• Title, Summary, Keyword: Bone metastases

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Discrepancy of Bone Metastases between F-18 FDG PET/CT and Bone Scan in a Patient with Prostate Cancer (전립선암에서 골전이 진단에 대한 F-18 FDG PET/CT와 골스캔의 불일치)

  • Choi, Seung-Jin;Kim, Chul-Soo;Byun, Sung-Su;Hyun, In-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.5
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    • pp.275-278
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    • 2006
  • We report the case of a 73-year-old man who had prostate cancer with bone metastases. Tc-99m HDP Whole body bone scan revealed multiple areas of increased bony uptake consistent with widespread bone metastases. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) demonstrated mild F-18 FDG uptake in the lymph nodes of neck, abdomen, and pelvis. However, abnormal F-18 FDG uptake was not seen in the skeletal system. Biopsy and immunohistochemical stains of left supraclavicular mass showed metastatic prostate adenocarcinoma. Currently, there are a few reported cases of F-18 FDG PET/CT evaluation of bone metastases in prostate cancer. We discuss the discrepancy between F-18 FDG PET/CT and bone scan in the detection of osseous metastases of prostate cancer.

Differentiation of Bone Metastases and Fractures using 24 hour/3 hour Radio-uptake Ratio in Bone Scintigraphy (골신티그라피의 3시간과 24시간 방사능 섭취비를 이용한 골 전이와 골절의 감별)

  • Han, Song-Yee;Chun, Kyung-Ah;Chung, Yong-Ahn;Kim, Sung-Hoon;Kim, Young-Joo;Chung, Soo-Kyo;Park, Seog-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.512-518
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    • 1999
  • Purpose: We evaluated the usefulness of 24 hour/3 hour radio-uptake ratio, lesion to non-lesion ratio, in differentiating bony metastases from acute (<2 months) and healing (${\geq}2$ months) fractures. Materials and Methods: Sixty-three patients (age range: 26-81, 32 males, 31 females) having 90 lesions (30 bone metastases, 30 acute fractures, 30 healing fractures) were included. Bone scans were obtained 3 and 24 hours after administration of 740 MBq of $^{99m}Tc$-MDP. The ratio of radio-uptake in the lesion to normal area was measured as 24/3 hour radio-uptake ratio ([lesion/non-lesion RUR at 24 hour]/[lesion/non-lesion RUR at 3 hour], 24/3 RUR) and analyzed clinical significance in differentiating bone metastases from acute or healing fractures. Results: Mean 24/3 RUR were $1.22{\pm}0.18$ for bone metastases, $1.25{\pm}0.14$ for acute fractures, and $0.99{\pm}0.15$ for healing fractures. 24/3 RUR values of bone metastases and acute fractures were not significantly different. But 24/3 RUR values of bone metastases and healing fractures, and those of acute and healing fractures were found to be significantly different (p<0.001). When 24/3 RUR of 1.0 was considered as the cut off point separating metastases from fracture, a sensitivity of 100% (30/30) was obtained. The specificity was 0% (0/30) in separating metastases from acute fractures, and 47% (14/30) in separating metastases from healing fractures. When 24/3 RUR of 1.2 was considered as the cut off point, sensitivity of 53% (16/30) in the diagnosis of bone metastasis, and specificity of 37% (11/30) in separating metastases from acute fractures, and 100% (30/30) in separating metastases from healing fractures were obtained. Conclusion: 24/3 RUR is useful in differentiating bone metastases from healing fractures, but not in differentiating bone metastases from acute fractures. A 24/3 RUR of less than 1.0 suggests healing fractures. A 24/3 RUR of more than 1.2 suggests bone metastases or acute fractures.

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Osteogenic Sarcoma with Osseous, Pulmonary, and Pericardial Metastases Simultaneously Demonstrated on Bone Scintigraphy at Initial Presentation (초기 골스캔에서 뼈, 폐와 심낭으로의 전이를 보인 골육종)

  • Lim, Seok-Tae;Kim, Min-Woo;Sohn, Myung-Hee;Hwang, Pyoung-Han
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.5
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    • pp.336-339
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    • 2003
  • Purpose: A 6-year-old boy with osteogenic sarcoma of the left humerus underwent bone scintigraphy. Tc-99m MDP was accumulated not only in the primary tumor but also in the osseous and extraosseous (pulmonary and pericardial) metastases. Osteogenic sarcoma directly produces osteoid, both in the primary and metastatic lesions. Tc-99m MDP is avidly taken up by tumor osteoid. At initial presentation, only 2% of cases have both pulmonary and osseous metastases. The patient had osseous, pulmonary, and pericardial metastases at presentation. This case presents that increased uptakes of Tc-99m MDP by the primary and metastatic tumor were demonstrated on bone scintigraphy at presentation.

Markers of Bone Metastases in Breast and Lung Cancers

  • Bilgin, Elif;Yasasever, Vildan;Soydinc, Hilal Oguz;Yasasever, Ceren Tilgen;Ozturk, Nakiye;Duranyildiz, Derya
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4331-4334
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    • 2012
  • Aim and Background: The aim of the present study was to evaluate correlations between serum osteocalcin, osteoprotegerin and NTX (Cross-linked N-telopeptides of Type I Collagen) and urinary NTX in breast and lung cancer patients with bone metastases. These four markers are considered to have important roles in bone formation, resorption and metastases. Methods: Four markers were determined in the sera of 60 breast cancer and 21 lung cancer patients and healthy controls (n=30). Serum levels were studied using ELISA and EIA. Results: The median levels of serum osteoprotegerin (p<0.001) and osteocalcin (p=0.003) were higher in patients. Significant correlations were observed between the serum NTX-osteocalcin (r=0.431; p<0.001), serum NTX-osteoprotegerin (r=0.42; p=0.003) and serum NTX - urine NTX (r=0.255; p=0.022). Conclusion: We conclude that osteocalcin, osteoprotegerin and NTX are independent diagnostic tools. Due to the ease of urine collection, urine NTX may be applied routinely to allow early detection of bone metastases and indicate progression of the disease.

Cerebral Infarction Mimicking Skeletal Metastases on Tc-99m MDP Bone Scintigraphy

  • Lim, Seok-Tae;Park, Soon-Ah;Sohn, Myung-Hee;Yim, Chang-Yeol
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.433-435
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    • 2000
  • A 6000-year-old male with carcinoma of the prostate and cerebral infarction underwent a Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bone scintigraphy (Fig. 1) showed multiple areas of increased uptake of Tc-99m MDP in the skull, spine, and ribs representing skeletal metastases. Two different patterns of uptake occurred in the skull region (Fig. 1A-C); one represents bony metastasis and the ether represents cerebral infarction. The shape, size, location, intensity, and border of the increased uptake differed between the two lesions. An oval-shaped pattern with smaller size, greater intensity and more sharply defined border in the frontal region was consistent with bony metastasis. A rectangular-shaped pattern with larger size, lesser intensity and relatively indistinct border in the temporo-parieto-occipital region was consistent with cerebral infarction. Increased uptake of bone-seeking radiotracers in cerebral infarction has been reported previously.$^{1-4)}$ A suggested mechanism by which bone-seeking radiotracers accumulate in the necrotizing cerebral tissue is an alteration of the blood-brain barrier induced during cerebral infarction, which results in entry of the radiotracers into the extracellular space of the brain.$^{4)}$ Brain CT (Fig. 2) performed 7 days before and one month after the bone scintigraphy revealed lesions on the right temporo-parieto-occipital region consistent with acute hemorrhagic and chronic cerebral infarction, respectively.

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Association of Metastasis with Clinicopathological Data in Mexican Patients with Osteosarcoma, Giant Cell Tumor of Bone and Chondrosarcoma

  • Estrada-Villaseor, E;Escamilla-Uribe, R;De la Garza-Montano, P;Dominguez-Rubio, R;Martinez-Lopez, V;Avila-Luna, A;Alfaro-Rodriguez, A;Ruvalcaba-Paredes, EK;Garciadiego-Cazares, D;Bandala, C
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7689-7694
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    • 2015
  • Background: Bone tumors are neoplasias with a high overall mortality; one of the main factors that reduce survival is their high capacity to develop metastases. It has been reported that finding lung metastases at diagnosis of osteosarcoma (OS), chondrosarcoma (CS) and giant cell tumor of bone (GCTb) is quite common. In this study, we inquire the relationship of metastases caused by these tumors with different clinical and pathological aspects, in order to guide medical personnel in the diagnosis and opportune treatment of metastases or micro metastases. Materials and Methods: We collected data of 384 patients with clinical, radiological and histopathological diagnosis of OS, GCTb and CS that attended the National Rehabilitation Institute (INR) during 2006 to 2014. Chi-square and Fisher's exact tests were performed for data analysis. Results: In the three tumor types, the presence of metastases at diagnosis was variable (p=0.0001). Frequency of metastases was 36.7%, 31.7% and 13.2% for OS, CS and GCTb respectively. The average age had no significant difference (p>0.05) in relation to metastases, even so, patients with OS and GCTb and metastases, were older while patients with CS and metastases were younger, in comparison to patients without metastases. Males had a higher frequency of metastases (68.2%, p = 0.09) in contrast to CS and GCTb, in which the metastases was more frequent in women with 51.9% (p = 0.44) and 57.9% (p = 0.56) respectively. Broadly, metastasis was associated with primary tumors located in the femur (44.4%), followed by the tibia (15.6%); metastases was more frequent when primary tumor of GCTb and OS were in the same bones, but were located in the hip (26.3%) for CS. Conclusions: The frequency of metastases in OS, GCTb and CS is high in our population and is determined by different clinicopathological variables related to the kind of tumor. Further studies are needed in order to evaluate metastases subsequent to diagnosis and associations with survival and clinicopathological factors, as well as to determine the sensitivity and specificity of current methods of detection.

Assessing the EORTC QLQ-BM22 Module Using Rasch Modeling and Confirmatory Factor Analysis across Countries: a Comprehensive Psychometric Evaluation in Patients with Bone Metastases

  • Lin, Chung-Ying;Pakpour, Amir H
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1405-1410
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    • 2016
  • Background: The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Bone Metastases Module (EORTC QLQ-BM22) is a recently designed supplement to EORTC Quality of Life Questionnaire-C30 (EORTC QLQ-C30). Additional psychometric properties, especially using confirmatory factor analysis (CFA) and the Rasch model, are warranted. Materials and Methods: A total of 573 patients with bone metastases were enrolled from eight countries with a mean${\pm}$SD age of $55.8{\pm}13.7years$. Slightly more than two thirds of them were female (n=383; 66.8%). CFA was used to examine the BM22 framework; Rasch models were applied to understand misfit items and differential item functioning (DIF). Results: The fit indices were satisfactory in CFA (comparative fit index=0.972, Tucker-Lewis index=0.964, root mean square error of approximation=0.076, and standardized root mean square residual=0.045). All items fit well in the Rasch models (mean square values were between 0.5 and 1.5), and only one item (number 17) displayed DIF across gender. However, there were six DIF items across Canada and Taiwan, ten across Canada and Iran, and six across Taiwan and Iran. Conclusions: The BM22 has satisfactory psychometric properties, and could assess the QoL of patients with bone metastases specifically focusing on their symptoms. Clinicians may want to use it to capture the underlying QoL for patients with bone metastases. However, the score of item 17 should be interpreted with caution when comparing male and female patients. In addition, researchers should note that variation in DIF items may occur when conducting an international study.

Computer programme to assess mandibular cortex morphology in cases of medication-related osteonecrosis of the jaw with osteoporosis or bone metastases

  • Ogura, Ichiro;Kobayashi, Eizaburo;Nakahara, Ken;Haga-Tsujimura, Maiko;Igarashi, Kensuke;Katsumata, Akitoshi
    • Imaging Science in Dentistry
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    • v.49 no.4
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    • pp.281-286
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    • 2019
  • Purpose: The purpose of this study was to evaluate the morphology of the mandibular cortex in cases of medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis or bone metastases using a computer programme. Materials and Methods: Fifty-four patients with MRONJ (35 with osteoporosis and 19 with bone metastases) were examined using panoramic radiography. The morphology of the mandibular cortex was evaluated using a computer programme that scanned the mandibular inferior cortex and automatically assessed the mandibular cortical index (MCI) according to the thickness and roughness of the mandibular cortex, as follows: normal (class 1), mildly to moderately eroded (class 2), or severely eroded (class 3). The MCI classifications of MRONJ patients with osteoporosis or bone metastases were evaluated with the Pearson chi-square test. In these analyses, a 5% significance level was used. Results: The MCI of MRONJ patients with osteoporosis(class 1: 6, class 2: 15, class 3: 14) tended to be higher than that of patients with bone metastases(class 1: 14, class 2: 5, class 3: 0)(P=0.000). Conclusion: The use of a computer programme to assess mandibular cortex morphology may be an effective technique for the objective and quantitative evaluation of the MCI in MRONJ patients with osteoporosis or bone metastases.

Comparison with $^{99m}Tc$ MDP Bone Scintigraphy and Whole body $^{18}FDG$ PET for the Evaluation of Bone metastases in Patients with Lung Cancer (폐암의 골전이에서 $^{99m}Tc$ MDP 골주사와 전신 $^{18}FDG$ PET의 비교)

  • Chung, Jae Ho;Park, Moo Suk;Hahn, Chang Hoon;Moon, Jin Wook;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Lee, Jong Doo;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.3
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    • pp.280-286
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    • 2003
  • Background : $^{99m}Technetium$ methylene diphosphonates($^{99m}Tc$ MDP) bone scintigraphy is current method of choice for the detection of bone metastases, but whole body $^{18}F$-fluoro-deoxy-D-glucose positron emission tomography($^{18}FDG$ PET) offers superior spatial resolution and improved sensitivity. So we compared whole body $^{18}FDG$ PET with $^{99m}Tc$ MDP bone scintigraphy in patients with skeletal metastases from lung cancer. Patients and Methods : Ninety-two patients with lung cancer taken $^{18}FDG$ PET together with a $^{99m}Tc$ MDP bone scintigraphy within 1 month between March 2000 and March 2003 were investigated retrospectively. Results : The sensitivity, specificity and accuracy of the $^{99m}Tc$ MDP bone scintigraphy versus $^{18}FDG$ PET for the detection of bone metastases in lung cancers were 59% vs 82%, 71% vs 94%, and 68% vs 91%, respectively. In the diagnosis of bone metastases from lung cancer, $^{18}FDG$ PET was statistically superior to $^{99m}Tc$ MDP bone scintigraphy in its specificity and accuracy(p<0.0001). Conclusions : Whole body $^{18}FDG$ PET may be useful in detecting bone metastases among patients with lung cancer.

The Radiopharmaceutical Therapy for Multiple Bone Metastases of Cancer (암의 다발성 뼈 전이의 방사성동위원소 치료)

  • Choi, Sang Gyu
    • The Korean Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.207-215
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    • 2014
  • Multiple bone metastases are common manifestation of many malignant tumors such as lung cancer, breast cancer, prostate cancer and renal cell carcinoma. Bone metastasis is secondary cancer in the bone, and it can lead to bone pain, fracture, and instability of the weight bearing bones, all of which may profoundly reduce physical activity and life quality. Treatment for bone metastasis is determined by multiple factors including pathology, performance status, involved site, and neurologic status. Treatment strategies for bone metastasis are analgesics, surgery, chemotherapy and radiotherapy. External beam radiotherapy has traditionally been an effective palliative treatment for localized painful bone metastasis. However, in some cases such as multiple bone metastases, especially osteoblastic bone metastasis originated from breast or prostate cancer, the radiopharmaceutical therapy using $^{89}Sr$, $^{186}Re$, $^{188}Re$, $^{153}Sm$ and $^{117m}Sn$ are also useful treatment option because of administrative simplicity (injection), few side effects, low risk of radiation exposure and high response rate. This article offers a concise explanation of the radiopharmaceutical therapy for multiple bone metastases.