• Title/Summary/Keyword: bone metastasis

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FDG-PET/CT Complements Bone Scan with Respect to the Detection of Skip Metastasis of Osteosarcoma: A Case Report (골육종의 도약전이 진단에서 골스캔의 보완검사로서의 FDG-PET/CT: 증례 보고)

  • Cheon, Gi-Jeong;Choe, Jae-Gol;Chae, In-Jung;Lee, Dae-Hee;Song, Sang-Heon;Kim, Myo-Jong;Park, Jong-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.45-49
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    • 2012
  • Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.

Guidelines for Evaluating Treatment Response Based on Bone Scan for Metastatic Castration-Resistant Prostate Cancer: Prostate Cancer Clinical Trial Working Group 3 Recommendations (전이성 거세 저항성 전립선암의 치료 반응 평가를 위한 뼈스캔 기반의 전이성 골병변 반응 평가 지침: Prostate Cancer Clinical Trial Working Group 3 권장사항)

  • Ji Sung Jang;Amy Junghyun Lee;Kye Jin Park;Kyung Won Kim;Hyo Jung Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1244-1256
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    • 2023
  • In prostate cancer, the bone is the most common site of metastasis, and it is essential to evaluate metastatic bone lesions to assess the tumor burden and treatment response. Castration-resistant prostate cancer refers to the state wherein the cancer continues to progress despite a significant reduction of the sex hormone level and is associated with frequent distant metastasis. The Prostate Cancer Working Group 3 (PCWG3) released guidelines that aimed to standardize the assessment of treatment effects in castration-resistant prostate cancer using bone scintigraphy. However, these guidelines can be challenging to comprehend and implement in practical settings. The purpose of this review was to provide an overview of a specific image acquisition method and treatment response assessment for bone scintigraphy-based evaluation of bone lesions in metastatic castration-resistant prostate cancer, in accordance with the PCWG3 guidelines.

Gelatinous Transformation of Bone Marrow Mimicking Malignant Marrow-Replacing Lesion on Magnetic Resonance Imaging in a Patient without Underlying Devastating Disease

  • Lee, Joohee;Yoo, Yeon Hwa;Lee, Sarah;Kim, Hak Sun;Kim, Sungjun
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.1
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    • pp.50-55
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    • 2018
  • Gelatinous transformation of bone marrow is characterized by hypoplasia of fat cells with focal loss of hematopoietic cells and deposition of extracellular gelatinous substances. It is known to be associated with devastating underlying diseases that starve bone marrow. Here, we present a case of a patient whose magnetic resonance (MR) imaging findings of vertebral column were interpreted as metastasis or hematologic malignancy, however, the final diagnosis revealed a gelatinous transformation of bone marrow. This is the first report of gelatinous transformation of bone marrow without evidence of underlying devastating disease.

Primary Neuroblastoma Uptake in $^{99m}Technetium$ Methylene Diphosphonate Bone Scan (2 Cases) ($^{99m}Technetium$ Methylene Diphosphonate Bone Scan에서 원발병소가 조영된 신경아세포종 2예의 치험)

  • Kwon, Tae-Won;Jung, Poong-Man;Cho, Suk-Shin;Ko, Young-Hyeh
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.2
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    • pp.213-219
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    • 1987
  • Although the exact mechanism is not clearly understood yet, there were examples of the uptake of radiopharmaceuticals to the soft tissue lesions with $^{99m}Technetium$ methylene diphosphonate bone scan. Recently, we experienced two cases of neuroblastoma of which primary sites were imaged with $^{99m}Tc-MDP$ bone scan preoperatively and could make the diagnosis. So, we report here that $^{99m}Tc-MDP$ bone scan is the reasonable method not only to find out the bone metastasis, but also to diagnose the neuroblastoma preoperatively.

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Establishment of automated manufacturing system for high-purity [18F]Sodium fluoride: 3-year production experience

  • Jung, Soonjae;Kim, Jung Young;Han, Sang Jin;Seo, Youngbeom;Lee, Kyo Chul;Ryu, Young Hoon;Choi, Jae Yong
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.5 no.1
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    • pp.48-53
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    • 2019
  • A bone metastasis is an important factor for prognosis and treatment of breast or prostate cancer patients. [$^{18}F$]Sodium fluoride ([$^{18}F$]NaF) is a PET radiopharmaceutical that can detect bone metastasis. Conventional [$^{18}F$]NaF production process included radioactive metal impurities because the product was prepared by adding saline after beam irradiation to $[^{18}O]H_2O$. In this study, we apply the method of removing radionuclidic impurities. To meet the criteria prescribed by GMP in quality control, we designed the custom-made [$^{18}F$]NaF automatic module. The mean radiochemical yield was $82.1{\pm}4.4%$ (n = 32) productions for 3 years) and the total preparation time was 4 min. The final produced [$^{18}F$]NaF solution meets the USP criteria for quality control. Thus, this fully automated system is validated for clinical use.

Early Imaging Findings of Hypertrophic Osteoarthropathy Mimicking Bone Metastasis from Extrathoracic Malignancy (뼈 전이로 오인될 수 있는 흉강 외 악성 종양으로 인한 비대성 골관절증의 초기 영상 소견)

  • Ji Yeon Hwang;Jang Gyu Cha;Yu Sung Yoon;Ahrim Moon
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1606-1612
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    • 2021
  • Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by digital clubbing, periosteal bone formation, and synovial effusions. Secondary HOA is associated with intrathoracic malignancy in most cases; however, in rare cases, HOA can be caused by extrathoracic conditions. We report early ultrasound, computed tomography, magnetic resonance imaging, and bone scintigraphy findings of HOA in a patient with breast cancer. Its ambiguous clinical and imaging findings that mimicked malignant conditions are particularly interesting and informative.

Differential Diagnosis of Metastatic Bone Disease and Benign Bone Disease on Spine SPECT in Patients with Low Back Pain (요통 환자의 척추골 SPECT에서 골전이 병변과 양성골질환의 섭취 양상 분석을 통한 감별진단이 가능한가)

  • Lee, Seung-Hun;Choi, Yun-Young;Cho, Suk-Shin
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.371-377
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    • 2001
  • Purpose: One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients. as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. Materials and Methods: We reviewed spine SPECT studios obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2. Posterior element: posterior to body (pedicle), posterior to Intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Results: Sixty-nine bone lesions were detected on SFECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis; linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Conclusion: Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients.

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Surgical Treatment of Metastatic Bone Tumor in Extremity (사지에서 전이성 골종양의 수술적 치료)

  • Lee, Han-Koo;Lee, Sang-Hoon;Baek, Goo-Hyun;Lee, Chang-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.45-51
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    • 1995
  • The incidence of metastatic bony lesion has been increased recently, with the advanced therapeutic modalities of malignant tumors. The purpose of this study was to evaluate the effectiveness of surgical treatment in impending or established pathologic fractures due to metastasis in extremity. From 1981 to 1992, thirty two patients who had established or impending pathologic fractures in extremity had been treated surgically. The locations of metastasis, were lower extremity in 24 cases(femsral head and neck;5, intertrochanteric;7, subtrochanteric;8, femoral shaft;4) and upper extremity in 8 cases(proximal humerus;2, humoral shaft;6). The method of surgery was excision of tumor mass and rigid internal fixation to allow immediate mobilization, except 2 cases of amputation. The results were analysed by two criteria. The first was the grade of performance status that was made by modification of Functional Classification of New York Heart Association. The second was the degree of pain relief. The performance status was improved at least one grade in all patients and the mean improvement was 1.7 grades. The satisfactory pain relief was achieved in 81% of patients. Postoperatively, most of the patients had only slight to moderate limitation of physical activities and they became comfortable at rest and ordinary activities. The solitary metastatic lesions showed better pain relief(92%) than multiple metastasis(75%). The curative surgery was done in 3 cases, and they showed more than 24 months of disease-free survival.

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Malignant Tumor of the Hand (수부에 발생한 악성 종양)

  • Park, Hong-Jun;Shin, Kyoo-Ho;Bae, Im-Don;Hahn, Soo-Bong;Kang, Eung-Shick
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.4
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    • pp.201-207
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    • 1999
  • Malignant tumors of the hand are very rare. Between 1989 and 1998, 17 patients with malignant tumors of the hand were evaluated for clinical features, prevalence, treatment and results. The mean age was 45 years and median duration of follow-up was 38 months. A painless mass was the most common symptom and the most common lesion was the digit. Fifteen cases of soft tissue and 2 cases of bone tumor were diagnosed. On pathology, soft tissue tumors were comprised of 8 cases of malignant melanoma, 2 cases of angiosarcoma and 1 case each of malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, extraskeletal chondrosarcoma, and squamous cell carcinoma. Bone tumors were metastatic tumors and each originated from the rectal cancer or lung cancer. Lymph node involvements were noted in 4 cases of malignant melanoma and 1 case of squamous cell carcinoma. Six cases of metacarpo-phalangeal joint disarticulation and 4 cases of phalanx amputation were performed. Wide excision, ray amputation and below-elbow amputation were also performed. Three cases expired due to metastasis and progression of the original lesion. Among the surviving 14 cases, a malignant melanoma had metastasis on the axillary lymph node and 13 cases showed no local recurrence or metastasis during the follow-up.

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A Case Report of Harpagophyti Radix Pharmacopuncture for the Patient with Breast Cancer Transpered to Spine (유방암의 척추전이 환자에 대한 천수근 약침을 병행한 한의학적 치료 증례 1례)

  • Bae, Young-Hyeon;Lee, Chong-Hwan;Kim, Hae-Sol;Kim, Ho-Sun;Suh, Chang-Yong;Kim, No-Hyeon;Song, Ju-Hyun;Yeom, Seung-Chul
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.1
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    • pp.117-127
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    • 2015
  • Objectives : Most of pains are important symptoms caused by cancer transpered to spine. Harpagophyti Radix Pharmacopuncture is highly effective in reducing fever, pain, inflammation but was never used to reduce pain from cancer transpered to spine. So I intended to use Harpagophyti Radix Pharmacopuncture to control pain. The purpose of this study is to evaluate the clinical application of Harpagophyti Radix Pharmacopuncture for Bone Metastasis of Breast Cancer and Spinal Stenosis. Methods : We examined patient with Bone Metastasis of Breast Cancer and Spinal Stenosis who admitted Jaseng Korean Medicine Hospital. The patient was treated by Korean Medicine treatment and Harpagophyti Radix Pharmacopuncture. This case was assessed by Numerical Rating Scale(NRS), Oswestry Low Back Pain Disability Index(ODI), Short-Form 36 Health Survey(SF-36), ROM(Range of Movement) and Special Test. Results : In this study, the patient's pain was controlled and NRS, ODI were decreased. I could identify the improvement in life quality from the positive change of SF-36 and also found out that treatment was successful from the improvement of ROM, Special test. Conclusions : Harpagophyti Radix Pharmacopuncture with Korean Medicine treatment for Bone Metastasis of Breast Cancer and Spinal Stenosis was proved to be useful to the pain relief and function recovery, but further research should take place for clear understanding of the exact amount of dosage and safety. Moreover it must be accompanied by long term follow up research.