technetium-tc-99m-sulfur-colloid and Bone-Diseases

Gaucher disease is the most prevalent inherited, lysosomal storage disease and is caused by deficient activity of the enzyme beta-glucocerebrosidase. Bone and bone marrow alterations are frequent in the most prevalent non-neuronopathic form of Gaucher disease. Imaging of bone manifestations in Gaucher disease is performed by a variety of imaging methods, conventional X-ray and MRI as the most frequently and most important ones. However, different modalities of scintigraphic imaging have also been used. This article gives an overview on scintigraphic imaging with respect to bone manifestations in Gaucher disease discussing the advantages and limitations of scintigraphic imaging in comparison to other imaging methods.

Topics: Bone Diseases; Bone Marrow; Gaucher Disease; Humans; Magnetic Resonance Imaging; Radiopharmaceuticals; Technetium Tc 99m Sestamibi; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon

Two cases of Erdheim-Chester disease are presented: a 26-year-old white male patient with lipoidgranulomatosis of numerous long and flat bones and infiltration of pericardium, pleura, liver, spleen, thyroid, skin, conjunctiva, gingiva, and false vocal cord; and a 54-year-old white male with involvement of bones, orbits, brain, pericardium, and retroperitoneum. The scintigraphic findings in this disease are described, and a comprehensive review of the 27 previously reported cases is given including an assessment of the value of scintigraphy for diagnosis and follow up of this rare disease.

Topics: Adult; Bone Diseases; Cholesterol; Follow-Up Studies; Granuloma; Humans; Lipidoses; Male; Middle Aged; Radionuclide Imaging; Syndrome; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

A series of plain radiographs, bone scans, bone marrow scans, and MRIs is reported in a patient with Gaucher disease type I, in whom two episodes of acute bone crisis developed during a 6-year period of follow-up. Acute bone crisis and global indolent bone marrow displacement could both be assessed by bone marrow scintigraphy, whereas MRI could better clarify the corti-comedullary alteration after bone infarction. Thus, MRI and bone marrow scintigraphy could be used as complementary imaging methods in the management of patients with Gaucher disease.

Topics: Acute Disease; Adult; Biopsy; Bone and Bones; Bone Diseases; Bone Marrow; Diagnostic Imaging; Follow-Up Studies; Gaucher Disease; Humans; Infarction; Magnetic Resonance Imaging; Male; Pain; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

In-111 WBC scintigraphy supplemented by visual comparison with concurrent Tc-99m SC bone marrow imaging is used to identify infection within the marrow-containing skeleton. This retrospective study demonstrates the value of the computer-generated WBC/SC bone marrow subtraction image. Thirty-one patients with various conditions (postsurgery with or without orthopedic hardware, bacteremia with persistent fever, joint arthroplasty, and miscellaneous) underwent combined WBC/SC with bone marrow subtraction imaging. Infection was present in 21 of 36 possible sites (14 osseous, 7 soft tissue; 8 acute, 13 chronic). The bone marrow subtraction image identified two of these sites, which were not appreciated by visual inspection. The sensitivity, specificity, and accuracy for bone marrow subtraction were 95%, 93%, and 94%, respectively, as compared to 86%, 93%, and 89%, respectively, for the visual assessment of WBC and SC images. Computer-assisted subtraction imaging improves overall accuracy and enhances diagnostic certainty of combined WBC/SC scintigraphy for infection in the marrow-containing skeleton.

Topics: Adult; Aged; Bacterial Infections; Bone Diseases; Bone Marrow; Child; Female; Humans; Image Processing, Computer-Assisted; Indium Radioisotopes; Leukocytes; Male; Muscular Diseases; Radionuclide Imaging; Retrospective Studies; Sensitivity and Specificity; Subtraction Technique; Surgical Wound Infection; Technetium Tc 99m Sulfur Colloid

Twenty-six cases of lipid (cholesterol) granulomatosis, Erdheim-Chester Disease (ECD), have been described in the literature to date. A new case of ECD in a 33-year-old man with an unusual presentation of exudative ascites following a four year history of abdominal pain is reported. The radiographic and bone scan findings in this disease have been established and Ga-67 scan findings are reported. The Tc-99m sulphur colloid bone marrow and In-111 chloride scan findings are presented.

Topics: Adult; Bone Diseases; Cholesterol; Humans; Indium Radioisotopes; Male; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Xanthomatosis

Topics: Bone Diseases; Humans; Mastocytosis; Radionuclide Imaging; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Radionuclide imaging (99mTc bone scans, 99mTc S colloid scans, 99mTc brain scans and 67gallium scans) and bone radiographs were done in 54 children with histiocytosis X. The results are discussed, compared with the literature and indications for the different nuclear medicine studies are given.

Topics: Adolescent; Bone and Bones; Bone Diseases; Child; Child, Preschool; Diphosphonates; Female; Gallium Radioisotopes; Histiocytosis, Langerhans-Cell; Humans; Infant; Liver; Male; Radiography; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Spleen; Technetium; Technetium Compounds; Technetium Tc 99m Sulfur Colloid

The effectiveness of CT and technetium-99m sulfur colloid (99mTc SC) bone-marrow scans in determining the extent and severity of skeletal involvement in 23 patients with type 1 Gaucher's disease was compared with the effectiveness of conventional radiographic techniques and technetium-99m methylene diphosphonate (99mTc MDP) bone scintigrams. Density measurements obtained by CT proved sensitive in differentiating normal marrow (-50 to -120 H). Scintigrams with the sulfur colloid nuclide demonstrated three distinct patterns of uptake: peripheral expansion of normal marrow (profile B), greater marrow expansion with patchy areas lacking uptake (profile C), and greater loss of uptake with retention of the nuclide in other reticuloendothelial organs and circulation (profile D). CT scans provided greater sensitivity in resolving the extent of marrow involvement in affected areas, while the 99mTc SC scintigrams were more effective in overall assessment of the severity of bone-marrow involvement. Both conventional radiographic techniques and 99mTc MDP bone scans were useful primarily as screening procedures or for evaluating specific involved areas. 99mTc MDP scans were useful in evaluating regional defects (i.e., ischemic necrosis) in certain cases, but no consistent patterns were observed. CT and 99mTc SC scans are useful for determining the extent and severity of Gaucher's disease involvement of bone marrow.

Topics: Bone Diseases; Female; Gaucher Disease; Humans; Male; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

A simultaneous dual isotope technique incorporating computer subtraction for the diagnosis of bone, joint, or soft-tissue infection using [67Ga]citrate and [99mTc]MDP or sulfur colloid is described. Comparison of this technique with visual congruence or noncongruence of the two radionuclide images in 41 patients shows that the two techniques have identical sensitivity (93%) and specificity (92%) but the computer technique gave additional information in 17% of all cases (44% of abnormals) concerning the anatomic location of the infective focus which aided in the subsequent surgical management of the patient.

Topics: Adolescent; Adult; Aged; Bone Diseases; Child; Child, Preschool; Computers; Connective Tissue Diseases; Diphosphonates; Female; Gallium Radioisotopes; Humans; Infections; Male; Middle Aged; Radionuclide Imaging; Subtraction Technique; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Radiographs were compared with 99mTc scans of the bones and bone marrow as well as 67Ga-citrate scans to evaluate their sensitivity in identifying skeletal lesions in 21 children with histiocytosis X. Seven of 20 bone scans were completely normal in patients with extensive radiographic evidence of skeletal disease. In only one patient were bone scan changes demonstrated prior to radiographic abnormalities. None of the lesions was "cold" on the bone scans. 99mTc-sulfur colloid bone marrow scans and 67Ga-citrate whole-body scans were not valuable. Radiographic survey of the skeleton should be the primary diagnostic test employed in patients with histiocytosis X who have suspected skeletal lesions. Bone scans should be obtained only when the radiographs are normal or equivocal.

Topics: Bone and Bones; Bone Diseases; Bone Marrow; Child; Child, Preschool; Diphosphonates; Etidronic Acid; False Negative Reactions; Female; Gallium Radioisotopes; Histiocytosis, Langerhans-Cell; Humans; Infant; Male; Organotechnetium Compounds; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid