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

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

A 74-year-old man underwent low anterior resection for rectal cancer. Technetium-99m methylene diphosphonate (MDP) bone scanning was performed as part of the patient's postoperative follow-up study. Scans revealed an area of increased tracer uptake in the left hemipelvis. Coronal single-photon emission computed tomography and caudal images clearly separated the lesion from the skeletal structures. Transverse magnetic resonance images showed a large diverticulum originating from the left lateral wall of the bladder. The pelvic findings on the bone scan were the result of tracer retained within this diverticulum.

Topics: Aged; Bone Neoplasms; Diagnosis, Differential; Diverticulum; Humans; Incidental Findings; Male; Pelvis; Radionuclide Imaging; Radiopharmaceuticals; Rectal Neoplasms; Severity of Illness Index; Technetium Tc 99m Medronate; Urinary Bladder Diseases; Whole-Body Counting

Topics: Bone and Bones; Bone Neoplasms; Humans; Intestines; Male; Middle Aged; Radiopharmaceuticals; Rectal Neoplasms; Stomach; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Urine; Whole-Body Counting

Bone scintigraphy was performed on a woman 2 y and 10 mo after surgery for rectal cancer. Intense extra-bone accumulations of 99mTc-HMDP were visible in an aortic atherosclerosis lesion and in a metastatic liver tumor. Uptake in the metastatic lesion was confirmed by x-ray CT. Uptake in the aortic lesion was shown as typical calcification by x-ray CT.

Topics: Aged; Aged, 80 and over; Arteriosclerosis; Bone and Bones; Female; Humans; Liver Neoplasms; Postoperative Care; Radionuclide Imaging; Radiopharmaceuticals; Rectal Neoplasms; Technetium Tc 99m Medronate

Compared to other primary neoplasms, bone metastases from carcinoid tumor are rare. Because some lesions may be clinically or radiographically occult, the radionuclide bone scan can be very helpful in delineating the extent of disease. The authors report a case of a patient with clinically occult widespread metastatic disease detected by bone scan, with radiographic correlation.

Topics: Bone and Bones; Bone Neoplasms; Carcinoid Tumor; Female; Humans; Middle Aged; Radiography; Radionuclide Imaging; Rectal Neoplasms; Technetium Tc 99m Medronate

A 30-yr-old woman with previously resected papillary thyroid carcinoma was found to have a pelvic lesion which concentrated radioiodine. By performing simultaneous 131I whole-body and 99mTc-methylene diphosphonate bone scans, we found the lesion to be in soft tissue between the sacrum and bladder. Radioiodine therapy was postponed so that the lesion, a benign teratoma of the rectal wall, could be surgically removed. Prior to laparotomy, the patient received a second tracer dose of 131I so that the lesion could be located at surgery with a hand-held gamma detector. A postoperative whole-body 131I scan confirmed that the lesion had been removed, thus reducing the absorbed radiation that would have been received by the ovaries during radioiodine therapy. Although the lesion contained both thyroid and gastric epithelium, accumulated 131I was limited to the area with thyroid follicles.

Topics: Adult; Bone and Bones; Carcinoma, Papillary; Dermoid Cyst; Female; Humans; Intraoperative Care; Iodine Radioisotopes; Neoplasms, Multiple Primary; Radionuclide Imaging; Rectal Neoplasms; Sigmoid Neoplasms; Technetium Tc 99m Medronate; Thyroid Neoplasms; Thyroidectomy

H-15 (HT-29-15) is an IgG1 mouse monoclonal antibody (mAb) to a cell surface antigen (molecular mass, 200,000 daltons) present on virtually all colorectal cancers and also in normal pancreatic ducts and bile ducts, but not in other normal tissues. The biological distribution and imaging characteristics of iodine-131 (131I)-labeled mAb H-15 were studied in 5 primary colorectal cancer patients and 9 patients with local recurrence of colorectal cancer. H-15 mAb labeled with 0.5-10 mCi of 131I was administered 7 to 8 days before surgery at 4 dose levels, ranging from 0.2 to 6 mg. Selective mAb H-15 localization to tumor tissues was demonstrated in 6 of 12 patients with antigen-positive tumors: in two patients, recurrent tumors were negative to H-15 mAb, although the primary tumors were positive. In six patients with positive radioimaging, tumor:normal tissue ratios ranged from 2.05 to 5.35 and tumor:serum ratios from 1.18 to 2.73. The clarity of images seems to correlate well with the latter ratios. Technetium-99 (99mTc)-albumin blood pool studies in selected cases showed that local recurrence of colorectal cancers was hypovascular, emphasizing the selective localization of mAb H-15 despite poor blood flow distribution in the tumors. The results altogether demonstrated that radioimmunodetection with 131I mAb H-15 is valuable for differentiating recurrent colorectal cancer from granuloma formation after surgery.

Topics: Adult; Aged; Colonic Neoplasms; Female; Humans; Immunoglobulin G; Iodine Radioisotopes; Male; Middle Aged; Neoplasm Recurrence, Local; Radioimmunodetection; Rectal Neoplasms; Technetium Tc 99m Medronate

Both biodegradable emboli and pharmacological agents can enhance regional therapy for hepatic targeting. Using a rat model with similar haemodynamic characteristics to human colorectal liver tumour and a radio-labelled marker of similar molecular weight to Adriamycin, we have combined the two approaches to see if the effect was addictive. Following induction of liver tumour in male hooded rats by intrahepatic injection of HSN sarcoma cells, the relative distribution of marker, 99mTc methylene diphosphonate (MDP), was studied in three groups given the following by injection into the hepatic artery. (1) Saline (Control) + MDP; (2) Degradable Starch Microspheres (DSM) + MDP; and (3) Angiotensin II + DSM + MDP. Both Degradable Starch Microspheres alone (P less than 0.001) and Degradable Starch Microspheres + Angiotensin II (P = 0.003) significantly increased the retention of marker in liver and tumour at 1 min following injection, with a 12-fold improvement over controls, but the tumour:liver ratio was unaltered. By 90 min the MDP levels in normal hepatic parenchyma had returned to control values. There was relatively less washout with significant retention in tumour tissue in both DSM (P = 0.03) and combination treated animals (P = 0.001), with a significantly improved (P = 0.001) tumour to liver ratio (5.22:1) in combination treated animal relative to those treated with DSM alone.

Topics: Angiotensin II; Animals; Colonic Neoplasms; Drug Carriers; Liver Neoplasms; Male; Microspheres; Neoplasm Metastasis; Radionuclide Imaging; Rats; Rats, Inbred Strains; Rectal Neoplasms; Sarcoma, Experimental; Starch; 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