• 대한핵의학회지
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• 제39권3호
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• pp.209-211
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• 2005

A tail-on-detector (TOD) view has been used to see the symphysis pubis or sacrococcyx in skeletal scintigraphy, but it is inconvenient to acquire because a patient must sit or lean on a detector. The TOD views are still frequently performed in training hospitals in Korea, although it is becoming almost impossible to sit on a camera in this age of dual-headed cameras. The authors show cases with lateral views obtained in supine position that were acquired for the same reason; they are easier and more useful than the TOD views.

• Nuclear Medicine and Molecular Imaging
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• 제41권3호
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• pp.260-262
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• 2007

A 68-year-old man with small cell carcinoma of the lung and adenocarcinoma of the prostate underwent Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bilateral symmetrical photon defects in both parietal bones of the skull were observed. The radiographs of the skull demonstrates biparietal thinning in the same area of the abnormality identified on bone scintigraphy. Although these findings in cancer patients can be mistaken for skeletal metastases, the symmetry and location of the photon defects are generally indicative of biparietal thinning.

• 대한핵의학회지
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• 제34권5호
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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.

• Nuclear Medicine and Molecular Imaging
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• 제43권4호
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• pp.253-258
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• 2009

Bone scintigraphy using $^{99m}$Tc-labeled phosphate agents has long been the standard evaluation method for whole skeletal system. However, recent shortage of $^{99m}$Tc supply and advanced positron emission tomography (PET) technology evoked the attention to surrogate radiopharmaceuticals and imaging modalities for bone. Actually, fluorine-18 ($^{18}$F) was the first bone seeking radiotracer before the introduction of $^{99m}$Tc-labeled agents even though its clinical application failed to become pervasive anymore after the rapid spread of Anger type gamma camera systems in early 1970s. However, rapidly developed PET technology made us refocus on the usefulness of $^{18}$F as a PET tracer. Early study comparing $^{18}$F-Na PET scan and planar bone scintigraphy reported that PET has higher sensitivity and specificity in the diagnosis of metastatic bone lesions than planar bone scan. Subsequent reports comparing between PET and both planar and SPECT bone image also revealed better results of PET scan in similar study groups. Rapid clinical application of PET/CT also accumulated considerable amount of experiences in skeletal evaluation and this modality is known to have better diagnostic power than stand alone PET system as well as bone scan. Furthermore $^{18}$F-Na PET/CT revealed better or at least equal results in detection of primary and metastatic bone lesions compared with CT and MRI. Therefore, it is obvious that $^{18}$F-Na PET/CT has potential to become new imaging modality for practical skeletal evaluation so continuous and careful evaluation of this modality and radiopharmaceutical must be required.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 1975년도 제14차 학술대회
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• pp.85.3-86
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• 1975

• 대한핵의학회지
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• 제35권3호
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• pp.161-167
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• 2001

목적: 골스캔은 다양한 골격계 질환을 평가하는데 가장 널리 이용되는 검사방법이다. 골격계를 침범하는 대사성 골질환은 골대사의 증가와 연관이 있다. 본 연구에서는 골스캔을 시행한 정상 여성에서 골스캔상의 섭취 증가와 골밀도와의 관계를 알아보고자 하였다. 대상 및 방법: 골밀도와 골스캔을 동시에 시행한 79명의 여자를 대상으로 골다공증 동반 여부와 골스캔 소견과의 상관관계를 조사하였다. 결과: 연령이 증가할수록 각 부위별 골밀도와는 음의 상관관계를 보였다. 골스캔의 7가지 소견 중 장골과 두개골 및 하악골의 섭취는 증가하였고, 늑연골 접합부의 섭취는 감소하는 소견을 보였다. 이들 소견중 두개골 및 하악골의 섭취 증가 소견은 요추와 대퇴경부 골밀도의 감소와 통계학적으로 의미있는 유의성을 보여주었다. 결론: 여성에서 골스캔상 두개골 및 하악골의 섭취증가 소견은 요추와 대퇴경부의 골밀도 감소와 관련이 있었고 이러한 사실은 폐경 후 여성에서 골감소증이나 골다공증을 시사하는 소견이 될 수 있다.

• 대한핵의학회지
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• 제32권2호
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• pp.168-171
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• 1998

We present a case in which a patient with acute hemorrhagic gastritis demonstrated abnormal gastrointestinal accumulation of radiotracer during $^{99m}Tc$-methylene diphosphonate(MDP) skeletal scintigraphy. A hemorrhagic gastritis was subsequently demonstrated by endoscopy. The mechanism for the intestinal localization of $^{99m}Tc$-MDP in this patient is not clear, but we guess that the extravasated blood containing the radiopharmaceutical cannot recirculate and stays at the bleeding site, so we can see the intestinal activity.

• 대한핵의학회지
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• 제35권4호
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• pp.291-292
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• 2001

We report a case of malignant pericardial effusion originated from adenocarcinoma of the lung incidentally diagnosed by bone scintigraphy, prior to echocardiographic detection. A 76 year-old man with adenocarcinoma of the lung underwent Tc-99m MDP bone scintigraphy to evaluate skeletal metastasis. Anterior images of the chest of the bone scintigraphy unexpectedly showed diffuse increased activity in the region of the heart surrounded by an oval-shaped band of increased activity corresponding to the periphery of the cardiac silhouette (Fig. 1). There was no evidence of bony metastasis. Pericardial effusion was confirmed by echocardiography (Fig. 2) and malignant cells were revealed by subsequent microscopic examination of the pericardial fluid. Bone scintigraphy using Tc-99m phosphate compounds is commonly used to detect bony metastasis in cancer patients. Tc-99m phosphate compounds occasionally accumulate in extra-osseous sites, including $pleural^{1,2)},\;pericardial^{3,4)},\;and\;ascitic\;fluids^{5,6)}$. It has been reported that their accumulation in serous effusions should strongly suggest $malignancy^{1-6)}$. The exact mechanism for accumulation of Tc-99m phosphate compounds in serous effusions is unclear. Several investigators have proposed that the radiopharmaceuticals exuded directly from peripheral vessels to the serous cavity due to increased vascularity and vascular permeability, and bleeding by disruption of blood vessels due to cancerous $infiltration^{5,6)}$.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3647-3652
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• 2013

Purpose: To evaluate the diagnostic value of $^{18}F$-FDG PET/CT for detection of bone metastasis in comparison with the efficacies of $^{18}F$-FDG PET/CT, CT, $^{18}F$-FDG PET and conventional planar bone scintigraphy in a series of cancer patients. Methods: Five hundred and thirty patients who underwent both $^{18}F$-FDG PET/CT and bone scintigraphy within 1 month were retrospectively analyzed. The skeletal system was classified into 10 anatomic segments and interpreted blindly and separately. For each modality, the sensitivity, specificity, accuracy, PPV and NPV were calculated and the results were statistically analyzed. Results: Bone metastases were confirmed in 117 patients with 459 positive segments. On patient-based analysis, the sensitivity, specificity, accuracy, PPV and NPV of $^{18}F$-FDG PET/CT were significantly higher than bone scintigraphy, CT and $^{18}F$-FDG PET (P<0.05). On segment-based analysis, the sensitivity of CT, bone scintigraphy, $^{18}F$-FDG PET and $^{18}F$-FDG PET/CT were 70.4%, 89.5%, 89.1% and 97.8%, respectively (P<0.05, compared with $^{18}F$-FDG PET/CT). The overall specificity and accuracy of the four modalities were 89.1%, 91.8%, 90.3%, 98.2% and 90.3%, 90.9%, 89.8%, 98.0%, respectively (P<0.05, compared with $^{18}F$-FDG PET/CT). The PPV and NPV were 89.8%, 87.6%, 85.6%, 97.2% and 85.6%, 93.2%, 92.8%, 98.6%, respectively. Three hundred and twelve lesions or segments were presented as lytic or sclerotic changes on CT images at the corresponding sites of increased $^{18}F$-FDG uptake. In lytic or mixed lesions, the sensitivity of $^{18}F$-FDG PET/CT and $^{18}F$-FDG PET were better than bone scintigraphy, while in osteoblastic lesions bone scintigraphy had a similar performance with $^{18}F$-FDG PET/CT but better than $^{18}F$-FDG PET alone. Conclusion: Our data allow the conclusion that $^{18}F$-FDG PET/CT is superior to planar bone scintigraphy, CT or $^{18}F$-FDG PET in detecting bone metastasis. $^{18}F$-FDG PET/CT may enhance our diagnosis of tumor bone metastasis and provide more information for cancer treatment.

• Nuclear Medicine and Molecular Imaging
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• 제41권1호
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• pp.64-65
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• 2007

A 49-year-old woman with invasive ductal carcinoma of the right breast underwent Tc-99m MDP bone scintigraphy for an evaluation of skeletal metastases. Multiple focal hot spots in the midline and left frontoparietal skull region were observed. The plain radiographs revealed the typical findings of the calcification of the falx cerebri and dura. These findings might be mistaken for metastases of the skull in cancer patients. Therefore, a radiographic correlation is essential when multifocal hot spots in the skull are observed in cancer patients.