technetium-tc-99m-medronate and Soft-Tissue-Neoplasms

Primary sarcoma of bone is a rare entity but nevertheless a significant cause of mortality in children and adolescents. The focus of the preoperative evaluation is to set up a histological diagnosis, define local tumor extent and develop a therapy regimen. In addition to patient history and clinical findings a radiograph in two orthogonal planes is still of great importance. MRI plays a major role in the further clarification of the diagnosis, while CT is valuable in the diagnosis of tumors of the axial skeleton as well as in systemic staging. A PET-CT can be performed to obtain an overview of further tumor sites. Open bone biopsy is the final diagnostic step and should be carried out at the institution where the definitive treatment will be performed. Complications such as fracture, neural lesions and spread of tumor cells are relatively rare if the biopsy is performed appropriately; however, patients should be instructed to strictly avoid weight-bearing on the affected extremity.

Topics: Adolescent; Angiography; Biopsy; Biopsy, Needle; Bone Neoplasms; Child; Humans; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Multimodal Imaging; Neoplasm Grading; Neoplasm Seeding; Neoplasm Staging; Positron-Emission Tomography; Radionuclide Imaging; Sarcoma; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Technetium-99m methylene diphosphonate (Tc-99m MDP) bone scans have long been used by clinicians to diagnose osseous metastases in patients with cancer. However, in several benign and malignant diseases, notably those characterized by extensive soft tissue calcification, Tc-99m MDP may be taken up by the tumor itself. We present a case of a stage IIIC psammoma-rich low-grade serous carcinoma of the ovary, whose identity and extent of disease were first suggested by Tc-99m MDP scintigraphy. The literature concerning this form of cancer, and the use of Tc-99m MDP bone scans to image soft tissue lesions, are reviewed.

Topics: Cystadenocarcinoma, Serous; Female; Humans; Middle Aged; Ovarian Neoplasms; Positron-Emission Tomography; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Although bone scanning is a test primarily concerned with skeletal abnormalities, important nonosseous findings are occasionally present on the images. To gauge the significance of such nonosseous uptake and, in particular, to determine whether these findings contain useful diagnostic information, the technical and medical staff in nuclear medicine must recognize the various patterns of nonbony uptake and understand their causes. The objectives of this article are to demonstrate the appearances of nonosseous uptake on bone scans, to categorize the forms of soft-tissue uptake, to emphasize technical artifacts leading to soft-tissue uptake, and to highlight the clinical significance of pathologic soft-tissue uptake.

Topics: Artifacts; Bone and Bones; Connective Tissue; Diagnosis, Differential; Extravasation of Diagnostic and Therapeutic Materials; Humans; Incidental Findings; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Urologic Diseases; Viscera

The TNM staging system is a modus for diagnosis and treatment in which T is the extent of the tumor involvement, N is lymph node involvement, and M is the metastases; this system is supplemented with a histologic malignancy grade. Staging systems identify specific prognostic factors with which to predict clinical outcome. Staging systems are useful for assigning treatment priorities, determining the role of adjuvant therapies, and evaluating clinical investigations. Unfortunately, no universally accepted staging system for soft-tissue sarcomas exists. This is related to the relatively low incidence of sarcomas, the unique and unpredictable behavior of sarcomas, significant disagreement regarding histogenesis and grading, and lack of consensus regarding the value of various prognostic factors. In adults, the two most commonly used staging systems are those developed by the American Joint Committee on Cancer and by Enneking. In children, the Intergroup Rhabdomyosarcoma Study and the International Union Against Cancer have described the systems most commonly used. These systems for soft-tissue sarcomas rely on an ability to accurately determine both the local and distant extent of disease. Advances in the field of computed tomography and magnetic resonance imaging have made this possible. It is likely that a staging system based upon a more sophisticated understanding of the basic biology of sarcomas will become available.

Topics: Adult; Biopsy; Child; Clinical Protocols; Humans; Incidence; Lymphatic Metastasis; Magnetic Resonance Imaging; Neoplasm Invasiveness; Neoplasm Metastasis; Neoplasm Staging; Prognosis; Rhabdomyosarcoma; Sarcoma; Sensitivity and Specificity; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Treatment Outcome

Topics: Aged; Bone Neoplasms; Diphosphonates; Female; Histiocytoma, Benign Fibrous; Humans; Lung Neoplasms; Male; Radionuclide Imaging; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Ultrasonography

The purpose of this study was to evaluate the usefulness of 201Tl scintigraphy in comparison with three-phase bone scintigraphy in the differentiation of residual/recurrent tumors from post-therapeutic changes, in patients previously treated for bone and soft-tissue tumors.. Thirty-five 201Tl and three-phase bone scintigraphy scans were obtained for 30 patients with a history of bone or soft-tissue tumor who had undergone chemotherapy, radiation therapy, tumor resection, or a combination of these treatments. The planar 201Tl images were acquired 10 mins (early) and 2 hrs (delayed) after the intravenous injection of 111 MBq 201Tl-chloride. Three-phase bone scintigraphy was performed using 740 MBq 99mTc-HMDP at the same lesion site as for 201Tl imaging. The blood flow images were obtained every 10 sec for 2 mins and were immediately followed by the blood pool image after 5 mins. Three to 4 hrs later, bone images were obtained. 201Tl and three-phase bone scintigraphies were correlated with the histopathologic findings and/or clinical follow-up of more than 3 months.. Of the 35 cases, 15 were free of disease and 20 had residual or recurrent tumors. Of the 20 residual or recurrent cases, all had true-positive 201Tl early and delayed scans, while bone scintigraphy was true-positive on the blood flow, blood pool and bone images in 16, 18 and 12 cases, respectively. 201Tl early and delayed images and 99mTc-HMDP blood flow and blood pool images were false-positive in one patient. The histology of this false-positive case showed the presence of lymph proliferative tissue.. Although 201Tl uptake after treatment does not always indicate recurrence, 201Tl scintigraphy may still be more useful than three-phase bone scintigraphy in the follow-up of patients with bone and soft-tissue tumors following therapy.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Neoplasms; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Prognosis; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thallium; Treatment Outcome

Technetium-99m-sestamibi (99mTc-MIBI) imaging is a well-established modality in oncologic investigations. The current study aimed to investigate whether any relationship could be found between 99mTc-MIBI uptake and local perfusion in malignant bone and soft-tissue tumours. It also aimed to compare 99mTc-MIBI images with those of technetium-99m-methylene diphosphonate (99mTc-MDP) bone scintigraphy with regard to the activity distribution pattern, intensity and lesion extension. The study group included 24 patients with various bone and soft-tissue tumours. Three-phase bone scintigraphy and 99mTc-MIBI studies were performed within the same week before any surgical and therapeutic intervention. Images were evaluated visually and quantitatively using regions of interest (ROIs) over the lesion and adjacent normal tissue. The 99mTc-MIBI study was positive with varying degrees of uptake (range, 1.4-5.3). The mean 99mTc-MIBI uptake and 99mTc-MDP blood-pool and osseous phase activity ratios were 2.5 +/- 0.5, 2.8 +/- 1.0 and 5.5 +/- 4.0, respectively. The correlation between the 99mTc-MIBI uptake and blood-pool ratios was 0.70 (P<0.05). While activity distribution patterns were in agreement in 99mTc-MIBI and blood-pool images in the majority of cases, 99mTc-MIBI better delineated tumour viability and extension in five cases. In conclusion, 99mTc-MIBI accumulation shows a reasonable correlation with blood-pool uptake assuming the presence of multifactorial mechanisms in addition to local hyperaemia. Better delineation of tumour outlines and cellular activity seems to be an advantage of 99mTc-MIBI scintigraphy which may be helpful in the evaluation of musculoskeletal tumours.

Topics: Adolescent; Adult; Bone Neoplasms; Child; Female; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Osteosarcoma; Radionuclide Imaging; Radiopharmaceuticals; Regional Blood Flow; Sarcoma; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi

To characterize 201Tl uptake in patients with bone and soft-tissue tumor, we studied 49 patients with surgically proven tumors and one patient with a tumor diagnosed arteriographically. In 37 of our 50 patients, the tumor was evaluated with 201Tl and arteriography. Moreover, in 14 of patients with pre-operative chemotherapy, pathologic changes were graded on the basis of percent tumor necrosis as defined histologically. The percent tumor necrosis histologically was compared with changes in the scintigraphic and conventional angiographic studies. Radiologic comparisons demonstrated a high degree of correlation with images of 201Tl and both arterial and blood pool phase of 99mTc-HMDP. Ninety-six percent of 28 malignant tumors had positive 201Tl uptake. None of the patients showed any thallium accumulation in the soft tissues or skeleton adjacent to the lesion. Activity of 201Tl was mainly dependent upon a tumor blood flow and a vascular density. In of 14 cases with the preoperative chemotherapeutic treatment, 201Tl scintigraphic changes showed concordance with % tumor necrosis. Thallium-201 was superior to 99mTc-HMDP in predicting tumor response to chemotherapy. Interestingly, delayed images of 99mTc-HMDP of 5 responders with > 90% tumor necrosis showed decreased uptake in the adjacent bone to the tumor mass lesions. It seems to be quite all right to consider that a major determinant of 201Tl uptake is intratumoral angiogenecity, which is closely connected with tumor viability. Therefore, 201Tl is a sensitive radiopharmaceutical for detection of vascular rich bone and soft-tissue tumors, and appears to be a simple and an accurate test for evaluating the response to specific therapeutic regimens of malignant bone and soft-tissue tumors.

Topics: Adolescent; Adult; Aged; Angiography; Bone Neoplasms; Cell Survival; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thallium Radioisotopes

Soft tissue giant cell tumor (GCT) is rare. It usually involves the extremities. We report the case of a 37-year-old woman who was suspected of having mediastinal tumor on radiograph. Thoracic CT revealed the tumor had extensive calcification and invaded the adjacent vertebrae and spinal canal. It intensively accumulated Tc-methylene diphosphonate on bone scan. The tumor showed hypointensity on T1-weighted and mixed intensity on T2-weighted fat-saturated sagittal images. Finally, a soft tissue GCT was confirmed by pathology. The case cautions us soft tissue GCT should be in the differential diagnosis spectrum in a calcified posterior mediastinal mass with Tc-methylene diphosphonate accumulation.

Topics: Adult; Diagnosis, Differential; Female; Giant Cell Tumors; Humans; Mediastinal Neoplasms; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Three-phase bone scintigraphy is sometimes of great value in the detection of uncharacteristic metastases and assists the management of patients in terms of primary focus detection. While evaluating the skeletal system with whole-body bone scintigraphy, other system pathologies may also be detected incidentally. In this case, we present the extraordinary findings on the 3-phase MDP bone scintigraphy and F-FDG PET/CT imaging of the complicated bone metastases in a patient with thyroid carcinoma.

Topics: Aged; Bone Neoplasms; Female; Fluorodeoxyglucose F18; Humans; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Myopericytoma is a rare type of unusual soft tissue tumor with perivascular myoid differentiation. A 53-year-old man with the diagnosis of colon cancer was referred to Tc-MDP bone scan and F-FDG PET/CT for staging. A subcutaneous mass located in right lower back with heterogeneous FDG uptake was detected on PET/CT. There was increased osteoblastic activity on MDP bone scan in the same region. Mass was resected and subsequently confirmed as myopericytoma by histopathology.

Topics: Bone Neoplasms; Colonic Neoplasms; Fluorodeoxyglucose F18; Humans; Incidental Findings; Male; Middle Aged; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Torso

A 74-year-old male patient with a newly diagnosed prostate cancer had whole-body bone scintigraphy for staging. The images did not demonstrate osseous metastasis. However, there was a large ring-shaped, relatively photopenic region with peripherally increased MDP activity in the left back, which was caused by a large lipoma.

Topics: Aged; Bone and Bones; Humans; Lipoma; Male; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Whole Body Imaging

Many children with sarcomas undergo whole body 2-deoxy-2-((18)F)fluoro-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and technetium methylene diphosphonate ((99)Tc-MDP) studies. It is unknown whether the combination of both tests results in more accurate detection of bone lesions than (18)F-FDG- PET/CT alone.. (99)Tc-MDP bone and (18)F-FDG PET/CT scans were each read by 2 "blinded" observers and then reviewed side-by-side by 3 readers. Bone lesions were graded qualitatively on a 5-point scale (from benign to malignant). Clinical and imaging follow-up (n = 21) and bone biopsy results (n = 8) served as reference standard.. A total of 39 paired (99)Tc-MDP and (18)F-FDG-PET/CT studies (cases) performed at a mean interval 4 ± 7 days, were performed on 29 patients (mean age 12 ± 5 y). Of these, 21 patients (72%) had bone sarcoma, whereas 8 patients (28%) had soft tissue sarcoma. By patient and case-based analysis, (18)F-FDG PET/CT had an accuracy of 100%. Tc-MDP had accuracies of 90% and 82% by patient and case-based analysis. The combined interpretation had an accuracy of 97%.. In this study, (99)Tc-MDP bone imaging does not provide an added diagnostic value for bone involvement over (18)F-FDG-PET/CT.

Topics: Adolescent; Bone Neoplasms; Child; Child, Preschool; Diagnostic Imaging; Female; Fluorodeoxyglucose F18; Humans; Image Interpretation, Computer-Assisted; Male; Multimodal Imaging; Positron-Emission Tomography; Radionuclide Imaging; Retrospective Studies; Sarcoma; Sensitivity and Specificity; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

The presence of metaplastic ossification within atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDLPS) is a rare occurrence. When present, bone formation is most often found in association with a dedifferentiated component arising within the primary tumor. It is important for the radiologist not only to recognize the differential diagnosis of a calcified or ossified soft tissue mass but also be aware of the various soft tissue neoplasms, both aggressive and non-aggressive, that may show such features. We report a case of ALT/WDLPS with unusual extensive metaplastic bone formation without an element of dedifferentiated liposarcoma.

Topics: Aged; Biomarkers, Tumor; Biopsy, Needle; Cyclin-Dependent Kinase 4; Diagnosis, Differential; Humans; Liposarcoma; Magnetic Resonance Imaging; Male; Metaplasia; Ossification, Heterotopic; Positron-Emission Tomography; Proto-Oncogene Proteins c-mdm2; Radiography, Interventional; Radiopharmaceuticals; Shoulder; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

The aim of this work was to report an unusual case of multiple soft tissue metastases of osteosarcoma detected using bone scan and confirmed by CT scan.. A 15-year-old patient with a history of osteogenic sarcoma presented with fatigue and loss of appetite in addition to a painless swelling of the distal left lower extremity. Bone scan and chest CT scan were performed for restaging purposes. The bone scan revealed multiple bone metastases and suspected tumor recurrence in the left lower extremity in addition to multiple extraosseous hot spots. The latter findings were assessed as ossified soft tissue metastases after considering the performed CT scan.. This case showed the double role of bone scan in osteosarcoma in simultaneously assessing the bone status and tumor spread in soft tissue. The benefit of a comparison of bone scan findings with other modalities was also demonstrated.

Topics: Adolescent; Bone Neoplasms; Humans; Male; Osteosarcoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Extraosseous accumulation of bone-seeking agents is rare, but has been previously reported in pediatric sarcomas and neuroblastomas. We present an unusual case of a 5-month-old male with an abdominal mass observed clinically by his parents and referring pediatrician. Contrast abdominal computerized tomography confirmed the presence of a large pelvic mass that was diagnosed pathologically as embryonal rhabdomyosarcoma. A bone scintigraphy that was performed for staging of the disease revealed accumulation of the radiopharmaceutical in the tumor. There was no evidence for skeletal metastatic disease. This case further demonstrates the nonspecificity of soft-tissue tumor uptake on bone scintigraphy.

Topics: Bone Neoplasms; False Positive Reactions; Humans; Infant; Male; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyosarcoma, Embryonal; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tissue Distribution

Topics: Adult; Aged; Aged, 80 and over; Bone Neoplasms; Breast Neoplasms; Esophageal Neoplasms; Female; Humans; Kidney Neoplasms; Male; Middle Aged; Neoplasm Staging; Patient Satisfaction; Prospective Studies; Prostatic Neoplasms; Radiopharmaceuticals; Sensitivity and Specificity; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Tomography, X-Ray Computed; Whole Body Imaging

Non-Hodgkin lymphoma (NHL) is rare in infancy, and we present a case of aggressive NHL of T-cell lineage in an infant with multifocal bone, cardiac, mediastinal nodal, paranasal sinus, calvarial, and soft-tissue deposits on presentation that were detected on whole-body MRI.

Topics: Bone Neoplasms; Heart Neoplasms; Humans; Infant; Lymph Nodes; Lymphoma, T-Cell; Magnetic Resonance Imaging; Male; Mediastinal Neoplasms; Paranasal Sinus Neoplasms; Radiopharmaceuticals; Skull Base Neoplasms; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Whole Body Imaging

Current imaging guidelines recommend that many cancer patients undergo soft-tissue staging by computed tomography (CT) whilst the bones are imaged by skeletal scintigraphy (bone scan). New CT technology has now made it feasible, for the first time, to perform a detailed whole-body skeletal CT. This advancement could save patients from having to undergo duplicate investigations. Forty-three patients with known malignancy were investigated for bone metastasis using skeletal scintigraphy and 16-detector multislice CT. Both studies were performed within six weeks of each other. Whole-body images were taken 4 h after injection of 500 Mbq (99m)Tc-MDP using a gamma camera. CT was performed on a 16-detector multislice CT machine from the vertex to the knee. The examinations were reported independently and discordant results were compared at follow-up. Statistical equivalence between the two techniques was tested using the Newcombe-Wilson method within the pre-specified equivalence limits of +/-20%. Scintigraphy detected bone metastases in 14/43 and CT in 13/43 patients. There were seven discordances; four cases were positive on scintigraphy, but negative on CT; three cases were positive on CT and negative on scintigraphy. There was equivalence between scintigraphy and CT in detecting bone metastases within +/-19% equivalence limits. Patients who have undergone full whole-body staging on 16-detector CT may not need additional skeletal scintigraphy. This should shorten the cancer patient's diagnostic pathway.

Topics: Adult; Aged; Aged, 80 and over; Bone Neoplasms; Breast Neoplasms; Esophageal Neoplasms; Female; Humans; Kidney Neoplasms; Male; Middle Aged; Neoplasm Staging; Patient Satisfaction; Prospective Studies; Prostatic Neoplasms; Radiopharmaceuticals; Sensitivity and Specificity; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Tomography, X-Ray Computed; Whole Body Imaging

Topics: Child; Humans; Intellectual Disability; Male; Muscles; Myositis Ossificans; Neoplasm Metastasis; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi

Topics: Adult; Arm; Bone Neoplasms; Diagnosis, Differential; Erythrocytes; Hemangioma; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thallium

Extraskeletal osteosarcoma is an extremely rare high-grade malignant soft tissue tumor, which accounts for approximately 4% of osteosarcomas and less than 1% of all soft tissue sarcomas. There have been reports describing the scintigraphic findings of this tumor, especially with Tl-201. We report a biopsy-proven case of extraskeletal osteosarcoma in which the bone and thallium scans were found to be useful in monitoring chemotherapy response. The Tc-99m HMDP bone scan revealed increased extraskeletal uptake in the tumor.

Topics: Bone Neoplasms; Humans; Male; Middle Aged; Muscle Neoplasms; Osteosarcoma; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thallium; Thigh

Extraskeletal osteosarcoma is a rare malignant soft-tissue tumor. There are few reports describing the radiological findings of this tumor, especially concerning its MRI and scintigraphic appearance. We report a 58-year-old man with extraskeletal osteosarcoma in the thigh. Radiographs showed small foci of mineralization in the mass. The tumor showed low intensity on T1-weighted images and predominantly high intensity on T2-weighted images, and the tumor was heterogeneously well enhanced on Gd-DTPA-enhanced T1-weighted images. Bone scintigraphy showed extraskeletal uptake in the tumor, and thallium-201 scintigraphy revealed marked inhomogeneous accumulation.

Topics: Contrast Media; Gadolinium DTPA; Humans; Image Enhancement; Magnetic Resonance Imaging; Male; Middle Aged; Osteosarcoma; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thallium Radioisotopes; Thigh

Topics: Animals; Cats; Fibrosarcoma; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Topics: Aged, 80 and over; Buttocks; Humans; Low Back Pain; Male; Radionuclide Imaging; Radiopharmaceuticals; Sarcoma; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Mixed medullary-follicular thyroid carcinoma (MMFTC) is a rare tumor with a metastatic behavior that has not been fully appreciated. Scintigraphy and radioiodine entrapment propensity of its metastases remains largely undescribed. The authors present a case of MMFTC with widespread bone and soft-tissue metastases, where every known site of metastases concentrated radioiodine intensely. The patient responded well to radioiodine therapy. The report suggests that the tumor may have a propensity to metastasize to the skeleton, and the metastases retain the ability to accumulate radioiodine.

Topics: Adenocarcinoma, Follicular; Bone Neoplasms; Carcinoma, Medullary; Female; Humans; Iodine Radioisotopes; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thyroid Neoplasms

Topics: Bone and Bones; Calcinosis; Connective Tissue Diseases; Edema; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Renal Dialysis; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Topics: Animals; Bone Neoplasms; Dog Diseases; Dogs; Female; Osteosarcoma; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

A 40-year-old woman presented with a known case of osteogenic sarcoma of the right leg and underwent below-the-knee amputation. The preoperative workup was negative for distant metastases, and the patient was followed regularly. Two years later she developed dyspnea and chest pain. Computed tomography revealed diffuse left lung metastases with pleural involvement and nodular metastases in the right lung. Tc-99m methylene diphosphonate whole-body bone scanning revealed the amputated right leg with a clean stump but with widespread metastases in the right thigh involving soft tissue and bone, and the pelvis, left femur, and skull. In addition, diffuse left lung metastases involving both parietal pleura and lung parenchyma were seen. Tc-99m methylene diphosphonate uptake has been observed in the soft tissue and lungs in patients with osteogenic sarcoma but is rarely observed in practice with this degree of aggressiveness.

Topics: Adult; Bone Neoplasms; Female; Humans; Lung Neoplasms; Osteosarcoma; Pleural Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Topics: Carcinoma, Non-Small-Cell Lung; Cartilage; Humans; Lung Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Ribs; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Topics: Abdominal Neoplasms; Abdominal Wall; Aged; Calcinosis; Diagnosis, Differential; Humans; Male; Plasma Cell Granuloma, Pulmonary; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Solitary Pulmonary Nodule; Technetium Tc 99m Medronate

The authors report a case of alveolar soft-part sarcoma with lung metastases demonstrated by "double imaging" with Tc-99m HDP and Tc-99m MIBI. The tumor originated in the soft tissue with direct invasion to the right scapula, which was hypoactive on bone scan and hyperactive on Tc-99m MIBI images. A focus of dense accumulation of Tc-99m MIBI in the lungs, suggesting metastasis was also demonstrated.

Topics: Bone Neoplasms; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Sarcoma, Alveolar Soft Part; Scapula; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi

A 63-year-old woman with previously treated stage I lung cancer was reexamined 5 years later for recurrence. A conventional work-up using computed tomographic scanning and transbronchial biopsy showed nothing abnormal. A Tc-99m depreotide scan, however, led to a noninvasive diagnosis of lung cancer recurrence with metastases, and it directed a noninvasive tissue diagnosis.

Topics: Adenocarcinoma; Bone Neoplasms; Female; Humans; Leg; Lung Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Scapula; Soft Tissue Neoplasms; Somatostatin; Technetium Tc 99m Medronate; Thoracic Vertebrae; Whole-Body Counting

To describe the radionuclide three-phase whole-body bone imaging (TPWBBI) technique and discuss the usefulness of its application.. TPWBBI was performed after a single intravenous injection of 555 to 925 MBq (15 to 25 mCi) Tc-99m MDP. Whole-body arterial flow (phase one) followed by blood-pool and tissue perfusion (phase two) images were obtained with the moving detector head speed set at 150 cm/minute and 40 cm/minute, respectively. Conventional whole-body static bone images (phase three) were obtained 3 hours later.. When 542 consecutive TPWBBI results were reviewed, 394 (166 extraskeletal and 228 skeletal) abnormalities were detected during phases one and two. The 166 extraosseous lesions included vascular diseases: abdominal aortic aneurysms and peripheral vascular diseases and renal abnormalities, liver abnormalities, ascites, and pleural effusions. Many of these were incidentally detected clinically significant findings and would not have been identified on conventional static bone images. It helps to differentiate among acute and chronic fractures, active and inactive inflammatory diseases such as arthritis or osteomyelitis, and Paget's disease.. With a single injection of Tc-99m MDP, whole-body images obtained in the arterial phase, the blood-pool and tissue perfusion phase, and the static bone phase can identify many clinically significant skeletal and soft tissue abnormalities. TPWBBI can differentiate between active and inactive phases of different disease processes and thereby provide a diagnosis that is more specific than a conventional single-phase bone scan. It may be applicable as a tool for nuclear physical examination.

Topics: Adult; Aged; Aged, 80 and over; Bone Diseases; Diagnosis, Differential; Digestive System Diseases; Feasibility Studies; Female; Female Urogenital Diseases; Humans; Male; Male Urogenital Diseases; Middle Aged; Predictive Value of Tests; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Vascular Diseases; Whole-Body Counting

This report describes a case of bone involvement by epithelioid sarcoma, which on imaging had the appearance of a primary intraosseous lesion of the scapula. The tumor initially presented as a subcutaneous nodule which was mistakenly diagnosed as "fibrosis" following initial resection. The lesion recurred locally and after several resections presented with several ulcerated subcutaneous nodules, at which time all imaging studies were performed. The patient was treated with en bloc upper humeral interscapulothoracic resection and shoulder reconstruction. Two years after the operation the patient is alive without local recurrence or metastasis.

Topics: Adult; Bone Neoplasms; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Radiopharmaceuticals; Sarcoma; Scapula; Shoulder; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Extraskeletal myxoid chondrosarcoma of the lower extremity is rare, and slowly progressive. The authors of this article present the case of a man with progressive enlargement of the right thigh that underwent bone scintigraphy. The bone images showed a diffuse, moderate increase in uptake in the swollen right thigh. Despite chemotherapy, the patient died 28 mo later. At autopsy, it was confirmed that he had extraskeletal myxoid chondrosarcoma of the right thigh, which had metastasized to the upper arms, left scapula, lungs, pleurae, and right lower quadrant of the abdomen. The myxoid chondroid matrix, a major feature of the extraskeletal myxoid chondrosarcoma, is thought to account for the localization of the bone-imaging agent.

Topics: Aged; Chondrosarcoma; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh

Malignant fibrous histiocytoma (MFH) is the most common soft tissue malignant tumour in late adult life. MFH has been mentioned to have avid uptake of 67Ga citrate, and only 38% is uptake of 99mTc-MDP, although few cases of MFH have been reported. We present the case of a 73 years old male patient with MFH. In the blood pool phase of the bone scintigraphy, MFH was presented as an intense hyperactive lesion. In the late phase the tumor is one of the few MFH described to have avid uptake for 99mTc-MDP. In this work we also review some cases of MFH described and the different techniques used in the diagnosis and follow-up of these tumours.

Topics: Aged; Arm; Histiocytoma, Benign Fibrous; Humans; Male; Neoplasm Invasiveness; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Although TI-201 is highly sensitive for detecting bone and soft-tissue tumors, its uptake is not specific for malignant lesions. This study assessed the differentiation of malignant and benign lesions and evaluated the sensitivity, specificity, and accuracy of TI-201 imaging and three-phase bone scans.. Forty bone and soft-tissue tumors (16 malignant and 24 benign) were evaluated. TI-201 static images were acquired 10 minutes (early) and 2 hours (delayed) after injection of the radionuclide. Within 14 days, three-phase bone scintigraphy was performed using Tc-99m HMDP with the patient in the same position. The count ratio of the lesion compared with the normal contralateral or adjacent site (L:N ratio) was measured.. With TI-201 scintigraphy, mean (+/- SD) values of early and delayed L:N ratios were 3.36 +/- 1.25 and 2.88 +/- 1.20, respectively, in malignant lesions; and 1.88 +/- 1.14 and 1.48 +/- 0.76, respectively, in benign lesions. TI-201 accumulation in benign lesions was significantly less than that of malignancies on early and delayed images. However, an overlap of both ratios between malignant and benign lesions was seen. No such significance was detected on three-phase bone scintigraphy (L:N ratios of malignant and benign tumors were 2.57 +/- 1.22 and 2.24 +/- 2.11, respectively, for blood flow imaging; 2.41 +/- 0.78 and 2.26 +/- 1.54, respectively, for blood pool imaging; and 2.80 +/- 2.10 and 2.89 +/- 4.55, respectively, for bone imaging). When we assumed that the tumor was malignant when the delayed TI-201 L:N ratio exceeded the blood pool phase L:N ratio with bone scintigraphy, the sensitivity rate was 81%, specificity rate was 100%, and accuracy rate was 93%.. TI-201 imaging for bone and soft-tissue tumors was better than three-phase bone scintigraphy alone but was not good enough to clearly differentiate malignant lesions from benign ones. TI-201 scintigraphy, performed in combination with three-phase bone scintigraphy, may be superior to either one of the two imaging procedures alone for bone and soft-tissue tumor diagnosis.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone and Bones; Bone Neoplasms; Female; Humans; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thallium Radioisotopes

A bone scan in a patient with proved osteogenic sarcoma of the tibia showed intense focal uptake in the gluteal region on the side of his cancer. This was proved to be a metastasis in the muscle.

Topics: Bone Neoplasms; Buttocks; Humans; Osteosarcoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tibia

Pasteurized autogenous bone graft sterilized at a low temperature (60 degrees C) is one option for reconstruction after resection of bone and soft tissue tumors. The purpose of this investigation was to assess the normal and abnormal radiographic and scintigraphic findings of pasteurized intercalary autogenous bone graft after resection of bone and soft tissue sarcomas.. This was a retrospective evaluation of the radiography and bone scintigraphy findings in patients after treatment of bone and soft tissue sarcomas using an intercalary pasteurized autogenous bone graft.. Among 10 consecutive patients, eight had intercalary grafts, and they constitute the subjects of this study. All available radiography and bone scintigraphy findings were reviewed for the healing process and the possibility of complications.. Healing and incorporation of the graft were observed in five patients during the follow-up, but the other three did not heal satisfactorily. Rapid incorporation of pasteurized autogenous bone graft can be demonstrated by means of radiography and bone scintigraphy.

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Bone Transplantation; Female; Humans; Male; Middle Aged; Radiography; Radionuclide Imaging; Retrospective Studies; Sarcoma; Soft Tissue Neoplasms; Sterilization; Technetium Tc 99m Medronate; Transplantation, Autologous; Treatment Outcome

Accumulation with bone scintigraphy using technetium-99m hydroxymethylene diphosphonate (99mTc-HMDP) in 68 cases with radiographically or pathologically verified soft tissue tumor was examined. Radiographical or histopathologic diagnoses of the 68 cases included; 14 lipomas, 11 liposarcomas, 11 neurinomas or neurofibromas, 6 malignant lymphomas, 5 malignant fibrous histiocytomas, 5 hemangioma, rhabdomyosarcomas, 2 Langerhans cell histiocytoses, 2 desmoid tumors and one each of neuroblastoma, hemangiopericytoma, angiomyxoma, plasmacytoma, liomyosarcoma, lymphangioma, fibrosarcoma, elastofibroma, synovial sarcoma, and ganglion. Thirty-seven (54%) showed positive accumulation and 31 were negative. One half of soft tissue tumors can be accumulated by 99mTc-HMDP.

Topics: Aged; Bone and Bones; Humans; Male; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Topics: Adenocarcinoma; Colonic Neoplasms; Humans; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Unusual, intense splenic radioactivity was seen on bone scintigraphy with Tc-99m HMDP in a 14-year-old boy with alveolar rhabdomyosarcoma complicated by disseminated intravascular coagulation. Abnormal splenic radioactivity was resolved after recovery from the disseminated intravascular coagulation. During treatment of disseminated intravascular coagulation and tumors, the patient received repeated blood transfusions, resulting in iron overload, but this did not prevent the abnormal splenic uptake from resolving. This case indicates that disseminated intravascular coagulation may be a cause of splenic accumulation of bone-seeking agents, and that abnormal splenic uptake can be resolved.

Topics: Adolescent; Disseminated Intravascular Coagulation; Humans; Lymphatic Metastasis; Male; Radionuclide Imaging; Radiopharmaceuticals; Rhabdomyosarcoma, Alveolar; Soft Tissue Neoplasms; Spleen; Technetium Tc 99m Medronate

Transient visualization of the uterus, mimicking a hypervascular soft tissue tumour in the pelvic region, in the blood flow and blood pool phases of a triple-phase bone scan, was seen in 78 of 91 females of reproductive age. It was noted in all cases of menstrual (n = 15), early proliferative (n = 9) and secretory (n = 42) phases of the cycle, but in only 12 of 25 subjects studied in the late proliferative phase. This observation differs from previous reports of uterine uptake only being seen in the menstrual and secretory phases, or in all menstrual cycle phases. None of the 58 control patients (20 males, 16 pre-menarcheal females and 22 post-menopausal females) had such uterine uptake in either the blood flow or blood pool phase in the pelvic region. We suggest that this normal physiological phenomenon, mimicking a hypervascular soft tissue tumour in the pelvis, occurs in the menstrual, early proliferative and secretory phases of pre-menopausal females and in all phases of the cycle in younger females of reproductive age.

Topics: Adolescent; Adult; Artifacts; Bone and Bones; Child; Diagnosis, Differential; Female; Humans; Male; Menarche; Menstrual Cycle; Middle Aged; Pelvic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Reference Values; Retrospective Studies; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Uterus

Topics: Bone and Bones; Colon, Sigmoid; Diagnosis, Differential; Fecal Impaction; Humans; Osteitis Deformans; Pelvic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Rectum; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Urinary Bladder; Whole-Body Counting

A malignant solitary fibrous tumor arising in the right buttock associated with metastatic parietal pleural and intrapulmonary tumors and pleural effusion was found in a 59-year-old man. A chest computed tomogram revealed three tumors attached to the parietal pleura with rib destruction, and a tumor in the left lower lung field. Histologically, the tumors of the buttock and parietal pleura were characterized by proliferation of bundles of spindle-shaped or oval cells separated by wavy hyalinized collagen tissue with no expression of cytokeratin, S-100 protein, muscle actin or epithelial membrane antigen, but these cells weakly expressed CD34 and strongly expressed vimentin.

Topics: Biomarkers, Tumor; Buttocks; Combined Modality Therapy; Extracellular Matrix Proteins; Follow-Up Studies; Humans; Immunohistochemistry; Lung Neoplasms; Male; Middle Aged; Neoplasms, Fibrous Tissue; Pleural Effusion, Malignant; Pleural Neoplasms; Radiography, Thoracic; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

We report a case of metastatic insular carcinoma of the thyroid evaluated with 201TI, 99mTc-MIBI, 99mTc-(V)DMSA, 99mTc-MDP and 131I whole-body scans, which were obtained after total thyroidectomy. For the majority of lesions detected in the skeleton and soft tissue, 131I images were generally available, although most were visualized easier with 99mTc-(V)DMSA. Technetium-99m-MDP images were considered better than 99mTc-(V)DMSA images in showing bone lesions but not soft-tissue lesions. Both 201TI and 99mTc-MIBI scans provided sufficient advantage to exhibit neck and mediastinal metastases, but they did not surpass 99mTc-(V)DMSA in detecting abdominal or bony lesions. In this patient with various metastases from insular carcinoma of the thyroid, 99mTc-(V)DMSA seemed to be the tracer of choice for whole-body imaging.

Topics: Bone Neoplasms; Carcinoma, Medullary; Female; Humans; Iodine Radioisotopes; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Soft Tissue Neoplasms; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Thallium Radioisotopes; Thyroid Neoplasms

Topics: Bone Neoplasms; Diagnosis, Differential; Female; Histiocytoma, Benign Fibrous; Humans; Ilium; Middle Aged; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Neurofibromatosis type 1 or von Recklinghausen's disease is one of the most common autosomal dominant genetic disorders. Between 29% and 77% of patients may suffer from a wide range of skeletal abnormalities and, thus, patients with neurofibromatosis frequently undergo skeletal scintigraphy, at which time the common peripheral nerve soft-tissue tumors that occur in this syndrome (neurofibromas, plexiform neuromas and neurofibrosarcomas) may be demonstrated.. Single or multiphase 99mTc methylenediphosphonate (MDP) bone scans were performed in five patients with neurofibromatosis as part of their clinical evaluation.. We imaged neurofibrosarcomas in three patients, cutaneous neurofibromas in one patient and a plexiform neuroma in one patient.. Single- or multiphasic bone scans may localize common soft-tissue tumors in neurofibromatosis.

Topics: Adult; Bone and Bones; Bone Diseases; Female; Humans; Infant; Male; Middle Aged; Neurofibroma; Neurofibroma, Plexiform; Neurofibromatosis 1; Neurofibrosarcoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

The authors present a case of extraskeletal myxoid chondrosarcoma. The MR study clearly showed the extent of the tumor and a "rings and arcs" pattern appeared after Gadolinium-DTPA administration in the T1 weighted images. Dynamic Tc-99m MDP and Tc-99m DTPA scintigraphy showed increased blood flow in the mass. The delayed 3-hour images demonstrated moderate Tc-99m MDP uptake, but intense Tc-99m DTPA accumulation in the tumor. Surprisingly, the Ga-67 scan failed to demonstrate the tumor.

Topics: Adult; Chondrosarcoma; Gallium Radioisotopes; Humans; Magnetic Resonance Imaging; Male; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Technetium Tc 99m Pentetate; Thigh

Myositis ossificans is primarily a disorder of adolescents or adults, whereby an area of muscle mass undergoes progressive ossification. Its radiographic and scintigraphic appearances have been well documented. In this paper, a case of histopathologically demonstrated myositis ossificans in the proximal thigh with unexpected TI-201 accumulation was presented.

Topics: Adult; Diagnosis, Differential; Female; Humans; Myositis Ossificans; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thallium Radioisotopes; Thigh

Topics: Adult; Bone and Bones; Diagnostic Imaging; Female; Humans; Neurofibroma, Plexiform; Neurofibromatoses; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

The purpose of this study was to evaluate the value of bone and Ga-67 imaging in patients with malignant fibrous histiocytoma (MFH). Thirty-four patients with biopsy-proven MFH were studied. Of these patients, 15 underwent Ga-67 imaging, 26 underwent Tc-99m MDP imaging, and 7 underwent both imaging procedures. In evaluation of the primary tumors, intense Ga-67 uptake was observed in 14 of 15 patients with a diagnostic sensitivity of 93.3%. However, positive bone imaging results were observed in only 10 of 26 patients with a diagnostic sensitivity of 38.5%. Most of these were secondary to Tc-99m MDP uptake in adjacent bone invaded by the primary tumor. Only two patients, of the 18 patients without direct bone invasion, had increased radioactivity in the tumors (11.1%). In evaluation of the metastatic lesions, increased Ga-67 uptake was observed in 8 of 8 metastatic sites (100%). However, Tc-99m MDP could only detect 5 of 12 metastatic sites (41.7%), which were all diagnosed to be bone metastases. None of the extraskeletal metastasis could be detected by Tc-99m MDP imaging. Ga-67 scintigraphy appears to be a very useful tool in the evaluation of both primary and metastatic lesions of MFH and is assumed to be useful in the follow-up. However, it is emphasized that bone scintigraphy is useful only when the tumor invades the skeletal system and is of limited value in the evaluation of extraskeletal lesions.

Topics: Bone and Bones; Bone Neoplasms; Evaluation Studies as Topic; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Middle Aged; Radionuclide Imaging; Sensitivity and Specificity; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Thirty-seven patients with newly diagnosed or treated sarcomas had 47 sets of sequential thallium scans (TS) followed by three-phase bone scan (TPBS) on the same day. The diagnosis in all patients was verified by biopsy (n = 40) or long-term follow-up studies (n = 7). The sensitivity, specificity, and accuracy of TS and TPBS in detecting sarcomatous lesions was calculated: TS sensitivity was 88%, specificity 69%, and accuracy 83%; blood flow (BF) and blood pool (BP) sensitivity was 91%, specificity 54%, and accuracy 81%; delayed bone scan (DB) sensitivity was 88%, specificity 38%, and accuracy 74%. In 17 studies the flow and blood pool parts of the TPBS and TS demonstrated the soft tissue component of sarcomas, which would have been missed if only the delayed bone scan had been performed. The TS lesion to normal tissue ratio alone was not very helpful in differentiating sarcomas from benign conditions because some benign lesions are highly cellular and vascular while some malignant lesions, such as chondrosarcoma, have poor vascularity and a less cellular chondroid matrix. However, when the thallium ratio was correlated with similar ratios calculated from the BP image, it was found that if the TS lesion to normal tissue ratio exceeded the BP lesion to normal tissue ratio (12 patients), the specificity for detecting sarcomatous lesions was 100%. Nevertheless, the reverse was not true. The positive predictive value of this observation was 100% and the negative predictive value was 37%.

Topics: Adolescent; Adult; Aged; Bone and Bones; Bone Neoplasms; Child; Chondrosarcoma; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Osteosarcoma; Predictive Value of Tests; Radionuclide Imaging; Sarcoma; Sensitivity and Specificity; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thallium Radioisotopes

Extracolonic manifestations of Gardner's syndrome are common and may precede the detection of colonic polyps. Tc-MDP bone scintigraphy performed on a patient with Gardner's syndrome demonstrated intense uptake of radiotracer within the maxilla and mandible as a result of the dental anomalies associated with this disorder. Nuclear scintigraphy has a role in the imaging of these patients for skeletal anomalies, the detection of thyroid carcinoma, and for skeletal metastases when colon carcinoma is detected.

Topics: Adult; Fibromatosis, Aggressive; Gardner Syndrome; Humans; Male; Mandibular Neoplasms; Maxillary Neoplasms; Osteoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

The authors report the casual discovery in 1991 of a metastasis during Tc-99m MDP imaging of a 57-year-old woman who underwent surgery in 1983 for cutaneous melanoma on the right calf. The scan did not show bone alterations but did reveal an area of hyperactive uptake in the soft tissue of the medial surface of the thigh, where slightly altered pigmentation was also apparent. A subsequent immunoscan with Tc-99m-F(ab')2 225.28S confirmed increased uptake at this site. The lesion was removed and was histologically diagnosed as a skin metastasis from melanoma. Inguinal adenopathy appeared 6 months later. The uptake of Tc-99m MDP by both primary and metastases tumors has been described, although this may be the first report concerning melanoma. The uptake mechanism is not known.

Topics: Antibodies, Monoclonal; Female; Humans; Immunoglobulin Fab Fragments; Lymphatic Metastasis; Melanoma; Middle Aged; Radioimmunodetection; Skin Neoplasms; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh

To evaluate previously described radiologic prognostic factors in extremity osteosarcoma.. In 47 pediatric patients, available images were evaluated for seven prognostic factors at diagnosis and seven additional factors after preoperative chemotherapy. These factors were correlated with histopathologic response and clinical outcome. The association of histopathologic response and outcome was also evaluated.. Metastases at presentation and a > 20-cm-diameter soft-tissue mass were predictive of a poor outcome but occurred in few patients. Factors most predictive of < 90% tumor necrosis after chemotherapy included an increase or no change in soft-tissue mass size and increased bone destruction. Although a significant relationship (P < .05) was found between histopathologic response and outcome, no factors predictive of histopathologic response were also predictive of outcome. The accuracy of pathologic response in predicting outcome was 66%.. Radiologic studies are of only limited use in predicting which patients with extremity osteosarcoma will have a poor response to chemotherapy or a poor outcome, and are not useful in predicting a good response or outcome.

Topics: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Child; Child, Preschool; Diagnostic Imaging; Female; Femoral Neoplasms; Follow-Up Studies; Humans; Humerus; Magnetic Resonance Imaging; Male; Osteosarcoma; Prognosis; Salvage Therapy; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tibia; Tomography, X-Ray Computed

A case of calcifying soft tissue malignant fibrous histiocytoma (MFH) which showed a concentration of Tc-99m MDP and Ga-67 citrate, is presented. Tc-99m MDP and Ga-67 citrate scintigraphies of the thigh mass were correlated with conventional radiography, computed tomography (CT) and angiography.

Topics: Aged; Citrates; Citric Acid; Female; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh; Tomography, X-Ray Computed

Topics: Adult; Female; Hemangioma; Humans; Skin Neoplasms; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh; Tomography, Emission-Computed, Single-Photon

Topics: Adult; Breast Neoplasms; Female; Humans; Lung Neoplasms; Phyllodes Tumor; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Combined Tc-99m MDP skeletal imaging and Tc-99m(V) DMSA whole body scans to detect metastases were performed during the follow-up of 30 patients who underwent surgery for breast carcinoma. Eight patients had normal Tc-99m MDP and Tc-99m(V) DMSA scans and were declared free of metastatic disease, further confirmed by no change in symptomatology over a 1-year follow-up period. Twenty-two patients had positive Tc-99m MDP scans with varied skeletal involvement. Tc-99m(V) DMSA scans showed matched areas of increased radiotracer concentration in bony metastases in 20 of these patients. Tc-99m(V) DMSA concentration was not seen in traumatic vertebral collapse or in coexistent osteoarthritic disease in vertebral metastatic involvement. Interestingly, Tc-99m(V) DMSA showed increased concentration in brain and liver metastases. Pentavalent Tc-99m(V) DMSA appears useful for detecting skeletal and soft-tissue metastases in breast carcinoma, and can improve the specificity of Tc-99m MDP bone scans in screening for bone metastases.

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Evaluation Studies as Topic; Female; Humans; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Sensitivity and Specificity; Soft Tissue Neoplasms; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate

Topics: Adult; Diagnosis, Differential; Hematoma; Humans; Liposarcoma; Male; Muscular Diseases; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

The purpose of this study was to compare the utility of bone and metaiodobenzylguanidine (MIBG) scintigraphy for the detection of primary and metastatic deposits of neuroblastoma. 99mTc methylene diphosphonate (MDP) bone and 131I-MIBG scans performed within 1 mo of each other in 85 patients with known or suspected neuroblastoma were evaluated for evidence of skeletal and extraskeletal disease. In 77 of 77 patients with confirmed neuroblastoma, the MDP and MIBG scans were concordant for the presence or absence of skeletal disease. A nearly twofold greater number of skeletal lesions were evident on MIBG scanning. No patients with normal bone scans had MIBG studies indicating bone involvement. In patients with histologic evidence of bone marrow involvement, each study suggested skeletal lesions in approximately 70%. In patients with extraskeletal disease demonstrated by CT, there was soft-tissue uptake of MIBG in 80% and MDP in 39%. We conclude that both MIBG and MDP are useful for the detection of skeletal neuroblastoma. MIBG is the better agent for characterizing the extent of disease, and MDP is a valuable adjunctive agent that provides skeletal landmarks for comparison. MIBG is clearly superior for the detection of extraskeletal neuroblastoma.

Topics: 3-Iodobenzylguanidine; Bone and Bones; Bone Marrow Diseases; Bone Neoplasms; Child; Humans; Infant; Iodine Radioisotopes; Iodobenzenes; Neuroblastoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Twenty patients with known primary untreated and recurrent bone and soft tissue tumors underwent thallium imaging and three-phase bone imaging in the same session. The ratio of thallium uptake in the tumor tissue to the contralateral normal tissue areas was compared with the same ratio for phase 1 (blood flow or arterial phase), phase 2 (blood pool), and phase 3 (delayed medroxy-diphosphonate, MDP, uptake). There was poor correlation between Tl uptake and phases 1 and 3 of the bone scan ratios; r = 0.37 and 0.46; P = 0.097 and 0.047, respectively. The thallium uptake ratios correlated well with blood pool ratios (phase 2) (r = 0.84 and P less than 0.01). In contrast to uptake into normal muscle, Tl-201 uptake into tumor is not highly dependent on blood flow alone and other factors predominate in determining its magnitude.

Topics: Bone Neoplasms; Female; Humans; Male; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thallium Radioisotopes; Time Factors

Topics: Aged; Humans; Knee; Liposarcoma; Male; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

A patient with ovarian carcinoma was evaluated for skeletal metastasis with a routine whole body bone scan. Although no bone metastases were visualized, there was dramatic accumulation of tracer in the soft tissues of the abdomen. CT revealed calcifying soft tissue metastases on the liver surface, the bowel serosa, and in the pelvis corresponding to the abnormal areas of Tc-99m MDP uptake. Tumor necrosis and ongoing calcification within the metastatic sites are possible explanations for this unusual soft tissue concentration of the bone-seeking radiopharmaceutical. In patients with metastatic ovarian carcinoma, careful review of extraosseous regions on bone scan images may provide valuable diagnostic information.

Topics: Abdominal Neoplasms; Adult; Bone Neoplasms; Carcinoma, Papillary; Female; Humans; Ovarian Neoplasms; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Pelvic pain in cancer patients can result from several causes. The most appropriate choice of imaging techniques for evaluating such patients has not been established. We evaluated 27 cancer patients with pelvic pain by using radionuclide bone scintigraphy (24 patients), abdominal CT (27 patients), and pelvic MR imaging (27 patients) and used the correlation between symptoms and imaging findings to compare these imaging methods. The study population included 11 patients with Ewing sarcoma, six with other sarcomas, five with colorectal cancers, and five with other tumors. All patients had pelvic pain, and eight had pain radiating to a leg. Twenty-three patients had soft-tissue masses, and 19 had bone metastases; 16 had both. Findings on bone scans explained the symptoms in 17 (71%) of 24 patients, findings on CT in 23 (85%) of 27 patients, and findings on MR imaging in 25 (93%) of 27 patients. The difference between bone scanning and CT or MR was statistically significant (p less than .05); however, the difference between CT and MR imaging was not significant (p greater than .05). MR imaging detected 41 (98%) of 42 relevant lesions, whereas CT detected 31 (74%) of 42, and bone scanning 17 (44%) of 39. We conclude that MR is superior to either bone scanning or CT in the initial evaluation of pelvic pain in cancer patients. Such information can be important in directing the treatment of these patients.

Topics: Adolescent; Adult; Bone Neoplasms; Diagnostic Imaging; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pain; Pelvic Neoplasms; Retrospective Studies; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Various causes for cold defects on bone scans (e.g., avascular necrosis) have been described. A case is presented in which a cold defect on a technetium-99m-methylene diphosphonate bone scan was the result of malignant fibrous histiocytoma.

Topics: Aged; Histiocytoma, Benign Fibrous; Humans; Male; Radionuclide Imaging; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Spinal Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Female; Humans; Middle Aged; Radionuclide Imaging; Sarcoma, Synovial; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh

Topics: Aged; Bone and Bones; Female; Humans; Lumbosacral Region; Lung Neoplasms; Osteosarcoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

A man with malignant fibrous histiocytoma of the thigh had avid uptake of Tc-99m MDP in the lesion. Review of tissue sections showed considerable accumulation of iron in the tumor. Iron is known to be a potential nidus for deposition of the Tc-99m diphosphonates. A review was made of tissue sections from two other reported cases of malignant fibrous histiocytoma which also had significant accumulation of Tc-99m diphosphonates. Both revealed iron within the tumor. The origin of the iron is unknown (perhaps from necrosis and hemorrhage, from trauma, or from innate phagocytic activity of the histiocytes). However, this observation may serve as a stimulus to studies attempting to discern the underlying mechanisms of extraosseous deposition of the Tc-99m diphosphonates.

Topics: Adult; Hemosiderin; Histiocytoma, Benign Fibrous; Humans; Male; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh

Two cases of alveolar soft part sarcoma were examined with gallium-67 citrate (67Ga), technetium-99m-methylenediphosphate (99mTc-MDP) and technetium-99m(V)-dimercaptosuccinic acid (Tc(V)-DMS) to compare the sensitivity of these three radiopharmaceuticals. All scintigrams were positive with primary tumor, and images with Tc(V)-DMS were the best. Skull metastasis could be also detected by all agents, but scintigrams with lung metastases were negative. In scintigraphic evaluation of alveolar soft part sarcoma, Tc(V)-DMS may be a better agent than 67Ga or 99mTc-MDP.

Topics: Adult; Citrates; Citric Acid; Humans; Male; Organotechnetium Compounds; Radionuclide Imaging; Sarcoma; Soft Tissue Neoplasms; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Medronate

Accumulation of Tc-99m MDP in soft tissue malignancies occurs frequently. When tumor overlaps adjacent bone structures, the bone margins can be indiscernible on a regular bone scan. Additional views should be taken to differentiate bone from tumor, however, separation is sometimes difficult and not always successful. This report presents a patient in whom accumulation of Tc-99m MDP in a liposarcoma of the thigh disappeared on a 24 hour scan and bone margins were seen clearly. A possible mechanism for this phenomenon and its utility are discussed.

Topics: Adult; Female; Femoral Neoplasms; Humans; Liposarcoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh; Time Factors

Topics: Adult; Biopsy; Diagnosis, Differential; Humans; Male; Myositis Ossificans; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Wounds and Injuries

The authors describe a case of a skull infarction initially suspected to be an isolated, remote metastasis in a patient diagnosed with soft tissue malignant fibrous histiocytoma. Osseous malignant fibrous histiocytoma has been reported to occur within a bone infarction but the presence of a benign bone infarction remote from a soft tissue malignant fibrous histiocytoma has not been reported previously. Bone infarctions and malignant fibrous histiocytomas are briefly reviewed.

Topics: Adult; Histiocytoma, Benign Fibrous; Humans; Infarction; Male; Radionuclide Imaging; Skull; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Malignant fibrous histiocytoma (MFH) is the most common soft tissue malignancy in adults. The Ga-67 citrate scan findings of an extremity-located MFH, the most common location of this neoplasm, have never been published in English language journals to the best of the authors' knowledge. Ga-67 citrate and Tc-99m MDP scans of the thigh mass accurately depicted the tumor's local extent, including the presence of central ischemic necrosis within the tumor, and the absence of adjacent osseous involvement and distant metastases, as correlated with computed tomography, angiography, and pathologic examinations.

Topics: Femur; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Male; Middle Aged; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh; Tomography, X-Ray Computed

Topics: Adult; Back; Bone and Bones; Buttocks; Female; Humans; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Neurofibromatosis 1; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh; Tomography, X-Ray Computed

Topics: Adult; Diagnosis, Differential; Dysgerminoma; Humans; Kidney; Kidney Neoplasms; Male; Radionuclide Imaging; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Teratoma; Testicular Neoplasms

Extraosseous uptake of radiophosphate compounds i well recognized in primary neural crest tumors. In a review of 32 cases of neuroblastoma presenting over a three-year period at Children's Hospital of Philadelphia, nine patients were noted to have secondary lesions in eleven different sites accumulating radiotracer. The extraosseous uptake in metastases included: ascites, liver, lung, anterior mediastinum, and posterior mediastinum. These cases are reported to emphasize the ability of bone imaging to detect the presence of extraosseous soft tissue metastases and primary lesions.

Topics: Bone Neoplasms; Child; Child, Preschool; Female; Ganglioneuroma; Humans; Infant; Male; Neuroblastoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

A correlation was made between the incidence and intensity of 99mTc-methylene diphosphonate (MDP) concentration and the radiographic incidence and volume of heterotopic calcium deposition in 44 patients with hip arthroplasties, as well as with the duration of the hip implants. The incidence of soft tissue para-articular MDP concentration was 95% compared to a 68% incidence of radiographically visible heterotopic calcium, bone or both. The concentration of MDP did not decrease on average with the age of the implant, which ranged from 6 months to 15 years, even though radiographs showed evidence of mature ossification in many of them. The cause of these sustained high uptakes is open to speculation, but the findings indicate that radiophosphate imaging is not a reliable means of assessing maturation of heterotopic bone associated with hip arthroplasty.

Topics: Adult; Aged; Bone and Bones; Choristoma; Female; Hip; Hip Prosthesis; Humans; Male; Middle Aged; Postoperative Complications; Radiography; Radionuclide Imaging; Retrospective Studies; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

The accumulation of a bone-seeking radiopharmaceutical on delayed imaging in a hemangioma has not been described previously. The variable scintigraphic findings of hemangiomas are described in detail.

Topics: Adolescent; Arm; Hemangioma; Humans; Male; Muscular Diseases; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Four patients are presented with malignant tumors involving both bone and adjacent soft tissue. In each of these neoplasms (two representing adenocarcinoma of the prostate, and one each of squamous cell carcinoma of lung and chondrosarcoma), the lesions were detected by accumulation of Tc-99m MDP. Involvement of both bone and soft tissue was confirmed by CT examination or surgery. It is probable that the lesions originated in bone and then extended to soft tissue.

Topics: Adolescent; Aged; Aged, 80 and over; Bone Neoplasms; Female; Humans; Male; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

A bone image demonstrating a "photopenic" vertebral lesion was found to be caused by tumor infiltration of adjacent muscle and probable secondary osseous ischemia. Magnetic resonance imaging was valuable in detecting the muscle abnormality.

Topics: Adult; Bone Neoplasms; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Muscles; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

Topics: Diphosphonates; Female; Humans; Liposarcoma; Middle Aged; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Thigh

Topics: Adult; Aged; Bone and Bones; Child; Child, Preschool; Diphosphonates; Female; Humans; Infant; Male; Middle Aged; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate

Three cases (rhabdomyosarcoma, lymphoma, and metastatic malignant melanoma) of unexpected increased uptake of methylenediphosphonate labelled by technetium 99m sodium pertechnetate (99mTc-MDP) are described. The possible mechanisms of the extraosseous tumoral accumulation of 99mTc-MDP in these malignancies are discussed. The usefulness of this method for the diagnosis, localization, and follow-up of some extraosseous tumors is evaluated.

Topics: Adult; Diphosphonates; Female; Humans; Lymphoma; Male; Melanoma; Middle Aged; Radionuclide Imaging; Rhabdomyosarcoma; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate

Topics: Adolescent; Adult; Bone and Bones; Choristoma; Diphosphonates; Gallium Radioisotopes; Humans; Male; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate

In a prospective study of forty-five patients, we evaluated the usefulness of bone and gallium scintigraphy prior to definitive surgery for a soft-tissue sarcoma in an extremity. Bone scintigraphy provides a baseline for staging and often reveals periosteal invasion that is not detected by routine radiographs. Blood-pool scintigraphy with bone tracers is very sensitive for a diagnosis of malignant disease. Gallium scintigraphy appeared to be a reliable preoperative indicator of malignant disease of soft tissue (sensitivity, 85 per cent; specificity, 92 per cent) and was useful for detecting the infrequent occult, non-pulmonary metastasis. Combined gallium and bone scintigraphy with blood-pool imaging provided a reliable prediction of the presence or absence of a malignant lesion in patients with a soft-tissue mass in an extremity. We recommend that bone and gallium scintigraphy be routinely used in the initial clinical staging of soft-tissue sarcomas.

Topics: Adolescent; Adult; Aged; Bone and Bones; Child; Diphosphonates; Etidronic Acid; Female; Gallium Radioisotopes; Humans; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Metastasis; Organotechnetium Compounds; Radionuclide Imaging; Sarcoma; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate

Skeletal scintigraphy of a distal femoral osteosarcoma revealed a band of soft-tissue uptake in the medial thigh extending to the groin, which corresponded to direct perivascular tumor extension.

Topics: Adult; Diphosphonates; Femoral Neoplasms; Humans; Male; Osteosarcoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Thigh

An unusual case of ovarian carcinoma is presented with extra-abdominal soft tissue metastasis. These demonstrate calcification on plain films and CT, as well as avid uptake of Tc-99m MDP.

Topics: Adult; Cystadenocarcinoma; Diphosphonates; Female; Humans; Ovarian Neoplasms; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Adult; Angiography; Bone and Bones; Diphosphonates; Humans; Leg; Male; Neuroblastoma; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

A total of 2530 consecutive bone scans were examined to evaluate the number and the type of soft tissue neoplasms detected with bone-seeking phosphonates. Sixty-eight primary or secondary soft tissue neoplasms of 63 patients accumulated 99mTc -methylene diphosphonate and 2 accumulated 99mTc -diphosphonate, and one metastasis was seen as a nonactive 'cold' focus in the urinary bladder. The localization of tumors was: 19 in the lung, 15 in the liver, 11 in the kidney, 10 in the peritoneal cavity or ascites, 5 in the large bowel, 4 in the vascular or lymphatic system, 3 in the connective tissue or muscles, 2 in the ovary, 1 in the urinary bladder, and 1 in the brain. Our results differ in many respects from those reported in the literature. The causes of the differences are discussed.

Topics: Abdominal Neoplasms; Adenocarcinoma; Adolescent; Adult; Aged; Bone and Bones; Carcinoma, Small Cell; Colonic Neoplasms; Diphosphonates; Female; Humans; Liver Neoplasms; Lung Neoplasms; Lymphoma, Non-Hodgkin; Middle Aged; Ovarian Neoplasms; Radionuclide Imaging; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Technetium; Technetium Compounds; Technetium Tc 99m Medronate

Topics: Child, Preschool; Diphosphonates; Humans; Male; Radionuclide Imaging; Rhabdomyosarcoma; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate

Topics: Adenocarcinoma; Colonic Neoplasms; Diphosphonates; Gallium Radioisotopes; Humans; Male; Middle Aged; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate

Topics: Calcinosis; Child; Diphosphonates; Female; Humans; Radionuclide Imaging; Sarcoma, Synovial; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Thigh

Two cases of bone radiotracer uptake by primary hepatic malignancies of childhood hepatocellular carcinoma and hepatoblastoma and their metastases are presented. These cases are illustrative of a previously unreported cause of extraosseous uptake of bone seeking radionuclide.

Topics: Carcinoma, Hepatocellular; Child; Diphosphonates; Humans; Infant; Liver Neoplasms; Male; Peritoneal Neoplasms; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate

Eleven patients with untreated primary Ewing sarcoma were studied with intravenously administered 13N-labeled L-glutamate. Seven were repeatedly scanned during chemotherapy using this agent and 99mTc-methylene diphosphonate (99mTc-MDP). The untreated primary tumor was distinctly visualized with 13N-L-glutamate in all cases; the distribution of 13N label in the tumor sometimes differed from that of 99mTc. A kinetic study showed rapid uptake of 13N by tumor tissue. Repeat scans following therapy indicated that 13N-L-glutamate and 99mTc-MDP uptake showed changes consistent with histological findings following subsequent surgery. 13N uptake often decreased more markedly than 99mTc uptake during chemotherapy, but metastatic lesions were not visualized with 13N-L-glutamate. Tumor imaging with this labeled amino acid may be of value in assessing the response of primary Ewing sarcoma to chemotherapy.

Topics: Adolescent; Adult; Bone Neoplasms; Child; Diphosphonates; Female; Glutamates; Glutamic Acid; Humans; Male; Middle Aged; Nitrogen Radioisotopes; Radionuclide Imaging; Sarcoma, Ewing; Soft Tissue Neoplasms; Technetium; 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

Topics: Adenocarcinoma; Aged; Diphosphonates; Female; Humans; Kidney Neoplasms; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate

Topics: Adult; Aged; Diphosphonates; Humans; Liposarcoma; Male; Radionuclide Imaging; Sarcoma, Synovial; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate