technetium-tc-99m-medronate and Plasmacytoma

Topics: Bone Neoplasms; Diagnosis, Differential; Humans; Ilium; Male; Middle Aged; Multiple Myeloma; Plasmacytoma; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Female; Humans; Middle Aged; Plasmacytoma; Radionuclide Imaging; Radiopharmaceuticals; Stomach Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

In 20 patients with multiple myeloma, the results of MR, x-ray, bone scintigraphy, bone marrow scintigraphy and bone marrow biopsy were compared. MR proved the most sensitive imaging method for the detection of bone marrow infiltration followed by x-ray examinations. Bone marrow scintigraphy and especially bone scintigraphy revealed false-negative results more often. These findings were more impressive by the direct comparison of several investigated regions showing different findings of each imaging method. False-positive results were not found. In 4 patients false-negative results of bone marrow biopsy had to be assumed because of definitely pathological findings by x-ray and MRI.

Topics: Aged; Aged, 80 and over; Biopsy; Bone and Bones; Bone Marrow; Bone Neoplasms; False Negative Reactions; False Positive Reactions; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Plasmacytoma; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

The bone scan features of different types of sacral tumors in 16 patients were assessed. Four out of five patients with chordoma, the most common sacral tumor, demonstrated either reduced uptake or normal distribution of isotope at the site of this midline tumor. Plasmacytoma, which is not usually central, also caused reduced uptake on the bone scan. Ewing's sarcoma gave no consistent pattern. All other tumors caused increased uptake except for one unusual case of osteogenic sarcoma. Bone scintigraphy can be very useful in the assessment of sacral tumors. A midline sacral tumor that is cold on the bone scan is very likely to be a chordoma.

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Chordoma; Female; Humans; Male; Middle Aged; Plasmacytoma; Radionuclide Imaging; Retrospective Studies; Sacrum; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

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

In the diagnosis of multiple myeloma (MM), the radiological skeletal survey (RSS) was proven to be most useful for the detection of bone lesions. Since 1961, a new technique radioisotopic bone scan (RIBS), for the detection of such lesions, using 85Sr and 99mTc, has been shown to be highly sensitive for the detection of skeletal metastases of epithelial tumors. We have studied 30 patients with plasma cell dyscrasia (PCD) by both methods and concluded that RSS is clearly superior to RIBS in PCD. As RIBS detected less than 50% of the lesions demonstrated by RSS there seems to be no indication for a routine RIBS in the initial work-up of patients suspected to have PCD. However, due to the fact that RIBS is useful for the detection of new bone formation it has a certain value in the localization of pathological fractures in MM, mainly in vertebral compression.

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Diphosphonates; Fractures, Spontaneous; Humans; Middle Aged; Multiple Myeloma; Osteoporosis; Pelvic Bones; Plasmacytoma; Radiography; Radionuclide Imaging; Ribs; Skull; Spinal Injuries; Spine; 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