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

Topics: Adult; Bone and Bones; Bone Marrow; Bone Marrow Examination; Bone Neoplasms; Child; Child, Preschool; Fractures, Bone; Gold Colloid, Radioactive; Humans; Indium; Infant; Infarction; Iron Radioisotopes; Organotechnetium Compounds; Osteonecrosis; Phytic Acid; Radionuclide Imaging; Technetium; Technetium Tc 99m Sulfur Colloid

Bone marrow aspiration and biopsy are excellent techniques for evaluating bone marrow, but this evaluation is limited to a small part of the total blood-forming organ. With the introduction of radionuclide bone marrow imaging, a simple technique became available that overcomes marrow sampling errors by giving a total body view of functioning marrow. Furthermore, the procedure is noninvasive and provides an atraumatic method for evaluating a number of clinical problems including a discrepancy between bone marrow histology and clinical status (possible marrow sampling error), the determination of amount of active marrow after radiation and chemotherapy when further therapy is being considered, detection of sites of extramedullary hematopoiesis, location of the optimal sites for bone marrow biopsy, the diagnosis and staging of diffuse hematologic disorders, detection of metastases, the diagnosis of bone marrow infarcts in hemolytic anemias, and detecting avascular necrosis of the femoral heads. There are two major classes of bone marrow agents: (1) those that are incorporated into the erythroid precursors such as radioiron and (2) colloids that are taken up by the reticuloendothelial system (RES). Indium-111 chloride was originally considered to be an erythropoietic agent but appears to share some properties of RES labels. The best label to use is dependent on the disease being evaluated.

Topics: Anemia, Aplastic; Anemia, Hemolytic; Anemia, Sickle Cell; Bone Marrow; Bone Marrow Diseases; Bone Neoplasms; Erythropoiesis; Femur Head Necrosis; Gold Colloid, Radioactive; Hematopoiesis; Humans; Indium; Iron Radioisotopes; Leukemia; Lymphoma; Mononuclear Phagocyte System; Polycythemia; Primary Myelofibrosis; Radioisotopes; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

The major role of nuclear medicine in clinical oncology is in tumor imaging, which includes evaluating specific organs or the entire body for the presence of tumor. Nuclear medicine studies have been used clinically in the initial evaluation of the tumor extent and in the subsequent management of the cancer patient to assess response to treatment, to detect early relapse, and to assist in making decisions concerning follow-up treatment. Technetium-99m macroaggregated albumin perfusion study for intraarterial chemotherapy has been helpful in monitoring the catheter tip, providing a map of regional perfusion at the capillary level (tumor vascularity), evaluating the degree of arteriovenous shunt in tumor bed, and optimizing division of the dose of chemotherapeutic agent when bilateral arterial catheters are used. Quantitative and serial radionuclide angiocardiography has been useful in assessing doxorubicin (Adriamycin, Adria Laboratories, Columbus, Ohio) toxicity, and 67Ga-citrate imaging has been used to monitor chemotherapy effect on lungs and kidneys. Radionuclide venography can demonstrate suspected thrombus, and the delineation of the vascular anatomy also allows proper placement of another catheter for continuous effective chemotherapy. Serial bone scans have been the primary modality to assess the response of bone metastasis to systemic therapy in breast cancer patients, and nuclear hepatic imaging may show tumor response, hepatocellular dysfunction, and cholecystitis related to chemotherapeutic agents.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Antineoplastic Agents; Bone and Bones; Bone Neoplasms; Chemotherapy, Cancer, Regional Perfusion; Doxorubicin; Gallium Radioisotopes; Heart Failure; Humans; Injections, Intra-Arterial; Kidney Diseases; Liver; Liver Diseases; Lung; Lung Diseases; Magnetic Resonance Spectroscopy; Neoplasms; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Thrombophlebitis; Tomography, Emission-Computed

Optimal treatment of prostate cancer depends on accurate staging. Computed tomography (CT) and magnetic resonance imaging have severe limitations, and standard bone scanning can show only destructive osseous metastases. A radiolabeled antibody specific to prostatic adenocarcinoma could theoretically find evidence of soft-tissue metastases and lymph node involvement.. An immunoconjugate (CYT-356) consisting of a murine monoclonal antibody against human prostatic adenocarcinoma bound to a linker-chelator and radiolabeled with indium 111 was administered intravenously to seven patients with documented Stage D adenocarcinoma of the prostate. Planar imaging was done on days 1, 2, and 3 after injection. The CYT-356 scans were compared with standard technetium Tc99m sulfur colloid bone scans and CT scans.. Optimal imaging results were obtained on the 72-h scans. All patients had lesions on both the 99mTc-sulfur colloid bone scan and the CYT-356 scan. The location of the lesions correlated to a great extent. Two patients had positive lesions biopsied, and both biopsies showed the presence of metastatic prostatic carcinoma. There were no side effects from administration of the antibody.. In this preliminary study, CYT-356 scanning appears to be a promising agent to accomplish specific staging of prostatic carcinoma.

Topics: Adenocarcinoma; Antibodies, Monoclonal; Bone Neoplasms; Humans; Indium Radioisotopes; Injections, Intravenous; Male; Prostatic Neoplasms; Radioimmunodetection; Reproducibility of Results; Technetium Tc 99m Sulfur Colloid

Topics: Aged; Bone Neoplasms; Carcinoma, Transitional Cell; Diagnosis, Differential; Female; Humans; Leukocytes; Neoplasms, Unknown Primary; Pyelonephritis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Sulfur Colloid

A 62-year-old woman with right breast carcinoma who had a breast biopsy 3 weeks earlier was referred for a whole-body Tc-99m MDP bone scan to identify possible osseous metastases. Twenty-four hours later, she underwent lymphoscintigraphy using four peritumoral injections of 250 microCi filtered Tc-99m sulfur colloid of 0.22 microm each. The lymphoscintigraphic images showed good delineation of three right axillary lymph nodes in relation to the rib cage. Performing a bone scan just before lymphoscintigraphy for sentinel node detection may help the surgeon to identify sentinel lymph nodes. This is more anatomically precise than using a flood source to delineate body contour. A Tc-99m MDP bone scan followed by lymphoscintigraphy should be considered in patients with breast carcinoma who will have both bone imaging and lymphoscintigraphy.

Topics: Bone and Bones; Bone Neoplasms; Breast Neoplasms; Female; Humans; Lymph Nodes; Lymphatic Metastasis; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Topics: Aged; Bone Marrow; Bone Neoplasms; Gallium Radioisotopes; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Lymphoma, Large-Cell, Immunoblastic; Male; Radionuclide Imaging; Syndrome; Technetium Tc 99m Sulfur Colloid

Eleven patients with proven primary bone tumour (five Ewing sarcomas, six osteosarcomas) and two cases of metastatic bone involvement (primary other than bone) were investigated with 99mTc-phytate and 99mTc-sulphur colloid to compare the behaviour of the two radiopharmaceuticals at the tumour site. After intravenous administration of the respective radiopharmaceutical, imaging of the tumour site and its contralateral part was carried out at 15 min and 1 h intervals. The data were stored in our computer. Bone scanning was also carried out in all patients. 99mTc-phytate uptake was observed at the tumour site in ten cases. The 99mTc-sulphur colloid study revealed sparse or no significant uptake in eight cases. In two patients, with osteosarcoma 99mTc-sulphur colloid investigation showed uptake at the primary tumour site. However, the distribution pattern is different from that of 99mTc-phytate. No significant uptake of either 99mTc-phytate or 99mTc-sulphur colloid was observed in the two patients with metastatic skeletal disease. It may be concluded that the unusual accumulation of 99mTc-phytate at the tumour site is not due to any generalized reticuloendothelial phenomenon and that the radiopharmaceutical itself is responsible for this.

Topics: Adolescent; Adult; Bone Neoplasms; Female; Humans; Male; Organotechnetium Compounds; Osteosarcoma; Phytic Acid; Radionuclide Imaging; Sarcoma, Ewing; Technetium Tc 99m Sulfur Colloid

The clinical records of 94 patients with regionally advanced melanoma (nodal disease or regional satellites) were reviewed to determine the value of preoperative bone and liver imaging. Of 68 bone scans obtained, none were suggestive of metastases. of 97 liver imaging studies (computed tomography, scintiscan, or sonography) in 88 patients, only two were found to have demonstrable metastases. Liver enzyme elevation was present in both of these patients. Bone and liver imaging in the absence of signs or symptoms of dissemination by history, physical examination, chest x-ray, and enzyme determination for regionally advanced melanoma appears to be of little value unless the patient is involved in a protocol study.

Topics: Alkaline Phosphatase; Bone Neoplasms; Female; Humans; Liver Neoplasms; Male; Melanoma; Middle Aged; Radionuclide Imaging; Skin Neoplasms; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Topics: Bone Neoplasms; Humans; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Topics: Bone Neoplasms; Diagnosis, Differential; Giant Cell Tumors; Humans; Infant; Male; Radiography; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Ulna

The objective of this study is to correlate the presence of bone and liver metastases in patients with breast cancer with respect to the results of bone and liver scans, axillary nodal status, and serum alkaline phosphatase levels. One hundred ninety-seven patients with breast cancer treated by modified radical mastectomy between the years 1978 and 1981 were studied. Fifty-nine (30%) of the total group had distant metastases during the course of observation of 60 to 96 months; of 35 patients in whom bone metastases developed, 30 had normal preoperative bone scan results. Of 21 patients who had liver metastases, 19 had normal preoperative liver scans. Nineteen (70%) of the 27 patients with abnormal bone scans had normal alkaline phosphatase levels. Seven (63%) of the 11 patients who had abnormal liver scans had a normal alkaline phosphatase. The study supports the concept that preoperative bone and liver scans are ineffective indicators of metastatic involvement. Selection of patients for screening by bone and liver scans according to alkaline phosphatase determinations was not supported by this study. The appropriate use of bone scans for screening in patients with breast carcinoma is suggested as a follow-up device in patients with positive lymph nodes.

Topics: Alkaline Phosphatase; Bone Neoplasms; Breast Neoplasms; Diphosphates; Female; Humans; Liver Neoplasms; Mastectomy; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Technetium Tc 99m Sulfur Colloid

Prognosis in Ewing's sarcoma is inversely related to the extent of the disease at the time of presentation. The most common sites of metastases are the lungs and skeleton. Bone marrow metastases may be present but clinically silent. We report the use of Technetium (Tc)-99m bone marrow scintigraphy to detect sites of marrow involvement by metastatic Ewing's sarcoma. This method of evaluation allowed identification of sites of involvement by Ewing's sarcoma that were not available by any other method of evaluation. In several instances, information provided by this method was pivotal in the management of these patients. Based on this small series of patients, bone marrow scintigraphy appears to be a sensitive modality in the detection of metastatic disease in patients with Ewing's sarcoma. Better understanding of the role of bone marrow scanning and its correlation with other diagnostic procedures in Ewing's sarcoma will require further study.

Topics: Adolescent; Bone Marrow; Bone Neoplasms; Child; Clavicle; Female; Femoral Neoplasms; Humans; Ischium; Male; Radionuclide Imaging; Ribs; Sarcoma, Ewing; Technetium Tc 99m Sulfur Colloid; Tibia; Tomography, X-Ray Computed

There is avid first-pass extraction of Tc-99m sulfur colloid by bone marrow. This factor must be considered when injection of the isotope is made via an unusual route. Tc-99m sulfur colloid was injected via an umbilical artery catheter into an infant's left iliac artery, causing marked marrow uptake in the left pelvis. The paucity of uptake on the right side of the pelvis simulated metastatic replacement of the marrow. A repeat study done via the jugular vein demonstrated no abnormalities of pelvic marrow uptake.

Topics: Bone Marrow; Bone Neoplasms; Female; Humans; Infant, Newborn; Pelvic Bones; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Umbilical Arteries

Topics: Aged; Bone Marrow; Bone Neoplasms; Diphosphonates; Humans; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Topics: Bone Neoplasms; Humans; Liver; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Ribs; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

We used a combination of bone and bone-marrow scintigraphy to study 25 patients with prostatic cancer. Of the 18 cases whose 99mTc-methylene diphosphonate (MDP) bone scans showed hot spots in the lower lumbar region of the spine and/or the pelvic bone, 8 had normal bone-marrow scintigrams. These 8 patients were subsequently shown to have senile, degenerative changes of the spine. On the other hand, in 9 of the 10 patients whose bone-marrow scintigrams showed accumulation defects, follow-up study and characteristic X-ray findings confirmed the presence of metastases. In all 6 cases with extensive bone metastases shown by 99mTc-MDP bone scintigraphy, 99mTc-sulphur-colloid bone-marrow scintigraphy showed multiple accumulation defects. In conclusion, bone-marrow scintigraphy was found to be useful in distinguishing metastatic lesions from benign degenerative changes in the cases with suspected bone involvement, as well as in evaluating equivocal lesions in the pelvis.

Topics: Aged; Bone Marrow; Bone Neoplasms; Humans; Male; Middle Aged; Prostatic Neoplasms; Radionuclide Imaging; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

The role of ultrasonography, computed tomography (CT), and radioisotopic scanning in the staging of bilharzial bladder cancer has not been reported previously. Forty patients with invasive bladder cancer seen at the King Faisal Specialist Hospital and Research Centre between January 1978 and June 1981 underwent complete preoperative workup for staging of their tumors prior to radical cystectomy. The preoperative radiologic investigations included excretory urography (IVP), ultrasonography (US), CT of the pelvis, and liver and bone scans. The results of these investigations were compared with the operative and pathologic staging. Ninety-three percent of the patients with bilharzial cancer had evidence of ureteric obstruction on IVP compared with 22% of the nonbilharzial cancer patients. The presence of ureteric obstruction in these patients did not correlate with the stage of the disease with 83% of the patients with superficial tumors (T1 and T2) having hydroureteronephrosis. Ultrasonography and CT had an 83% accuracy in the staging of superficial tumors. Stage T3 tumors were understaged in 14% of the cases. Ultrasonography did not differentiate Stages T3 and T4 tumors while CT scan differentiated these two stages in 57% of the cases. Bone scan failed to reveal evidence of metastatic disease in any of the bilharzial cancer patients. Liver scan was suspicious for liver metastases in two patients with bilharzial cancers in whom open liver biopsy revealed only hepatic bilharziasis. Of all the radiographic studies, US or preferably CT scan seem to be of some value in the staging of bilharzial tumors localized to the bladder. Bone and liver scans are probably of no cost effective benefit.

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Diphosphonates; Humans; Liver Neoplasms; Middle Aged; Neoplasm Staging; Prognosis; Radionuclide Imaging; Schistosomiasis; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography; Urinary Bladder Neoplasms; Urography

Indium is generally presumed to localize in the bone marrow within the erythroid cell line. Fibrosis, inflammation, lymphoma, extended field radiation, chemotherapy, or combinations of both treatment modalities generally depress the uptake of indium by the marrow a complex fashion. We report a case of metastatic breast carcinoma and pancytopenia in which the In-111 scan appeared qualitatively similar to a Tc-99m MDP bone scan. Findings were confirmed by bone marrow biopsy.

Topics: Bone Marrow; Bone Neoplasms; Breast Neoplasms; Diphosphonates; Female; Humans; Indium; Middle Aged; Pancytopenia; Radioisotopes; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Thirty-four patients with surgically documented medullary carcinoma of the thyroid (MCT) and elevated serum calcitonin levels had Tc-99m phosphate bone and/or Tc-99m sulfur colloid liver images for suspected metastases. Liver images demonstrated metastatic lesions in nine of 32 patients (28%). Bone images were positive for metastases in eight of 30 patients (27%). Four of these eight abnormal bone studies detected only skeletal lesions, two demonstrated only extraosseous metastases, and two showed both kinds. Of 18 patients with both radionuclide bone studies and skeletal radiographs, four demonstrated skeletal metastases, and lesions were recognized on both examinations. This study demonstrates that radionuclide bone and liver images frequently detect metastatic lesions in patients with MCT and elevated serum calcitonin levels, and that some nonskeletal metastases in patients with this tumor display an unusual affinity for bone-seeking radiotracers.

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Carcinoma; Child; Female; Humans; Liver Neoplasms; Male; Middle Aged; Phosphates; Radiography; Radionuclide Imaging; Splenic Neoplasms; Technetium; Technetium Tc 99m Sulfur Colloid; Thyroid Neoplasms

Between 1978 and 1980, 33 patients with cervical cancer, 40 patients with ovarian cancer, and 28 patients with uterine cancer underwent clinical diagnostic staging. Fifty-four patients had bone scans, and 101 patients received liver scans as a part of their staging work-up. No positive bone scan results were found. Eight of 33 patients with Stage IV disease had positive liver scan results consistent with hepatic metastases. Only 1 of 69 patients with Stage I-III disease had a positive test for metastases. While these numbers are small, the authors conclude that bone and liver scanning in asymptomatic patients with early stage gynecologic cancers may not be warranted as staging procedures.

Topics: Bone and Bones; Bone Neoplasms; Diphosphonates; Female; Genital Neoplasms, Female; Humans; Liver; Liver Neoplasms; Neoplasm Staging; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Time Factors

To evaluate the cost-effectiveness of liver and bone isotope scans results were reviewed in 114 patients with invasive transitional cell carcinoma of the bladder. In 100 patients cystectomy was performed. In no patient has the results of the scans influenced or changed treatment. Routine use of isotope scans is not warranted for the preoperative evaluation of bladder cancer patients.

Topics: Bone and Bones; Bone Neoplasms; Carcinoma, Transitional Cell; Cost-Benefit Analysis; Female; Humans; Liver; Liver Neoplasms; Male; Preoperative Care; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Urinary Bladder Neoplasms

Topics: Aged; Bone Marrow; Bone Neoplasms; Breast Neoplasms; Female; Gallium Radioisotopes; Humans; Liver; Liver Neoplasms; Male; Neoplastic Cells, Circulating; Prostatic Neoplasms; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Staging bone scans or skeletal surveys were obtained of 97 patients with endometrial carcinoma. Of the 77 patients with Stage I or II disease, no metastases were identified at staging. Three patients in the entire series demonstrated bony metastases; all of these metastases were detectable by radionuclide bone scan and radiographic bone survey. Eighty-nine patients were examined with radionuclide liver/spleen scanning at the time of staging. Four of the 89 initial scans were interpreted as demonstrating hepatocellular disease, and all four patients had abnormal liver function studies. Only one patient demonstrated a possible hepatic metastasis at initial diagnosis. This patient also had abnormal liver function studies. Based on these results, bone surveys and radionuclide bone scans are not indicated as screening procedures in endometrial carcinoma. It is suggested that screening for liver metastases in patients with endometrial carcinoma is not warranted in patients with normal liver function studies.

Topics: Bone Neoplasms; Carcinoma; Diphosphates; Diphosphonates; Female; Humans; Liver Neoplasms; Neoplasm Staging; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Uterine Neoplasms

The hospital course of a patient with diffuse skeletal hemangiomatosis is presented with reference to the role of radionuclide imaging procedures in the diagnosis and evaluation of this disorder. In addition to static scans of liver, bone, and bone marrow, flow studies using Tc-99m-sulfur colloid and methylene diphosphonate (MDP) were performed.

Topics: Adult; Angiomatosis; Bone Marrow; Bone Neoplasms; Diphosphonates; Humans; Liver; Male; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Radionuclide scintigraphy was performed in 46 children with rhabdomyosarcoma. Of the 63 radiologically confirmed sites of bone disease, 76% were detected by 99mTc-labeled phosphate uptake. All 15 sites of hepatic involvement and eight of the nine cranial sites of disease exhibited isotope accumulation. Gallium 67 scans showed 57% of the 43 proven sites of disease, including four previously unsuspected areas. Twelve false-positive sites were obtained with gallium. Radionuclide scanning is a valuable aid in the diagnostic evaluation and management of childhood rhabdomyosarcoma.

Topics: Adolescent; Bone Neoplasms; Child; Child, Preschool; False Positive Reactions; Female; Gallium Radioisotopes; Head and Neck Neoplasms; Humans; Infant; Infant, Newborn; Liver Neoplasms; Male; Radionuclide Imaging; Rhabdomyosarcoma; Splenic Neoplasms; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Urogenital Neoplasms