• The Korean Journal of Nuclear Medicine
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• v.24 no.1
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• pp.119-123
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• 1990

Unexpected renal abnormality can be detected on bone scan using Tc-99m-MDP. The purpose of the study is to evaluate the diagnostic significance of diffusely increased bliateral renal uptake on bone scarf. 1,500 boor scan were reviewed and 43 scans which showed diffusely increased bliateral renal uptake were selected for analysis. Laboratory findings for renal and liver function tests including routine urinalysis were reviewed in 43 patients. 26 of 43 case showed abnormality in urinalysis and renal function stud 20 of 43 cases showed abnormal liver function study and 3 of these cases were diagnosed as hepatorenal syndrome later. 13 of those 20 cases had liver cirrhosis with or without hepatoma. 12 of 43 cases showed abnormality both in renal and liver function studies. 2 of 43 cases showed diffusely increased bilateral renal uptake after chemotherapy for cancer but not on previous scans before chemotherapy. 2 of 43 cases showed hypercalcemia and 8 of 43 cases had multifocal bone uptake due to metastasis or benign bone lesion. but the latter showed no hypercalcemia at all. There was no significant correlatrion between increased renal uptake and MDP uptake in soft tissue other than kidneys. This study raised the possibility that the impaired liver and/or renal function may result in diffuse increase of bliateral renal uptake of MDP of unknown mechaninsm. It seems to need further study on this correlation.

• Journal of radiological science and technology
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• v.36 no.4
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• pp.299-304
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• 2013

Whole body bone scan has been used to confirm bone metastasis and follow-up study with radio isotope. However, if the factors related to $^{99m}Tc$ uptake and waiting time for study are inappropriate, it would be image of low quality. The purpose of present study was to investigate correlation between the evaluation index of renal function and uptake of radiopharmaceuticals. The population for this retrospective study consisted of 387 patients who underwent whole body bone scan between June 2012 and December 2012. As a result of quantitative and qualitative analysis, we were able to confirm that GFR of less than normal range and creatinine levels in blood of more than average are more likely to be under the mean uptake rate. As a result of analysis on the indicator affecting soft-tissue and bone uptake, the correlation of all elements was somewhat low. Also there are no statistically significances due to the other parameters we did not deal with. Therefore, further research on additional factors is needed for exact study and improvement of the image quality.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.4973-4976
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• 2013

Background: To identify correlation and incidence of bone metastases in prostate cancer patient with low Gleason scores (GS) and prostate specific antigen (PSA) levels. Materials and Methods: This descriptive restrospective study covered patients with prostate cancer in Cipto Mangunkusumo Hospital in 2006-2011. Of a total of 478, those who had PSA values, histological examination, and bone scan were included, resulting in 358 eligible cases. PSA values were measured using the sandwich electrochemiluminescent immunoassay. Histological examination was graded according to Gleason's grading system and divided into 3 categories: well differentiated ($GS{\leq}6$), moderately differentiated (GS 7) and poorly differentiated (GS 8-10). Bone scans were performed using a radiopharmaceutical agent ($T_c$ 99m methylenen diphosphonate) with images captured by gamma camera. Results: The mean age was $67.5{\pm}7.8$, mean GS was $7.7{\pm}1.3$ and median PSA was 56.9 (range: 0.48-17000 ng/mL). There were 11 patients (3.0%) with positive bone scan with PSA<20 ng/mL and GS<8. Furthermore, there were 2 patients (0.6%) with $GS{\leq}6$ and PSA<10 ng/mL showing bone metastasis. Conclusions: In our study, there were still small percentage of patients with bone metastasis even when low values of PSA (PSA<10 ng/mL) and GS ($GS{\leq}6$) were applied.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.133-137
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• 2010

Purpose: Breast cancer is known to be more vulnerable to bone metastasis and lymph node metastasis than other types of cancer, and nuclear examinations whole body bone scan and lymphoscintigraphy are performed commonly before and after breast cancer operation. In case whole body bone scan is performed on the day before lymphoscintigraphy, the radiopharmaceutical taken into and remaining in the bones provides anatomical information for tracking and locating sentinel lymph nodes. Thus, this study purposed to examine how much bone density affects in locating sentinel lymph nodes. Materials and Methods: The subjects of this study were 22 patients (average age $52{\pm}7.2$) who had whole body bone scan and lymphoscintigraphy over two days in our hospital during the period from January to December, 2009. In the blind test, 22 patients (average age $57{\pm}6.5$) who had lymphoscintigraphy using $^{57}Co$ flood phantom were used as a control group. In quantitative analysis, the relative ratio of the background to sentinel lymph nodes was measured by drawing ROIs on sentinel lymph nodes and the background, and in gross examination, each of a nuclear physician and a radiological technologist with five years' or longer field experience examined images through blind test in a five-point scale. Results: In the results of quantitative analysis, the relative ratio of the background to sentinel lymph nodes was 14.2:1 maximum and 8.5:1 ($SD{\pm}3.48$) on the average on the front, and 14.7:1 maximum and 8.5:1 ($SD{\pm}3.42$) on the average on the side. In the results of gross examination, when $^{57}Co$ flood phantom images were compared with images containing bones, the score was relative high as 3.86 ($SD{\pm}0.35$) point for $^{57}Co$ flood phantom images and 4.09 ($SD{\pm}0.42$) for bone images. Conclusion: When whole body bone scan was performed on the day before lymphoscintigraphy, the ratio of the background to sentinel lymph nodes was over 10:1, so there was no problem in locating lymph nodes. In addition, we expect to reduce examination procedures and improve the quality of images by indicating the location of sentinel lymph nodes using bone images as body contour without the use of a source.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.907-915
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• 2001

Objective : Percutaneous vertebroplasty is often complicated by the presence of multiple fractures or non-localizing pain in the patients with osteoporotic vertebral fractures. The purpose of this study is to estimate the value of preoperative radiologic studies in the localization of symptomatic vertebrae and to determine the factors which can influence on the clinical results. Materials and Methods : We retrospectively reviewed the clinical and radiologic data of 57 vertebrae in 30 patients underwent percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Inclusion criteria was severe pain(McGill-Melzack score 3, 4 or 5) associated with the acute vertebral fractures and absence of spinal nerve root or cord compression sign. Acute symptomatic vertebral fracture was determined by the presence of signal change on MR images or increased uptake on whole body bone scan. Results : Pain improvement was obtained immediately in all patients and favorable result was sustained in 26 patients(86.7%) during the mean follow-up duration of 4.7 months(5 complete pain relief, 21 marked pain relief). Those who underwent vertebroplasty for all acute symptomatic vertebrae had significantly better clinical result than those who did not. Further vertebral collapse and eventual bursting fracture occurred in 1 vertebra which showed intradiskal leakage of bone cement and disruption of cortical endplate on postoperative CT scan. Conclusion : Preoperative MR imaging and whole body bone scan are very useful in determining the symptomatic vertebrae, especially in the patients with multiple osteoporotic vertebral fractures. To obtain favorable clinical result, the careful radiologic evaluation as well as clinical assessment is required. Control of PMMA volume seems to be the most critical point for avoiding complications.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.287-293
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• 2009

Purpose: This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Materials and Methods: Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest a findings of rib fracture were analyzed. Results: The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p = 0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p =0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest a, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p = 0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p = 0.001). Conclusion: Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.1
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• pp.13-18
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• 2008

Purpose: The image processing method due to the algorism which is various portion nuclear medical image decision is important it makes holds. The purpose of this study is it applies hereupon new image processing method SIEMENS (made by Pixon co.) Onco. flash processing reconstruction and the comparison which use the image control technique of existing the clinical usefulness it analyzes with it evaluates. Materials & Methods: 1. Whole body bone scan-scan speed 20 cm/min, 30 cm/min & 40 cm/min blinding test 2. Bone static spot scan-regional view 200 kcts, 400 kcts for chest, pelvis, foot blinding test 3. 4 quadrant-bar phantom-20000 kcts visual evaluation 4. LSF-FWHM resolution comparison ananysis. Results: 1. Raw data (20 cm/min) & processing data (30 cm/min)-similar level image quality 2. Low count static image-image quality clearly improved at visual evaluation result. 3. Visual evaluation by quadrant bar phantom-rising image quality level 4. Resolution comparison evaluation (FWHM)-same difference from resolution comparison evaluation Conclusion: The study which applies a new method Onco. flash processing reconstruction, it will be able to confirm the image quality improvement which until high level is clearer the case which applies the method of existing better than. The new reconstruction improves the resolution & reduces the noise. This enhances the diagnostic capabilities of such imagery for radiologists and physicians and allows a reduction in radiation dosage for the same image quality. Like this fact, rising of equipment availability & shortening the patient waiting move & from viewpoint of the active defense against radiation currently becomes feed with the fact that it will be the useful result propriety which is sufficient in clinical NM.

• Journal of Periodontal and Implant Science
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• v.40 no.6
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• pp.283-288
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• 2010

Purpose: The aim of this case report is to present a case of incomplete bone formation after sinus augmentation. Methods: A patient having alveolar bone resorption of the maxillary posterior edentulous region and advanced pneumatization of the maxillary sinus was treated with sinus elevation using deproteinized bovine bone in the Department of Periodontology, Kyung Hee University School of Dentistry and re-evaluated with computed tomography (CT) follow-up. Results: Even though there were no significant findings or abnormal radiolucency on the panoramic radiograph, incomplete bone formation in the central portion of the augmented sinus was found fortuitously in the CT scan. The CT scan revealed peri-implant radiolucency in the apical portion of the implant placed in the augmented maxillary sinus. Nevertheless, the dental implants placed in the grafted sinus still functioned well at over 15 months follow-up. Conclusions: The result of this case suggests that patients who received maxillary sinus augmentation may experience incomplete bone formation. It is possible that 1) osteoconductive graft material with poor osteogenic potential, 2) overpacking of graft material that restricts the blood supply, and 3) bone microbial contamination may cause the appearance of incomplete bone formation after sinus augmentation. Further studies are needed to elucidate the mechanism of this unexpected result and care must be taken to prevent it.

• 대한핵의학회:학술대회논문집
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• 1979.05a
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• pp.19.3-20
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• 1979

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.130-138
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• 1996

Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.