unilateral tibia in one, both femora in one, and a unilateral femur in one. Plain radiographs and either conventional or computed tomography were available for all patients and 99mTc-methylene diphosphonate bone scans, for five patients. All patients underwent open biopsy and/or surgical decompression.. The diagnosis was reached in all patients through a combination of clinical findings (lack of systemic signs of infection or laboratory values suggesting metabolic bone disease), imaging, histologic evaluation, and specimen cultures. Radiographs and tomographic studies showed benign-appearing endosteal and periosteal cortical thickening. Intense uptake of radionuclide tracer was confined to the shaft of all involved bones. All pathologic specimens revealed nonspecific changes that included a slow increase in the mass of cortical and endosteal bone. These specimens also assisted in excluding neoplastic or infectious causes for the new bone formation.. Ribbing disease is a rare disorder that, on imaging studies, may simulate stress fracture, chronic infection, bone-forming neoplasia, or a systemic metabolic or endocrine disorder. Clinical and imaging features may suggest the correct diagnosis.

Topics: Adult; Camurati-Engelmann Syndrome; Diagnosis, Differential; Diaphyses; Female; Femur; Humans; Osteosclerosis; Radionuclide Imaging; Technetium Tc 99m Medronate; Tibia; Tomography, X-Ray Computed

To determine whether temporal changes in scintigraphic and bone radiographic findings have prognostic significance in patients with skeletal metastases from breast cancer.. Clinical information and films were retrospectively reviewed in 101 randomly selected patients with skeletal metastases. Images from sequential bond scans and bone radiographs were correlated with survival after detection of the metastases.. Time to detection of skeletal metastases and the length of time for which patients were classified as radiologically stable after development of skeletal metastases correlated with survival (r = 0.843; r = 0.821, respectively). Failure to develop a radiographically and scintigraphically stable pattern after treatment was associated with significantly decreased survival compared with the rest of the patients (mean survival 2.1 +/- 1.3 years vs 4.3 +/- 2.3 years; p < 0.001). Scintigraphic regression of metastases was associated with significant survival benefit and longer stabilization of disease compared to all other patterns (mean survival 5.0 +/- 2.7 years of regressive disease vs 3.7 +/- 1.9 years for stable disease and 2.2 +/- 1.3 years for progressive disease; p < 0.001).. Sequential scintigraphic and radiographic imaging is useful in breast cancer patients not only for detection of metastases and monitoring of treatment effect, but also because these studies provide valuable prognostic information.

Topics: Adult; Aged; Analysis of Variance; Bone Neoplasms; Breast Neoplasms; Disease Progression; Female; Follow-Up Studies; Forecasting; Humans; Middle Aged; Osteosclerosis; Outcome Assessment, Health Care; Prognosis; Radiography; Radionuclide Imaging; Remission Induction; Retrospective Studies; Survival Rate; Technetium Tc 99m Medronate; Treatment Outcome

Progressive diaphyseal dysplasia was incidentally discovered in two patients referred for Tc-99m MDP bone scintigraphy (one for intense sciatica, the other for the detection of breast cancer metastases). Tracer accumulation in the diaphyses of the lower limbs and the base of the skull was accompanied by bone thickening and patency of the medullary cavity, as demonstrated by radiography, MRI, and bone marrow scanning. Comparison of the clinical pictures with the results of instrumental examinations showed that these were cases of sporadic progressive diaphyseal dysplasia of slight and average gravity, respectively. The differentiation of Ribbing's disease is explained and reference also is made to a finding not mentioned in the literature, namely frontal bone resorption lacunules in one patient.

Topics: Bone and Bones; Bone Marrow; Camurati-Engelmann Syndrome; Diagnosis, Differential; Female; Humans; Middle Aged; Osteosclerosis; Radionuclide Imaging; 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

Topics: Adult; Arm; Hand; Humans; Male; Melorheostosis; Osteosclerosis; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

An unusual case of osteopoikilosis was found in a 52-year-old black woman. The rather large diffuse focal increased densities involving the ribs, spine, and pelvis as seen in the roentgenograms were believed to represent metastatic bone lesions. The normal nuclide bone images helped revise the diagnosis to osteopoikilosis. Early recognition of osteopoikilosis would have prevented the patient's apprehension and the extensive work-up for the primary tumor.

Topics: Bone and Bones; Bone Neoplasms; Diagnosis, Differential; Female; Humans; Middle Aged; Osteopoikilosis; Osteosclerosis; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate