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Sample records for 99mtc-mdp bone scintigraphy

  1. Bone scintigraphy for horses

    Scintigraphy (bone scan) is being used approximately since 1980 in the horse under general anaesthesia. With the construction of custom-made overhead gantries for gamma-cameras scintigraphy found widespread entry in big equine referral hospitals for bone-scanning of the standing horse. Indications for the use of a bone scan in the horse are inflammatory alterations in the locomotor apparatus. It is primarily used for diagnosis of lameness of unknown origin, suspect of stress fracture or hairline fracture and for horses with bad riding comfort with suspected painful lesions in the spine. (orig.)

  2. Bone scintigraphy of decompression sickness

    Value of bone scintigraphy in decompression sickness of 42 patients was retrospectively evaluated. Bone scintigraphy was positive in 30 of 42 patients (83 lesions), while radiography and symptoms were positive in 23 patients (48 lesions), and in 29 patients (44 lesions) respectively. Bone scintigraphy was positive in many lesions with negative radiography or symptoms. However, approximately half of the lesions in which either radiography or symptoms was positive could not be detected by bone scintigraphy. These cases mostly showed radiographic abnormalities such as irregular calcified areas and ''bone island'' in the cervical regions of the humerus, femur and tibia. Both bone scintigraphy and radiography were positive in most of the patients with symptoms of the bends and there seems to be a close relationship between the bends symptoms and bone lesion. We concluded that bone scintigraphy is useful for the evaluation of decompression sickness, but it must be complemented by bone radiography to avoid a significant number of false negative cases. (author)

  3. Bone scintigraphy in psoriasis

    Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.

    1980-08-01

    Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones.

  4. Bone scintigraphy in psoriasis

    Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones. (orig.)

  5. Bone scintigraphy in children: trauma

    The sensitivity of radionuclide imaging in identifying skeletal trauma in children has been established. Growth plates present a set of problems unique to pediatric studies and diagnotic accuracy is very technique dependent. Imaging for sports injuries and suspected child abuse has been productive. An expanding role for bone scintigraphy in the management of orthopedic problems post-trauma is developing

  6. Bone scintigraphy in drug addiction

    Lopez-Majano, V.; Miskew, D.; Sansi, P.

    1981-01-01

    In 22 drug addicts, the clinical diagnosis of osteomyelitis and/or septic arthritis was suspected because of symptoms of sepsis and pain in various locations. All patients underwent bone scintigraphy with 17-20 mCi of /sup 99/sup(m)Tc labeling either pyrophosphate or methylene diphosphonate. Whole body and spot scans located the area of disease in most patients. This permitted biopsy of the affected area when the pathogen recurs. One of the two patients whose scintigrams were normal was on adequate treatment before the bone scintigram and the other was on oxacillin. Radiographs of the affected areas were normal, which indicates bone scintigraphy should be preferred to radiography in the early diagnosis of osseous infections.

  7. Bone scintigraphy in drug addiction

    In 22 drug addicts, the clinical diagnosis of osteomyelitis and/or septic arthritis was suspected because of symptoms of sepsis and pain in various locations. All patients underwent bone scintigraphy with 17-20 mCi of 99sup(m)Tc labeling either pyrophosphate or methylene diphosphonate. Whole body and spot scans located the area of disease in most patients. This permitted biopsy of the affected area when the pathogen recurs. One of the two patients whose scintigrams were normal was on adequate treatment before the bone scintigram and the other was on oxacillin. Radiographs of the affected areas were normal, which indicates bone scintigraphy should be preferred to radiography in the early diagnosis of osseous infections. (orig.)

  8. Pathogenetic differentiation of the bone superscan using bone marrow scintigraphy

    The case of a 54-year old patient suffering from a prostatic carcinoma is presented. At the time of diagnosis multiple bone metastases were detected by bone scintigraphy. An initial improvement was observed following antiandrogenic therapy. After three years the patient presented with increasing bone pain, which was most prominent in the knee joints. A 'superscan' was found in bone scintigraphy with an unusually high uptake in the peripheral skeleton. Bone marrow scintigraphy showed a nearly complete metastatic displacement of central bone marrow and a peripheral marrow extension as explanation for the bone scan findings. (orig.)

  9. Bone scintigraphy in traumas and stress injuries

    Bone scintigraphy is an easy and cheap diagnostic method for examination of stress injuries of lower extremities. A more specific diagnosis often has to be supplemented by MR scanning or X-radiography. (EG)

  10. Neonatal osteomyelitis examined by bone scintigraphy

    Thirty-three infants less than six weeks of age and suspected of having osteomyelitis were examined by bone scintigraphy. Each of the 25 sites of proved osteomyelitis in 15 individuals demonstrated abnormal radionuclide localization. Ten additional scintigraphically positive but radiographically normal sites were detected. Optimal quality scintigrams of the growth plate complex and osteomyelitis in neonates appeared similar to those in older children. All neonates suspected of having osteomyelitis should be studied with bone scintigraphy following initial radiographs

  11. Radionuclide bone scintigraphy in pediatric orthopedics

    Radionuclide bone scintigraphy is highly sensitive and specific for diagnosing the musculoskeletal disorders of childhood. Conditions such as neonatal osteomyelitis, septic arthritis, diskitis of childhood, Legg-Calve-Perthes disease, the osteochondroses, the toddler's fracture, sports injuries, spondylolysis, myositis ossificians, and reflex sympathetic dystrophy are readily defined. High-quality state-of-the-art scintigraphy is essential in infants and young children. 64 references

  12. Radionuclide bone scintigraphy in pediatric orthopedics

    Conway, J.J.

    1986-12-01

    Radionuclide bone scintigraphy is highly sensitive and specific for diagnosing the musculoskeletal disorders of childhood. Conditions such as neonatal osteomyelitis, septic arthritis, diskitis of childhood, Legg-Calve-Perthes disease, the osteochondroses, the toddler's fracture, sports injuries, spondylolysis, myositis ossificians, and reflex sympathetic dystrophy are readily defined. High-quality state-of-the-art scintigraphy is essential in infants and young children. 64 references.

  13. Findings of Bone Scintigraphy After Leech Theraphy

    Özyurt, Sinem; Koca, Gökhan; Demirel, Koray; Baskın, Aylin; Korkmaz, Meliha

    2014-01-01

    In this case report, we present a 70 year old female patient who had recieved Leech therapy (hirudotherapy) on her leg without informing referring physician. In dynamic bone scintigraphy there was increased perfusion and hyperemia in her left ankle and leg, also in late static images moderate increased uptake was seen in soft tissue region and at the fracture site of ankle. We learned that she had Leech therapy applied on her leg, which could explain the increased perfusion and hyperemia in dynamic and blood pool phases of bone scintigraphy because of Leech therapy’s dilatory effects on superficial veins. Leech therapy may lead to an increase in perfusion and hyperemia in blood pool phase of bone scintigraphy, which may cause confusion in differential diagnosis. To our best knowledge this report is the first case that shows the scintigraphic findigs after Leech therapy. Conflict of interest:None declared. PMID:24653932

  14. Bone lesions in early syphilis detected by bone scintigraphy.

    Hansen, K.; Hvid-Jacobsen, K; Lindewald, H; Sørensen, P S; Weismann, K

    1984-01-01

    We report a case of early syphilis with multiple bone lesions which all resolved after treatment with penicillin. We discuss why bone lesions may be more prevalent than generally believed and why 99m-Tc-MDP-bone scintigraphy is more sensitive than radiography in detecting syphilitic periostitis.

  15. Value of bone scintigraphy in psoriasis

    Nakayama, Chikashi; Nakata, Hajime; Kimoto, Tatsuya; Nakayama, Takashi; Yokomizo, Yu (University of Occupational and Environmental Health, Kitakyushu, Fukuoka (Japan). School of Medicine)

    1982-10-01

    We performed bone scintigraphy on 16 cases of psoriasis to evaluate its possible value in this disease and obtained the following results: 1) Bone scintigraph was abnormal in 15 of 16 cases and the frequent association of arthritis in psoriasis was confirmed. 2) Abnormal uptake on bone scintigraph was noted in various joints including peripheral joints of extremities, sternoclavicular joint, shoulder and rib. Abnormality of sacroiliac joint or ankle was less frequent than previously reported. 3) Findings of bone scintigraph were not necessarily related with clinical symptoms or laboratory data. Abnormal uptake was also noted in many joints whose X-ray examinations were negative. Bone scintigraphy thus seems to be useful in early detection of arthritis and to become an initial therapeutic indicator of arthritis in psoriasis.

  16. Value of bone scintigraphy in psoriasis

    We performed bone scintigraphy on 16 cases of psoriasis to evaluate its possible value in this disease and obtained the following results: 1) Bone scintigraph was abnormal in 15 of 16 cases and the frequent association of arthritis in psoriasis was confirmed. 2) Abnormal uptake on bone scintigraph was noted in various joints including peripheral joints of extremities, sternoclavicular joint, shoulder and rib. Abnormality of sacroiliac joint or ankle was less frequent than previously reported. 3) Findings of bone scintigraph were not necessarily related with clinical symptoms or laboratory data. Abnormal uptake was also noted in many joints whose X-ray examinations were negative. Bone scintigraphy thus seems to be useful in early detection of arthritis and to become an initial therapeutic indicator of arthritis in psoriasis. (author)

  17. Functional bone marrow scintigraphy in psoriatics

    24 psoriatics as well as 24 normal healthy adults were studied by functional bone marrow scintigraphy using Tc-99m-labeled human serum albumin millimicrospheres (Tc-99m-HSA-MM). Functional bone marrow scintigraphy is an in vivo test system for the assessment of various functional properties of fixed macrophages. 58% of psoriatics who had no systemic drug treatment demonstrated peripheral extension of the bone marrow space indicating hyperplasia of bone marrow macrophages. This phenomenon could be observed only in one normal subject who was a high-performance sportsman. 83% (n=6) of psoriatics with cirrhosis of liver demonstrated bone marrow extension. The 'capacity' of bone marrow macrophages to engulf Tc-99m-HSA-MM ('uptake ratio') was diminished in 42% of non-treated as well as 66% of psoriatics treated with aromatic retinoid. The phagocytic and proteolytic turnover of Tc-99m-HSA-MM in bone marrow, spleen, and liver was found to be accelerated in 66% of non-treated psoriatics, normal, accelerated or delayed in psoriatics treated with aromatic retinoid as well as considerably delayed in all of the psoriatics with cirrhosis of liver. Functional bone marrow scintigraphy proved to be an appropriate in vivo test system to reveal abnormalities of fixed macrophages in psoriatics. Furthermore, theratpeutic effects as well as influences of pre-existing disorders on different macrophage populations can be assessed. (Author)

  18. Cartilage Calcification Mimics Polychondritis in Bone Scintigraphy

    Hasan Atilgan

    2013-04-01

    Full Text Available 58 year-old male patient with sternal pain was referred to our Nuclear Medicine Clinic for bone scintigraphy for 2.5 months. Markedly increased activity accumulation in the first bilateral sternocostal junction and increased activity accumulations in 3rd, 4th, 5th sternocostal junctions and lateral portion of inferior part of corpus sterni were seen in late static images without increased perfusion and hyperemia. Soft tissue density and lytic lesions were seen bilaterally in bilateral first costa, sternocostal joints and in right side of xiphoid in his 3D computed tomography (CT. Sternocostal lesions that were seen in bone scintigraphy and CT, was reported as normal in biopsy.

  19. Findings of Bone Scintigraphy After Leech Theraphy

    Sinem Özyurt; Gökhan Koca; Koray Demirel

    2014-01-01

    In this case report, we present a 70 year old female patient who had recieved Leech therapy (hirudotherapy) on her leg without informing referring physician. In dynamic bone scintigraphy there was increased perfusion and hyperemia in her left ankle and leg, also in late static images moderate increased uptake was seen in soft tissue region and at the fracture site of ankle. We learned that she had Leech therapy applied on her leg, which could explain the increased perfusion and hyperemia in d...

  20. Bone scintigraphy in fluoride treated osteoporosis

    Quantitative bone scintigraphy was performed on 23 white females with post-menopausal osteoporosis and vertebral compression fractures. These patients were then entered into a randomized, double-blind clinical trial or sodium fluoride therapy (NaF=14, placebo=9) which included repeat bone scintigraphy every six months. Scintigraphic images were acquired for 500K counts per image over the total body with computer acquisition over the posterior thoracic and lumbar spine. Images were obtained on a wide field-of-view gamma camera two hours after injecting 15 mCi of Tc-99m MDP. Data analysis showed a significant reduction in the activity ratio of abnormal vertebral body to normal vertebral body in those patients treated with sodium fluoride (paired t-test p=0.0095). No significant change was observed in the control group of (p=0.142). These results suggest that sodium fluoride therapy promotes more rapid healing of osteoporotic vertebral fractures. They also demonstrate the utility of serial quantitative bone scintigraphy in assessing osteoporotic patients with vertebral compression fractures

  1. Studies on bone scintigraphy in renal osteodystrophy

    Bone scintigraphy was superior over roentgenography for detection of abnormal bone findings in chronic dialysis patients. According to the type of scintigraphic findings, an increase in the hot area in the cranium or the mandibule seemed to express fibrous osteitis due to secondary hyperparathyroidism. Multiple coin-shaped hot areas in ribs were thought to indicate advanced osteomalacia or osteomalacia in patients with aluminum poisoning. The 4 hr-B/St ratio of the cranium was thought to serve as a quantitative indicator of the status of fibrous osteitis due to secondary hyperparathyroidism to show the progress and therapeutic course of the disease. (Chiba, N.)

  2. A case of primary myelofibrosis showing an interesting image on bone and bone marrow scintigraphy

    On a 73-year-old woman with primary myelofibrosis, bone and bone marrow scintigraphy were performed. Bone scintigram showed the diffusely increased skeletal uptake, especially in peripheral bones, and the relatively diminished renal uptake. On the other hand, bone marrow scintigraphy showed the remarkable peripheral expansion. Thus, to evaluate the pathophysiology and the lesion of bone and bone marrow in primary myelofibrosis, both scintigraphies seem to be useful and essential. (author)

  3. Detectability of metastatic bone tumor by Ga-67 scintigraphy

    Koizumi, Kiyoshi; Uchiyama, Guio; Araki, Tsutomu; Hihara, Toshihiko; Ogata, Hitoshi; Monzawa, Shuichi; Kachi, Kenji; Matsusako, Masaki

    1989-03-01

    Ga-67 scintigrams in patients with malignant diseases sometimes reveal uptake of the tracer in the bone metastases. Detectability of Ga-67 scintigraphy for metastatic bone tumors and benign bone lesions was compared with that of Tc-99m bone scintigraphy. Countable bone metastases detected by bone scintigraphy were evaluated whether the lesion showed apparent, faint, or negative Ga-67 uptake. Of 47 lesions 23 (49%) showed apparent uptake and 17 (36%) showed negative uptake, only 7 (10%) mostly fracture/osteotomy, showed apparent uptake of the tracer. Uptake in the other benign lesions such as trauma of the ribs, spondylosis deformans, and arthrosis deformans was rather faint. In patients with multiple bone metastases, 9 patients (82%) out of 11 showed more prominent abnormal findings in Tc-99m MDP bone scintigraphy than in Ga-67 scintigraphy; that is, Ga-67 scintigraphy was not able to reveal all metastatic bone lesions. In patients with untreated or recurrent tumors, relation between Ga-67 uptake in the tumors and that in the bone metastases was evaluated. Of 7 patients with negative Ga-67 uptake in the bone metastases; that is, there seemed to be little relation between Ga-67 affinity to the primary tumors and that to the bone metastases. Mechanisms of the Ga-67 uptake in the bone metastases were discussed. Not only the tumor cells or tissues in the bone metastases but also bone mineral or osteoclasts might be the deposition sites of Ga-67.

  4. Dynamic scintigraphy of bone and bone marrow in multiple myeloma patients with bone-marrow transplants

    Purpose: To determine whether dynamic registration at bone and bone-marrow scintigraphy produces additional information compared to subsequent static registrations of bone-marrow transplants in multiple myeloma patients. Material and Methods: In a prospective study, 8 dynamic bone and 6 dynamic bone-marrow scintigraphies were performed in 10 patients. The dynamic scintigraphies were compared with conventional radiography, MR images, and static scintigraphies of bone and bone marrow. Results: No additional information was revealed by the dynamic registration method; on the contrary, 4 of the 8 known lesions were not discerned at dynamic registration. An incidental observation was that the time-activity curves of both radiopharmaceuticals had a specific pattern. (orig.)

  5. Bone marrow scintigraphy with antigranulocyte antibody in multiple myeloma: comparison with simple radiography and bone scintigraphy

    Simple X-ray study and bone scan have limitations for early diagnosis of bone or bone marrow lesions in multiple myeloma. The purpose of this study was to evaluate the diagnostic usefulness of bone marrow immunoscintigraphy using anti-granulocyte monoclonal antibody for the evaluation of bone involvement in multiple myeloma. In 22 patients (Male: 15, Female: 7) with multiple myeloma, we performed whole-body immunoscintigraphy using 99mTc-labelled antigranulocyte antibody (BW 250/183, Scintimum Granulozyt R CIS, France) and compared the findings with those of simple bone radiography and 99mTc-MDP bone scan. Abnormal findings in bone marrow scintigraphy were considered to be present in case of expansion of peripheral bone marrow or focal photon defect in axial bones. Marrow expansion was noted in 15 of 22 patients (68%). Focal photon defects were found in 18 patients (82%). While one (33%) of 3 patients with Stage II disease showed focal defects in bone marrow scan, abnormal focal defects were observed in 17 of 19 (90%) patients with Stage III. Among 124 focal abnormal sites which were observed in bone marrow scan, bone scan or simple bone radiography, bone marrow scan detected 92 sites (74%), whereas 82 sites (66%) were observed in simple bone radiogrpahy (58 sites, 47%) or bone scan (40 sites, 32%). Fifty-one(41%) out of 124 bone lesions were detected by bone marrow scan only, and located mostly in thoracolumbar spine. Bone marrow scan using 99mTc-labelled antigranulocyte antibody seems to be a more sensitive procedure for the detection of pathologic bone lesions than simple bone X-ray or bone scan in patients with multiple myeloma

  6. Development of combining bone scintigraphy and tumor markers in the diagnosis of bone metastases

    Bone is one of the most common metastatic sites for advanced cancers. The skeletal-related events caused by bone metastases could have a significant influence on patient's clinical outcome and quality of life. Currently, bone scintigraphy is the first choice for detecting bone metastases. Although the sensitivity is high, the specificity of bone scintigraphy is still very low. It has been reported that by combining bone scintigraphy and tumor markers, the specificity can be significantly increased. Meantime, the sensitivity and accuracy of bone scintigraphy in diagnosis of bone metastases can be improved. We reviewed the literatures in the recent years to evaluate the potential value of combination with bone scintigraphy and tumor markers in the diagnoses of bone metastases. (authors)

  7. Bone scintigraphy during therapy with cytostatically acting drugs

    Case reports show up, that bone scintigraphy during therapy of metastasing cancer of mamma or prostata with cytostatically acting drugs may reveal 'pseudonormal' results. False negative diagnosis can be excluded only by carefully regarding drug history. Gamma-camera with wholebody scan device for scintigraphy in two projections simplifies safe evaluation significantly. (orig.)

  8. Periostitis in secondary syphilis: a place for bone scintigraphy.

    Veerapen, K; Bruckner, F E; Halsey, J P; Davidson, F; Saeed, A

    1985-01-01

    Two cases of secondary syphilis are reported with periostitis as the main presenting feature. Technetium-99m bone scintigraphy was found to be superior to radiography in both defining the extent of involvement and in picking up early lesions.

  9. Radiography and bone scintigraphy in bone marrow transplant multiple myeloma patients

    Purpose: To compare conventional radiography and bone scintigraphy in relation to clinical outcome in bone marrow transplant multiple myeloma patients. Material and Methods: A total of 70 radiographies and 70 bone scintigraphies were compared in 35 patients. Results: The skull, the extremities, the iliac and public bones were better assessed with radiography. For new vertebral lesions and for lesions in the ribs and sternum, bone scintigraphy proved superior. For the sacrum, the methods were equal. When bone scintigraphy was used as a complement to radiography, 4% more pathological sites were found. No patient had both a normal radiography and a pathological bone scintigraphy, but 5 patients had both a normal bone scintigraphy and a pathological radiography. The results of the radiological examinations did not always correlate with the clinician's grading of the patient's disease. The radiological examinations had no prognostic value for the 7 patients examined on several occasions. Conclusion: The ability of conventional radiography and bone scintigraphy to disclose myeloma lesions varies, depending on location and size of the lesions. Radiography should remain the primary examination modality also for bone marrow transplant multiple myeloma patients. Bone scintigraphy can severe as a complement for investigating unexplained pain, e.g. caused by lesions in vertebrae or ribs. (orig.)

  10. Bone marrow scintigraphy in hemopoietic depletion states

    Bone marrow scintigraphy was performed in 29 patients with hemopoietic depletion states of various etiology. Two tracers were used for visualization, viz., sup(99m)Tc-sulfur-colloid and 111InCl3;some patients were examined using both indicators. 111InCl3 is bound to transferrin and is adsorbed on the surface of reticulocytes and erythroblasts. A scintillation camera PHO GAMMA SEARLE IV fitted with a moving table and computer CLINCOM were used to obtain whole-body images. The comparison of all scans and marrow puncture smears was done. In patients with aplastic anemia with both hyperplastic or hypoplastic marrow good correlation of bone marrow scans and sternal puncture smears was found. In several cases the scintigraphic examination helped to establish the diagnosis of marrow depletion. A peculiar disadvantage of the imaging method with either sup(99m)Tc-sulfur-colloid or 111InCl3 is that it shows the disorders in erythropoietic and reticuloendothelial cells whereas the defects in myelopoietic cell series and platelet precursors are not provable. According to literature data, great attention is paid to the prognostic value of scintigraphic examination in aplastic anemia. (author)

  11. Bone scintigraphy in non-neoplastic diseases in children

    Since the introduction of 99mTc labeled polyphosphates bone scintigraphy has become a widely accepted method for the evaluation of non-neoplastic bone diseases in children. High quality images require the child's immobilisation and a correct positioning as well as an optimized technical equipment. Two or three phase scintigraphy is the routinely procedure but additional techniques like pinhole images or SPECT can be very helpful for special indications and localizations. Due to the age and sex dependent differences of bone metabolism in the developing skeleton the interpretation of the bone scan in children is more difficult than in adults and requires more experience. Infections, trauma and aseptic necrosis are the most important non-neoplastic diseases requiring bone scintigraphy. Bone scan has a high sensitivity in the early detection of pathological bone metabolism indicating bone disease; other investigations, which are describing morphological changes like X-ray are less sensitive especially at the beginning of the disease. Negative bone scan rools out significant bone disorders with a high certainty. Follow-up studies can give additional information about the response to therapeutical regimes and about the prognosis. To improve the specificity of a bone scan a combined interpretation of scintigraphy and X-ray is recommended

  12. Bone scintigraphy for metastasis detection in canine osteosarcoma

    The purpose of this study was to assess the usefulness of serial bone scintigraphy in the detection of skeletal and extraskeletal metastases in dogs with appendicular osteosarcoma. Twenty-six dogs with primary, appendicular osteosarcoma were entered into a limb-sparing protocol. Bone scintigraphy was performed upon presentation, after neoadjuvant therapy but prior to surgery and at selective intervals after limb-sparing surgery to evaluate for the presence of metastasis. Thoracic radiographs, and radiographs of other sites, were also made at the time of each bone scan. All dogs had a complete necropsy. No dog had bone or lung metastases detected prior to treatment. The bone scans, medical records, and radiographs of each dog were reviewed retrospectively. All but one dog developed metastatic disease. Bone metastatic sites were confirmed at necropsy in 12 of the 26 dogs. Seven of these 12 dogs had bone metastatic sites which were not producing clinical signs, i.e. an occult metastasis. In five of the seven dogs, the occult site was the first metastatic site detected. Extraskeletal metastases were identified scintigraphically in six of the 26 dogs, but these were clinically apparent prior to bone scintigraphy in each dog. Suspected malignant scintigraphic lesions were proven benign in six dogs. In five dogs with malignant bone lesions at necropsy the last bone scan prior to euthanasia was normal. The time interval between scintigraphy and necropsy was variable in these five dogs. All dogs without bone metastases at necropsy had normal bone scans. This study validates the usefulness of bone scintigraphy for detection of occult bone metastasis and improved ability for tumor staging in dogs with appendicular osteosarcoma

  13. Investigations by bone scintigraphy of patients treated with retinoids

    The possible early side effects of the retinoid therapy on scleletal system was studied by bone scintigraphy carried out by 99mTc labelled phosphone in a dose of 550 MBq administered iv. 18 acne patients received isotretinoin (for 4 months, 1 mg/kg), 15 psoriatic patients received etretinate (for 4 months, 0,7-1,0 mg/kg). Increased activity was observed in 3 members of the isotretinoin group while no alterations due to etretinate treatment were found. Epiphysis fugue activity was found to be decreased during isotretinoin therapy. The authors consider bone scintigraphy suitable for the early detection of retinoid therapy-related bone alterations. (author) 12 refs

  14. Bone scintigraphy for horses; Die Skelettszintigrafie beim Pferd

    Jahn, Werner [Pferdeklinik Bargteheide (Germany)

    2010-03-15

    Scintigraphy (bone scan) is being used approximately since 1980 in the horse under general anaesthesia. With the construction of custom-made overhead gantries for gamma-cameras scintigraphy found widespread entry in big equine referral hospitals for bone-scanning of the standing horse. Indications for the use of a bone scan in the horse are inflammatory alterations in the locomotor apparatus. It is primarily used for diagnosis of lameness of unknown origin, suspect of stress fracture or hairline fracture and for horses with bad riding comfort with suspected painful lesions in the spine. (orig.)

  15. A case of synovial sarcoma with bone metastasis identified by bone marrow scintigraphy

    Otsuka, N.; Morita, R.; Yamamoto, T.; Muranaka, A.; Tomomitsu, T.; Yanagimoto, S.; Sone, T.; Fukunaga, M.

    1985-04-01

    In a patient with synovial sarcoma, routine bone survey showed no abnormality, while bone marrow scintigraphy with Tc-99m sulfur colloid revealed a defect in the fifth lumbar vertebra. At surgery, tumorous invasion was noted in the fifth lumbar vertebra and the surrounding tissues. It was suggested that the bone marrow scintigraphy was particularly useful in the detection of tumorous invasion into the bone marrow at the early stage before the destruction of skeletal tissue.

  16. A case of synovial sarcoma with bone metastasis identified by bone marrow scintigraphy

    In a patient with synovial sarcoma, routine bone survey showed no abnormality, while bone marrow scintigraphy with Tc-99m sulfur colloid revealed a defect in the fifth lumbar vertebra. At surgery, tumorous invasion was noted in the fifth lumbar vertebra and the surrounding tissues. It was suggested that the bone marrow scintigraphy was particularly useful in the detection of tumorous invasion into the bone marrow at the early stage before the destruction of skeletal tissue

  17. The usefulness of bone and bone-marrow scintigraphy in the detection of bone lesion in patients with multiple myeloma

    We used a combination of bone and bone-marrow scintigraphy to study 15 patients with multiple myeloma (7 in untreated group and 8 in chemotherapy group). Of the 3 cases in untreated group whose 99mTc-methylene diphosphonate (MDP) bone scans showed no abnormality, one had abnormal bone-marrow scintigraphy. In other 4 cases of untreated group whose 99mTc-MDP bone scan showed cold defects, 99mTc-sulfur colloid bone-marrow scintigraphy clearly delineated the areas of tumor-cell invasion. In all chemotherapy cases, multiple hot spots were observed on bone scintigram, but abnormalities were not recognized on bone-marrow scintigram in all of their lesions. In conclusion, the combination technique of bone and bone-marrow scintigraphy was a useful method in evaluating bone lesions in patients with multiple myeloma. (author)

  18. Opportunities of bone scintigraphy in patients with endoprotesis of knee joint

    The aim of this work evaluation of bone scintigraphy in patients with endoprotesis of knee joint. Bone scintigraphy was investigated 65 patients from 28 to 71 years. In this work was established that method of bone scintigraphy are sensible and specific investigation in the diagnosis inflammation diseases in patients before and after endoprotesis operation. Bone scintigraphy are useful method for evaluation dynamic of diseases in area of knee joint

  19. Scintigraphy of bone marrow for neoplastic lesions in breast carcinoma

    Bone marrow scintigraphy was performed in 259 patients including 124 females with breast carcinoma using the technique of 99mTc-labelled colloid retention by phagocytizing cells, thus visualizing the reticuloendothelial component of the bone marrow. The objective was to early diagnose hematogenic metastases. In five patients, simultaneous skeleton scintiscanning was not performed. The technique was shown to play a role in early diagnosis of bone metastases and of bone lesions in less usual loci and especially in the differential diagnosis of nonmalignant bone disease, such as arthrosis. Its constraints include an intensive cumulation of the radiopharmaceutical in the liver and the splenic reticuloendothelial systems, which precludes the assessment of the bone marrow in the adjacent areas; further a difficult interpretation of the results, high cost and long time of examination. It has no role in patients with disseminated forms of the disease with multiple bone metastases already shown by scintigraphy. Bone marrow scintigraphy alone is not a reliable method for early diagnosis of breast carcinoma (L.O.)

  20. The usefulness of bone scintigraphy and 67Ga scintigraphy in the evaluation of rib lesions in patients with multiple myeloma

    Rib lesions in 13 patients with multiple myeloma were evaluated by using 99mTc-phosphorous compounds bone scintigraphy and 67Ga scintigraphy. In 10 patients (22 sites), hot lesions were observed on bone scintigraphy. In 6 of 10 patients no abnormal accumulations were noted on 67Ga scintigraphy. Among these 6 patients, osteolytic change was recognized on skeletal roentgenograms in only one patient. In 7 patients, both radionuclides accumulated in the rib lesions. Osteolytic change was observed in 3 patients (one lesion was histologically confirmed) and osteoporotic change was noted in 2 patients on skeletal roentgenograms. The appearance of multiple hot spots was observed in one patients on sequential 67Ga scintigraphy. Thus, the combination technique of bone and 67Ga scintigraphy seems to be a useful method for evaluating rib lesions in patients with multiple myeloma. (author)

  1. Bone and 67Ga scintigraphy in the evaluation of rib lesions in patients with multiple myeloma

    Rib lesions in 14 patients with multiple myeloma were evaluated by 99mTc-phosphorous compound bone scintigraphy and 67Ga scintigraphy. In the present study, in order to accurately detect rib lesions in multiple myeloma. bone and 67Ga scintigraphy were performed in 14 patients with multiple myeloma. The patterns of radionuclide accumulation in rib lesions on bone scintigraphy were classified by their grade, type, and site, and the findings were compared with the results of 67Ga scintigraphy. Thus, in cases of multiple myeloma, it was important to consider carefully both the intensity and the design of bone scintigraphy in combination with follow-up study by 67Ga scintigraphy. As a result of such consideration, we found that bone and 67Ga scintigraphy were useful in distinguishing invasive lesions from benign degenerative changes in the rib cage in cases with suspected rib involvement of multiple myeloma. (author)

  2. Radionuclide bone scintigraphy in patients with histiocytosis X

    The term histiocytosis X (HX) refers to a spectrum of disorders varying from unifocal eosinophilic granuloma (UEG), multifocal eosinophilic granuloma (MEG), to the Abt-Letterer-Siwe syndrome. In a series of 16 patients with different types of HX and skeletal lesions, whole body bone scintigraphy was performed at the time of diagnosis and during follow up. Results were compared with radiographic findings. In patients with MEG with or without extra-skeletal dissemination bone scintigraphy revealed cold spots or hot spots, but half of the lesions were not visualised scintigraphically, resulting in false negative scans. In UEG the lesions were visualised as areas of increased uptake or as a cold spot with increased uptake at its borders. No false negative scans were encountered. The reliability of skeletal scintigraphy in patients with HX seems to depend on the type of the disorder: in UEG bone scintigraphy is a safe procedure. In MEG false negative bone scans have to be expected, and radiography is superior. (orig.)

  3. Super bone scans on bone scintigraphy in patients with metastatic bone tumor

    Eight patients with malignant tumor (3 with gastric cancer, 4 with prostatic cancer, 1 with transitional cell carcinoma), which showed diffusely increased uptake of 99mTc labelled phosphorous compound in axial skeleton (''Super Bone Scan'') on bone scintigraphy were clinically studied. No relationship with its histological type of the tumor was recognized. All cases revealed extremely high serum ALP concentration, which might reflect increased osteoblastic activity. Furthermore, on bone roentgenograms all cases showed predominantly osteosclerotic change in the metastatic bones, while some did locally osteolytic change. In three cases with gastric cancer, although they had diffuse skeletal metastases, two had no evidence of liver metastases. Thus, it seemed that clinical study of patients with ''Super Bone Scan'' was interesting to evaluate the mechanism of accumulation of 99mTc labelled phosphorous compound to bone and bone metabolism, and the pathophysiology in the pathway of bone metastases. (author)

  4. Symptomatic and asymptomatic accessory navicular bones: Findings of Tc-99m MDP bone scintigraphy

    Chiu, N.-T.; Jou, I.-M.; Lee, B.-F.; Yao, W.-J.; Tu, D.-G.; Wu, P.-S

    2000-05-01

    AIM: The accuracy of bone scintigraphy in diagnosing symptomatic accessory navicular bones has not been well studied. We conducted a retrospective study to explore the results and use of scintigraphy in symptomatic and asymptomatic accessory navicular bones. MATERIALS AND METHODS: Thirteen patients with a total of 13 symptomatic and 10 asymptomatic accessory navicular bones were included in the study. We used a scoring system to grade the scintigraphic abnormalities. The patients' symptoms and scintigraphic findings were recorded. RESULTS: Though focally increased radiopharmaceutical uptake was observed in all symptomatic accessory naviculars, half of the asymptomatic accessory navicular bones had the same manifestations. The scoring system was of no value in differentiating symptomatic from asymptomatic accessory navicular bones. CONCLUSION: Bone scintigraphy is a sensitive but not a specific tool for diagnosing a symptomatic accessory navicular. Chiu, N.-T. (2000)

  5. Symptomatic and asymptomatic accessory navicular bones: Findings of Tc-99m MDP bone scintigraphy

    AIM: The accuracy of bone scintigraphy in diagnosing symptomatic accessory navicular bones has not been well studied. We conducted a retrospective study to explore the results and use of scintigraphy in symptomatic and asymptomatic accessory navicular bones. MATERIALS AND METHODS: Thirteen patients with a total of 13 symptomatic and 10 asymptomatic accessory navicular bones were included in the study. We used a scoring system to grade the scintigraphic abnormalities. The patients' symptoms and scintigraphic findings were recorded. RESULTS: Though focally increased radiopharmaceutical uptake was observed in all symptomatic accessory naviculars, half of the asymptomatic accessory navicular bones had the same manifestations. The scoring system was of no value in differentiating symptomatic from asymptomatic accessory navicular bones. CONCLUSION: Bone scintigraphy is a sensitive but not a specific tool for diagnosing a symptomatic accessory navicular. Chiu, N.-T. (2000)

  6. Relation between serum PAP (prostate acid phosphatase) and bone scintigraphy in prostatic cancer

    Seventy-seven patients with prostatic cancer were treated at our department in the last 5 years. Of these patients 30 cases were followed by bone scintigraphy and serum PAP. In 27 follow-up scintigraphy procedures changes of bone scintigraphy corresponded to changes in serum PAP levels. Changes of PAP levels did not always correspond to changes of scintigraphy, but almost all cases in which the level of PAP increased in a short period showed progression of bone metastasis. A 3-month interval between bone scintigraphy procedure in stage D2 prostatic cancer patients is generally recommended. However, we think that in prostatic cancer patients follow-up bone scintigraphy at regular short intervals is unnecessary if there is no change in serum PAP levels, symptoms or physical condition. Bone scintigraphy should be performed when the tumor marker changes rapidly or when any physical symptom appears. (author)

  7. Comparison of bone scanning and bone-marrow scintigraphy in the detection and monitoring of bone metastases

    The purpose of this review is to define the role of bone scanning and bone-marrow scintigraphy in the detection and monitoring of skeletal metastasis. The bone scan has remained the screening method of choice for many years, because of its exquisite sensitivity for lesion detection and its ability to evaluate the whole skeleton in one setting. Bone-marrow scintigraphy with 99mTc-labelled antigranulocyte monoclonal antibodies allows high-quality, whole-body visualization of hematopoetically active bone marrow. The importance of imaging the bone marrow is founded in the fact that, in general, bone-marrow invasion precedes skeletal involvement in the development of skeletal metastasis. The advantages and disadvantages of the two methods are compared, and the possible indications for using bone-marrow scintigraphy complementary to or instead of the bone scan are discussed. (orig.)

  8. Bone scintigraphy in two cases of chronic brucellosis

    As shown in the case reports, bone scintigraphy plays an important part considering the diagnosis of chronic brucellosis, an infectious disease which occurs rarely in Germany. To establish the diagnosis knowledge of symptoms and signs of the disease is necessary. Chronic brucellosis may occur in each organ, ionvolving especially bones and joints. The disease may manifest as spondilytis (especially of the lumbar spine) or arthritis of large joints, sacroiliacal joints or costotransverse joints. Chronic brucellosis has to be considered if a bone scan reveals a typical pattern even without a typical history. (orig.)

  9. Comparison of bone and 67Ga scintigraphy in the initial diagnosis of bone involvement in children with malignant lymphoma

    The relative efficacy of bone and 67Ga scintigraphy for detecting the presence of bone involvement by malignant lymphomas is compared. 83 children were evaluated (mean age 12 years) with histologically proven HD and NHL utilizing bone and 67Ga scintigraphy which were performed prior to treatment. Three of these patients had biopsy proven primary malignant lymphoma of bone. Bone scintigraphy detected 18 bone lesions in 13 patients and 67Ga scintigraphy detected the same 18 bone lesions and in addition 101 extraosseous lesions. Radiography confirmed the presence of focal bone lesions. Both osteolytic and osteoblastic lesions were identified. It was concluded that bone scintigraphy is not necessary in the initial staging of children with malignant lymphoma unless there are specific osseous symptoms. (author)

  10. Bone marrow scintigraphy with 111In-chloride

    111In-chloride as a useful bone marrow-scanning agent has been used for various hematological diseases. We also have studied the distribution of indium-111 by scintigraphy in 28 patients with systemic hematopoietic disorders and other: 4 with aplastic anemia, 8 with leucemia, 3 with iron-deficiency anemia, one with pernicious anemia, 2 with myelofibrosis, 3 with multiple myeloma, one with malignant lymphoma, 3 with liver cirrhosis or Banti-syndrome and 3 with seminoma received post operative irradiation. The results of scintigraphy (the image of bone marrow, liver, spleen, kidney and intestine) were compared with bone marrow biopsies, ferrokinetic data and Se.I./TIBC. The bone marrow image was interpreted on a three-point scale: normal distribution of activity (+), abnormal distribution (+-), body back ground level (-). In the cases of iron-deficiency anemia and pernicious anemia with hyperplastic erythroid marrow, regardless of its severe anemia, the scintigrams showed clearly delineated bone marrow images and normal organ distribution of indium. On the other hand, the scan images revealed severe suppressions of bone marrow activity and markedly increased renal activity in some cases of aplastic anemia, acute leucemia and malignant lymphoma with hypoplastic and/or tumour-cell infiltrative marrows. Thus, it may be said that the bone marrow uptake of indium-111 correlates well with the degree of erythroid elements, no correlation with nucleated cell counts, and there is a strong tendency to increased renal activity in the cases of markedly decreased erythropoietic cell counts. (auth.)

  11. Quantitative bone scintigraphy. A study in patients with prostatic carcinoma

    Quantitative bone scintigraphy was performed in patients with prostatic carcinoma before orchiectomy as well as two weeks, two and six months after operation. The count rate was recorded as serial gamma camera images over the lower thoracic and all lumbar vertebrae from 1 to 240 min and at 24 h after injection of 99Tcm-MDP. In almost all abnormal vertebrae an increased count rate was observed within one hour after injection. Most of the vertebrae which were considered normal at 4 h after injection, but had an increased 24h/4h ratio developed into abnormal vertebrae later in the study. The patients with normal bone scintigrams showed no change in 99Tcm-MDP uptake during the study. The reproducibility of quantitative bone scintigraphy was found to be ± 7% (1 SD). In response to therapy, most of the patients with abnormal bone scintigrams showed an increase in count rate two weeks after operation followed by a decrease to the pre-operative level after two months and a further decrease after six months. This so called 'flare phenomenon' was found to indicate 99Tcm-MDP in the vascular phase as well as an active bone uptake. In some of the patients the whole-body retention of 99Tcm-MDP after 24 h and the bone mineral density in the vertebrae were determined and found to be valuable in the interpretation of skeletal metastases and the assessment of response to therapy. (71 refs.)

  12. Unusual bone scintigraphy in chronic myelogenous leukemia - report of a case showing extensive uptake defect

    An extensive 99mTc-methylene diphosphonate uptake defect was observed on bone scintigraphy in a 35-year-old male with chronic myelogenous leukemia. This type of bone scintigraphy pattern is quite unusual in leukemic patients and we speculate that acute disturbance of blood supply to the bone marrow was probably the cause. (orig.)

  13. Bone scintigraphy in the follow-up of thyroid carcinoma patients

    In patients with bone metastases of papillary or follicular thyroid carcinomas (n=23 and n=92, resp.) a retrospective study is conducted to find out whether the follow-up requires bone scintigraphy to detect bone metastases. Although there was no case of primary diagnosis of bone metastases established by bone scintigraphy, further bone focusses that had not been detected by I-131-whole body scintigraphy nor by whole body radiology were found in 24 patients by bone scintigraphy. Bone scintigraphy is of no use if applied as a routine to follow-up tumor patients with papillary of follicular thyroid carcinomas, but it is necessary if clinical findings, tumor markers, I-131 scans or X-rays suggest the occurence of metastases. (orig./TRV)

  14. Bone scintigraphy. A contribution to oncology

    The bone scintiscanning is evaluated including aspects as accuracy, precision and no invasiveness of the method in diagnosis. A review of radiotracers used in this technique is presented. The value of bone scintiscanning as a diagnostic technique and also as clinic follow up in neoplasms is discussed. (M.A.C.)

  15. Three-phase bone scintigraphy of hydroxyapatite ocular implants

    Hydroxyapatite ocular implants are replicas of lamellar bone tissue derived from the exoskeleton of a reef-building coral by a hydrothermal chemical exchange reaction. Attached to the eye muscles, they act as a passive framework for fibrovascular ingrowth and can be drilled to hold the visible part of the artificial eye and allow synchronous eye movement. Fibrovascular ingrowth has to be confirmed by bone scintigraphy before the drilling procedure. This study monitored the vascular ingrowth into the implant in ten patients over 12 months to establish a clinically feasible imaging protocol. Tracer accumulation was monitored visually and quantitatively in dynamic and single-photon emission tomography (SPET) scans after the intravenous administration of 600 MBq of 99mTc-DPD. The implants showed no tracer accumulation in the arterial or blood pool phase. Accordingly, dynamic scintigraphy can be omitted from the imaging protocol. Delayed tracer accumulation appeared no earlier than 2 and no later than 6 months after surgery. Planar scintigraphy is not recommended as high-resolution SPET is necessary to separate the implant from the surrounding bone. We conclude that imaging can be confined to high-resolution SPET 3 h after tracer injection, no earlier than 3 months after surgery. The vascularized hydroxyapatite orbital implant is an important in vivo model for bone-seeking agents to study their uptake kinetics independently of any soft tissue and bone disease. Our results provide evidence that in normal bones the chemical adsorption of 99mTc-DPD into the crystalline structure of hydroxyapatite is the only quantitatively relevant uptake mechanism. (orig.)

  16. Bone scintigraphy in costo-iliac impingement syndrome

    Madsen, Jan L

    2008-01-01

    Abstract: A syndrome of back pain caused by impingement of the lowest ribs against the iliac crest has been described in patients with osteoporotic vertebral fractures and loss of height of the patient. A case is presented of an 81-year-old woman with a long history of osteoporosis with compression...... fractures of several thoracic and lumbar vertebrae. She presented with progressive lower back pain and weight loss. Bone scintigraphy revealed increased uptake in the lower ribs on both sides compatible with the costo-iliac impingement syndrome. There were no signs of bone metastases....

  17. Quantitative bone gallium scintigraphy in osteomyelitis

    Gallium imaging offers many practical advantages over indium-111-labeled leukocyte imaging, and calculating quantitative ratios in addition to performing the routine bone-gallium images allows accurate and easy evaluation of patients with suspected osteomyelitis. To add objectivity and improve the accuracy and confidence in diagnosis of osteomyelitis, quantitative comparison of abnormalities seen on bone scans and gallium scans was performed. One hundred and ten adult patients with 126 sites of suspected osteomyelitis were evaluated and categorized by gallium-to-bone ratios, gallium-to-background ratios, and spatial incongruency of gallium and bone activity. Combined evaluation using these criteria gave a 70% sensitivity and 93% specificity for the diagnosis of osteomyelitis. (orig.)

  18. Nurse exposure doses resulted from bone scintigraphy patient

    Tunçman, Duygu; Kovan, Bilal; Poyraz, Leyla; ćapali, Veli; Demir, Bayram; Türkmen, Cüneyt

    2016-03-01

    Bone scintigraphy is used for displaying the radiologic undiagnosed bone lesions in nuclear medicine. It's general indications are researching bone metastases, detection of radiographically occult fractures, staging and follow-up in primary bone tumors, diagnosis of paget's disease, investigation of loosening and infection in orthopedic implants. It is applied with using 99mTc labeled radiopharmaceuticals (e.g 99m Tc MDP,99mTc HEDP and 99mTc HMDP). 20 -25 mCi IV radiotracer was injected into vein and radiotracer emits gamma radiation. Patient waits in isolated room for about 3 hours then a gamma camera scans radiation area and creates an image. When some patient's situation is not good, patients are hospitalized until the scanning because of patients' close contact care need. In this study, measurements were taken from ten patients using Geiger Muller counter. After these measurements, we calculated nurse's exposure radiations from patient's routine treatment, examination and emergency station.

  19. Bone scintigraphy in polyostotic fibrous dysplasia

    Wadhwa, S.S.; Mansberg, R.; Fernandes, V.B. [Illawarra Regional Hospital, Wollongong, NSW, (Australia)

    1998-03-01

    Fibrous dysplasia is a benign skeletal disorder of unknown aetiology. Fibrous dysplasia characteristically involves the fibrous replacement of portions of the medullary cavities of a single bone (monostotic) or multiple bones (polyostotic). Bones typically involved include the femurs, tibiae, ribs and maxillae. The polyostotic form may be accompanied by skin pigmentation and endocrine abnormalities (McCune Allbright Syndrome). Radiological findings in fibrous dysplasia are variable, ranging from completely radiolucent to radio-opaque lesions, depending on the amount of fibrous or osseous tissue deposited in the medulla. The most common radiographic finding is that of a ground glass-like semi-opaque lesion. Case reports on scintigraphic manifestation of fibrous dysplasia are scanty. We present radiological and scintigraphic findings of polyostotic fibrous dysplasia in a young male. (authors). 3 refs., 1 fig.

  20. Stress fracture development classified by bone scintigraphy

    There is no consensus on classifying stress fractures (SF) appearing on bone scans. The authors present a system of classification based on grading the severity and development of bone lesions by visual inspection, according to three main scintigraphic criteria: focality and size, intensity of uptake compare to adjacent bone, and local medular extension. Four grades of development (I-IV) were ranked, ranging from ill defined slightly increased cortical uptake to well defined regions with markedly increased uptake extending transversely bicortically. 310 male subjects aged 19-2, suffering several weeks from leg pains occurring during intensive physical training underwent bone scans of the pelvis and lower extremities using Tc-99-m-MDP. 76% of the scans were positive with 354 lesions, of which 88% were in th4e mild (I-II) grades and 12% in the moderate (III) and severe (IV) grades. Post-treatment scans were obtained in 65 cases having 78 lesions during 1- to 6-month intervals. Complete resolution was found after 1-2 months in 36% of the mild lesions but in only 12% of the moderate and severe ones, and after 3-6 months in 55% of the mild lesions and 15% of the severe ones. 75% of the moderate and severe lesions showed residual uptake in various stages throughout the follow-up period. Early recognition and treatment of mild SF lesions in this study prevented protracted disability and progression of the lesions and facilitated complete healing

  1. Three Phase Bone Scintigraphy in Active and Inactive Osteomyelitis

    To Appreciate the value of bone scintigraphy in determination of the bony infection, we performed three phase bone scintigraphy in 34 cases of osteomyelitis of extremities prospectively. They were clinically inactive in 11 and active in 23 cases. We confirmed the active osteomyelitis by operation or aspiration within one week after scintigraphy. Perfusion, blood pool and delayed images were analyzed respectively and compared with the plain roentgenograms. All 23 active lesions showed diffusely increased perfusion in affected limbs. The areas of the increased activities on blood pool images were larger than or similar to those on delayed images in 17 cases (73.9%) with active osteomyelitis and smaller in 6 cases (26.1%). 5 of the latter 6 cases showed definite soft tissue activities on blood pool images. In inactive cases bone scintigrams were completely normal in 4 cases. Two of those were normal on plain films and remaining two showed mild focal bony sclerosis. Among 7 inactive lesions, perfusion was normal in 2 cases, diffusely increased in 4 cases and diffusely decreased in 1 case. 6 of these 7 cases showed increased activities both on blood pool and delayed images and the areas of increased activities on blood pool images didn't exceed those on delayed images. Bony sclerosis was noted on plain films in those 7 inactive lesions and the extent of the sclerosis correlated well to delayed images. Large blood pool activity was characteristics of active osteomyelitis. Normal three phase bone scintigram may indicate the time to terminate the treatment, but increased activity on perfusion and blood pool scans is not absolute indication of active lesion if the extent of the lesion on the blood pool image is smaller than that on delayed image and if no definite soft tissue activity is noted on perfusion and blood pool images in clinically inactive patient.

  2. Soft tissue- and bone-phase scintigraphy for diagnosis of navicular disease in horses

    Radiography and soft tissue- and bone-phase scintigraphy were performed on 14 clinically normal horses and 35 horses in which definite, probable, or possible navicular disease had been diagnosed. The specificity of radiography and scintigraphy in revealing signs of navicular disease were nearly equal; however, the sensitivity of scintigraphy appeared to be greater than that of radiography. The greatest sensitivity and specificity were achieved when the results of radiography and scintigraphy were evaluated together. Differences in sensitivity were greatest when scintigraphy revealed lesions not detected by radiography. Although a diagnosis of navicular disease was sometimes made when only soft tissue-phase or only bone-phase scintigraphy revealed lesions, results obtained during the 2 phases generally were similar. It was concluded that scintigraphy can be a valuable aid in diagnosing navicular disease in horses, especially when radiographic findings do not support clinical findings

  3. Bone scintigraphy in the diagnosis of bone invasions of face and skull epitheliomas and ORL neoplasms

    Bone scintigraphy has been considerably improved by the use of technetium 99m-labelled organic phosphates: the physical characteristics are almost ideal for detection and the extemporaneous labelling of the product is convenient. This study on 75 patients has proved the value of bone scintigraphy in evaluating the bone invasion of tumoral lesions affecting the face and skull. An 88% agreement was found for scintigraphy, radiography giving 81%. The technique allows a fast assessment of whole-body bone invasion from one examination, with no extra injection of radioactive product, and it is therefore possible to orient the radiological enquiry without having to X-ray the whole skeleton, which reduces the amount of irradiation delivered to the organism. From these observations it may be concluded that scintigraphy is a simple, harmless method, with many advantages, but its limits must be known and it must always be interpreted as a function of other clinical and radiological data. It should be systematic in research on the local spreading of face and skull epitheliomas, in neoplasms of the ORL sphere and in the search for bone metastases

  4. Malignant external otitis: The diagnostic value of bone scintigraphy

    Technetium99m Methylene Diphosphate bone scintigraphy (BS) of the skull was performed in three patients with malignant external otitis (MEO). Pathological uptake of the radioisotope in the mastoid region was found during the early stages of MEO updating radiologic findings. The extent of the radioisotope accumulation during the early stages of MEO indicates that the actual tissue damage exceeds the clinical estimation. The follow-up BS findings correlate well with the clinical course of MEO indicating either healing or extension to the base of skull

  5. The clinical experience of radiocolloid bone marrow scintigraphy

    Results of the bone marrow (BM) scintigraphy in 129 patients with various malignant neoplasms and 10 practically healthy persons are discussed. Domestic preparations Technefit and Koren labelled with 99mTc and injected intravenously were used as radiopharmaceuticals. Apex-SP6 gamma camers (Eliscint company, Israel) was applied. The possibility of obtaining BM qualitative pattern permitting to perform the efficient diagnosis o BM metastases in oncological patients is shown. Dependence between the expansion of colloid radiopharmaceuticals concentration area (hemopoiesis peripheric expansion rate) and the BM metastases availability was not confirmed

  6. Decisive diagnosis of seronegative polyarthritis by 3-phase bone scintigraphy

    Inflammatory joint disease is mainly diagnosed on grounds of clinical investigation, laboratory testing (acute phase reactants), and radiography. Radionuclide imaging has recently been added to the armamentarium of clinician. This case report points out the role of three-phase bone scan and HIG (human immunoglobulin) scan in the discovery of the inflammatory nature of polyarthralgia in a young woman with equivocal clinical and laboratory results. In the aim of diagnosing arthritis early in its course scintigraphy proved to be superior to conventional radiography. It also allows more discriminating selection of subsequent X-ray examination to limit radiation exposure. (orig.)

  7. Bone scintigraphy in the initial evaluation of dogs with primary bone tumors

    Bone scintigraphy was performed as part of an initial diagnostic evaluation of 70 dogs admitted with primary bone tumors during a 2-year period. Tumors involved major long bones of the appendicular skeleton and included 62 osteosarcomas, 6 fibrosarcomas, and 2 chondrosarcomas. All dogs were free of radiographically detectable pulmonary metastases. Bone scintigraphy was not of value in distinguishing among various types of primary tumors. One dog with an ulnar chondrosarcoma had a scintigraphically detectable occult osseous metastasis or synchronous primary tumor, and 1 dog with osteosarcoma had a scintigraphically detectable lymph node metastasis. Pulmonary metastases were not detected scintigraphically. Of the 70 dogs, 44.3% had areas of increased isotope uptake associated with nonneoplastic disease processes

  8. Bone scintigraphy, plasma ALP, TAP and PAP in patients with prostatic cancer

    This study assessed the ability of bone scintigraphy, alkaline phosphatase (ALP), total acid phosphatase (TAP), and prostatic acid phosphatase (PAP) to diagnose bone metastasis in a series of 62 patients with histologically proven prostatic cancer. Abnormal uptake was seen on the bone scan in 49 patients (79 %). A final diagnosis of bone metastasis was made in 40 patients (65 %). The sensitivity and specificity were 100 % and 59 %, respectively, for bone scintigraphy; 50 % and 96 % for ALP; 65 % and 82 % for TAP; and 73 % and 77 % for PAP. For 40 patients with bone metastasis, all of the ALP, TAP, and PAP were positive in 17 patients (43 %) and negative in 8 patients (20 %). Higher levels of ALP, TAP, and PAP tended to be associated with more extensive bone metastasis. Although serological examination showed lower sensitivity than bone scintigraphy in the diagnosis of bone metastasis, PAP may be most frequently used as a screening procedure of bone metastasis. (Namekawa, K.)

  9. Bone scintigraphy and osteo-articular tuberculosis in transplant patients: a study of 50 bone scans

    Bone scintigraphy with 99 m technecium labelled phosphorus compounds was achieved in 50 west Africans migrant workers in Paris. Bone and joint tuberculosis was assumed in 20 cases. In 5 of these 20 cases, bone scan, but not X-ray, showed abnormalities, and in 4, bone scan disclosed more localisations than X-rays. In 7 cases, yet, bone scan was normal, with major osteolytic X-rays lesions in 3 cases, minor in 2 cases, and isolated cold abcesses in two more cases: these means 7 false-negative results. Among the 30 other cases, 29 were considered as mechanical vertebral pathology, and 1 sacro-iliitis Brucellosis. Bone scan was normal in 28 cases the 2 others are unexplained false-positive. Although non-specific and not completely reliable, we think that bone-scanning is useful in bone-tuberculosis check-up, especially to obtain early diagnosis and detect multifocal localisations

  10. Bone scintigraphy and osteo-articular tuberculosis in transplant patients: a study of 50 bone scans

    Coulaud, J.P.; Mechali, D.; Morau, G. (Hopital Claude-Bernard, Paris (France))

    1982-01-01

    Bone scintigraphy with 99 m technecium labelled phosphorus compounds was achieved in 50 west Africans migrant workers in Paris. Bone and joint tuberculosis was assumed in 20 cases. In 5 of these 20 cases, bone scan, but not X-ray, showed abnormalities, and in 4, bone scan disclosed more localisations than X-rays. In 7 cases, yet, bone scan was normal, with major osteolytic X-rays lesions in 3 cases, minor in 2 cases, and isolated cold abcesses in two more cases: these means 7 false-negative results. Among the 30 other cases, 29 were considered as mechanical vertebral pathology, and 1 sacro-iliitis Brucellosis. Bone scan was normal in 28 cases the 2 others are unexplained false-positive. Although non-specific and not completely reliable, we think that bone-scanning is useful in bone-tuberculosis check-up, especially to obtain early diagnosis and detect multifocal localisations.

  11. The usefulness of bone scintigraphy in SAPHO syndrome

    SAPHO syndrome is well known to various disease entities including synovitis, acne, pustulosis, hyperostosis and polyarthritis. The purpose of this study is to evaluate sicntigraphic findings and to compare with radiologic findings in SAPHO syndrome. Five patients (M:F=5:0, Age 22.8±4.78 yrs) with SAPHO syndrome were enrolled in our study. All patients underwent whole-body bone scintigraphy with intravenous administration of 740 MBq of Tc-99m MDP. Among them, two patients were additionally perfomed SPECT of the spine to evaluate the location and extent of spinal lesion. All patients were demonstrated abnormal increased uptakes in sternoclavicular joint (SC), sacroiliac joint (SI), and small joints of both hands. Among them, three patients were bilateral involvement (3/5) and two were unilateral (2/5) in SC. Involvement of SI showed bilateral in four patients (4/5) and unilateral in one (1/5). SPECT images demonstrate that the lesion sites of the lumbar spine are more likely facet joints than vertebral bodies or pedicles. As SAPHO syndrome is the disease entity involved polyarticular joints with various dermatologic manifestations, the bone scintigraphy may be a very useful method to evaluate the location and extent of joint involvement, and to avoid inadequate surgical management or ineffective antibiotic treatment

  12. The usefulness of bone scintigraphy in SAPHO syndrome

    Lim, Seok Tae; Sohn, Myung Hee [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2002-08-01

    SAPHO syndrome is well known to various disease entities including synovitis, acne, pustulosis, hyperostosis and polyarthritis. The purpose of this study is to evaluate sicntigraphic findings and to compare with radiologic findings in SAPHO syndrome. Five patients (M:F=5:0, Age 22.8{+-}4.78 yrs) with SAPHO syndrome were enrolled in our study. All patients underwent whole-body bone scintigraphy with intravenous administration of 740 MBq of Tc-99m MDP. Among them, two patients were additionally perfomed SPECT of the spine to evaluate the location and extent of spinal lesion. All patients were demonstrated abnormal increased uptakes in sternoclavicular joint (SC), sacroiliac joint (SI), and small joints of both hands. Among them, three patients were bilateral involvement (3/5) and two were unilateral (2/5) in SC. Involvement of SI showed bilateral in four patients (4/5) and unilateral in one (1/5). SPECT images demonstrate that the lesion sites of the lumbar spine are more likely facet joints than vertebral bodies or pedicles. As SAPHO syndrome is the disease entity involved polyarticular joints with various dermatologic manifestations, the bone scintigraphy may be a very useful method to evaluate the location and extent of joint involvement, and to avoid inadequate surgical management or ineffective antibiotic treatment.

  13. Clinical evaluation of stress fractures using bone scintigraphy

    Clinical evaluation of stress fractures were performed in 58 athletes using bone scintigraphy with sup(99m)Tc-MDP. Stress fractures of the tibia were most often seen in the males with running type sports. They occurred more often in the proximal tibia and on the right side. Stress fractures of the fibula were most often seen in females with jumping type sports, such as volley ball. They occurred more often in the distal fibula and on the right side. Tarsal bone fractures were seen most often rugby players. Metatarsal fractures occurred in the third fourth and fifth metatarsals. No lesion was seen in the first and second metatarsals. We feel that stress fractures of the femur can be differentiated from osteosarcoma by small loculated radionuclide accumulation as well as symptome, course and tomographic and CT finding. Bilateral involvement was seen in two cases in patellae and calcanei. Most of the other fractures were seen on the right side. Negative radiographs were seen in 36% of the patients and occurred most commonly in the tarsal bones excluding calcaneus. Bone scintigrams were positive in all cases and were most useful in fractures of the tarsal bones excluding calcaneus. (author)

  14. Analysis of bone scintigraphy in chronic dialysis patients

    The dialysis period, plain roentgenography, hemological tests and bone mineral content were studied dividing bone scintigraphic patterns in 120 dialysis patients due to the chronic renal failure into 5 groups (A-E). Moreover, variations of its patterns in 103 patients whose chronological changeable observation is available were studied. In group A (6 cases) strong accumulation in the cranial bone and jaw bone by bone scintigraphy, salt and pepper signs in the cranial bone by plain roentgenography, high level of PTH and ALP, and swelling of parathyroid gland in all cases were detected. In group B (11 cases) being sporadically observed hot spot by slightly high background and group C (33 cases) without observing hot spot by high background, fracture and pseudo-fracture were observed by plain roentgenography. The similar results in both group B and group C were observed by hemological tests. The transfer from group E to others or from others to group E, and mutual transfer of group B and group C were chronologically observed. In group D (6 cases), accumulated site was observed by plain roentgenography. In group E (64 cases) showing normally accumulated pattern, cases revealing fracture and pseudo-fracture were observed by plain roentgenography. The transfer in other groups in majority cases, and transfer from groups B and C in some cases were chronologically observed. From the above-mentioned results, classification of the bone scintigraphic patterns and its chronological observation were considered to be very useful for evaluation of the pathology and variation of osseous lesions in dialysis patients. (author)

  15. Bone scintigraphy as an aid in the diagnosis of occult distal tarsal bone trauma in three horses

    History, physical examination, and bone scintigraphy were used to diagnose central and/or third tarsal bone trauma in 3 acutely lame horses. In all 3 cases, the results of initial radiographic examination were negative. Bone scintigraphy revealed focal, intense radioisotope uptake at the level of the distal tarsal bones in the 3 horses. Radiographs obtained 4 weeks after injury in one horse demonstrated a slab fracture of the central tarsal bone. Conservative management of the tarsal bone disease resulted in acceptable return to function in all 3 horses

  16. Bone marrow scintigraphy with 111In-chloride

    It is assumed that 111In-chloride is bound to serum transferrin and then transported into reticulocyte in erythropoietic marrow. However, several biochemical differences between radioiron and 111In have been reported since these years. In present study, clinical usefulness of 111In-chloride bone marrow scintigraphy was examined especially by comparing 111In-chloride image with sup(99m)Tc-colloid. Obtained results are as follows: 1) In most cases, both 111In-chloride and sup(99m)Tc-colloid images showed similar bone marrow distributions. 2) In three out of 7 cases with hypoplastic anemia and two patients with bone marrow irradiation (700-1,000 rad), the central marrow or irradiated marrow showed marked decreased uptake of 111In, and showed normal uptake of sup(99m)Tc. 3) In two out of 3 cases with chronic myelogenous leucemia, central marrow showed normal uptake of 111In, and showed decreased uptake of sup(99m)Tc. From the present study, the same dissociation findings as those between radioiron and radiocolloid could be obtained in hypoplastic anemia and bone marrow irradiation. 111In-chloride would appear to be a useful erythropoietic imaging agent, although further study of exact comparison with radioiron should be necessary. (auth.)

  17. The role of bone scintigraphy in predicting femoral head collapse following cervical fractures in children

    Bone scintigraphy was performed before or after osteosynthesis or both in 11 children aged 9 to 14 years with femoral neck fractures. The role of bone scintigraphy in predicting development of femoral head necrosis with subsequent collapse was studied. Scintigraphy was not a useful study of this purpose. The explanation of this may be that reposition and osteosynthesis jeopardize the blood supply to the femoral head and invalidates the findings at the pre-operative scan. The childhood femoral head also has a strong potential for revascularization and complete reconstruction of the necrotic bone. (orig.)

  18. Bone scintigraphy in Erdheim-chester disease: a case report

    Siqueira, V.L.; Soares, L.M.M.; Ribeiro, V.P.B.; Coura Filho, G.B.; Sapienza, M.T.; Ono, C.R.; Watanabe, T.; Costa, P.L.A.; Hironaka, F.; Buchpiguel, C.A. [Universidade de Sao Paulo (FM/USP), SP (Brazil). Fac. de Medicina. Hospital das Clinicas

    2008-07-01

    Full text: Introduction: Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis, of unknown etiology, characterized by infiltration of foamy histiocytes. Clinically, patients usually present with bone pain, and various extraskeletal manifestations. ECD differs from Langerhans cell histiocytosis (LCH) by radiologic and immunohistochemistry features. Case report: A 57-year-old woman presented with a history of intense pain on her left hand, besides eyelid xanthelasmas and xanthoms on frontal area ten years ago. Four years late she presented with pain on hips, legs and feet. Xanthoms spread to perioral area, mento and neck. Radiographs of the hands showed osteolysis of carpal bones bilaterally, osteolysis of fifth left metacarpal bone, osteosclerosis of all metacarpal bones bilaterally, except the fifth, and osteosclerosis of the second and third proximal falanges bilaterally. The legs showed bilateral diaphyseal and metaphyseal osteosclerosis. Bone scintigraphy demonstrated increased uptake on face bone (maxilla), and symmetric intense uptake on elbows, distal radii and ulnae, hands, distal area of femurs, tibias particularly on proximal and distal area, and feet. A tibia biopsy and a biopsy of neck lesion were made. The analysis of histology and immunohistochemistry were consistent with ECD. She has been treated with a-interferon for 1,5 year, and she reports delay in xanthoms progression and bone pain remission. Discussion: ECD is an adult multisystemic xanthogranulomatous infiltrative disease of unknown etiology. It may be confused with LCH, however ECD have distinctive immunohistochemistry and radiologic findings. LCH shows typically lytic bone lesions on axial skeleton, whereas symmetrical long-bone osteosclerosis is the radiologic sign for ECD. LCH stain positive for CD1a and S-100 protein, and the electron microscopy of cytoplasm discloses Biberck granules. ECD stain positive for CD68, negative for CD1a and S-100 protein, shows absent of

  19. Bone scintigraphy in Erdheim-chester disease: a case report

    Full text: Introduction: Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis, of unknown etiology, characterized by infiltration of foamy histiocytes. Clinically, patients usually present with bone pain, and various extraskeletal manifestations. ECD differs from Langerhans cell histiocytosis (LCH) by radiologic and immunohistochemistry features. Case report: A 57-year-old woman presented with a history of intense pain on her left hand, besides eyelid xanthelasmas and xanthoms on frontal area ten years ago. Four years late she presented with pain on hips, legs and feet. Xanthoms spread to perioral area, mento and neck. Radiographs of the hands showed osteolysis of carpal bones bilaterally, osteolysis of fifth left metacarpal bone, osteosclerosis of all metacarpal bones bilaterally, except the fifth, and osteosclerosis of the second and third proximal falanges bilaterally. The legs showed bilateral diaphyseal and metaphyseal osteosclerosis. Bone scintigraphy demonstrated increased uptake on face bone (maxilla), and symmetric intense uptake on elbows, distal radii and ulnae, hands, distal area of femurs, tibias particularly on proximal and distal area, and feet. A tibia biopsy and a biopsy of neck lesion were made. The analysis of histology and immunohistochemistry were consistent with ECD. She has been treated with a-interferon for 1,5 year, and she reports delay in xanthoms progression and bone pain remission. Discussion: ECD is an adult multisystemic xanthogranulomatous infiltrative disease of unknown etiology. It may be confused with LCH, however ECD have distinctive immunohistochemistry and radiologic findings. LCH shows typically lytic bone lesions on axial skeleton, whereas symmetrical long-bone osteosclerosis is the radiologic sign for ECD. LCH stain positive for CD1a and S-100 protein, and the electron microscopy of cytoplasm discloses Biberck granules. ECD stain positive for CD68, negative for CD1a and S-100 protein, shows absent of

  20. Bone marrow scintigraphy and MR tomography in malignant lymphoma: Comparison with results of histology

    One hundred and seven patients with malignant Hodgkin and non-Hodgkin lymphoma were examined by bone marrow scintigraphy, MRI of bone marrow and bone marrow biopsy to detect bone marrow infiltration. The findings of bone marrow imaging and biopsy were classified as normal (grade 0), suggesting reactive changes of bone marrow (grade 1) or suspicious for infiltration (grade 2). About half of all results of biopsy and imaging methods agreed completely. There was a difference of two steps in the classification in only 2 cases (MRI) and 5 cases (scintigraphy). In patients with chronic lymphocytic leukemia false negative findings by both bone marrow imaging techniques were frequent. Although a positive biopsy result must be accepted as proof of bone marrow infiltration, our results indicate that a negative biopsy does not exclude tumor involvement. In all 4 patients with infiltration suspected on MRI or scintigraphy results but with normal findings or reactive changes in the first blind biopsy, blind rebiopsy or guided rebiopsy confirmed the results of the imaging methods. In both patients evaluated at autopsy the preceding MRI and scintigraphy results were confirmed completely, although in both of these patients antemortem biopsy had indicated different findings. Based upon these observations, bone marrow scintigraphy and MRI should be routinely included in the staging of malignant lymphoma as an adjunct to blind bone marrow biopsy in the complete evaluation of bone marrow status. (orig./MG)

  1. The diagnostic value of bone scintigraphy in patients with low back pain

    Bone scintigraphy has been studied in two groups of patients presenting with low back pain. In one group of 38 patients suffering ''non-specific'' back pain, bone scintigraphy and laboratory findings were negative in 24. There were abnormal laboratory findings in all of the remaining 14 and 7 had positive bone scans indicative of clinically significant disease. Selection of patients for bone scintigraphy in this group should therefore be influenced by abnormal laboratory findings and elevation of the erythrocyte sedimentation rate in particular. By comparison, the bone scans were reviewed from another group of patients suffering previously known malignancy. Out of 138 patients, nearly 40% showed a positive bone scan due to subsequently proven metastasis. Bone scintigraphy was positive in a further 14% as a result of osteoporotic rib fracture and vertebral body collapse. In half of these, it was not possible to exclude malignancy by scintigraphy. The present findings indicate that bone scintigraphy is not a useful procedure in patients with long-standing low back pain who have normal radiographs and normal laboratory findings. (orig.)

  2. Bone infection in patients suspected of complicating osteomyelitis: the diagnostic value of dual isotope bone-granulocyte scintigraphy

    Buhl, Thora; Stentzer, Kim; Hede, Adam;

    2005-01-01

    AIM: The purpose of this study was to evaluate the diagnostic value of dual isotope bone-granulocyte scintigraphy in patients with known bone pathology clinically suspected of osteomyelitis, i.e. complicating osteomyelitis, using per-operative bacterial culture from bone as reference. METHODS...... interpreted as positive for osteomyelitis if regions of interests of pathologic 111In granulocyte accumulation included 99mTc MDP activity on the bone images (except in the spine). RESULTS: The sensitivity, specificity, and accuracy were 84, 71 and 79%, respectively, for simultaneous, dual isotope bone......-granulocyte scintigraphy, higher than the other diagnostic parameters. CONCLUSION: Simultaneous bone-granulocyte scintigraphy is a valuable diagnostic tool in diagnosing osteomyelitis complicating other bone pathology with or without soft-tissue infection....

  3. SPECT bone scintigraphy of medial collateral ligament/meniscus injury

    Full text: Acute or chronic knee pain is common amongst athletic persons. MRI is generally regarded as the best test, but is not widely available and may lack specificity in meniscal tears and cruciate injury. Bone scan with SPECT is an appealing alternative since it is relatively cheap and easily obtained. Further, a number of investigators have published data indicating sensitivity and specificity exceeding 85%. The purpose of the study is to determine typical scintigraphic findings in medial collateral ligament or medial meniscus injury. We present a small group of patients with acute knee trauma in whom arthroscopy and/or clinical follow-up indicated medial collateral ligament injury. Bone scans were undertaken after 900-1000 MBq of 99mTc-MDP with immediate blood pool, delayed planar images and SPECT acquired on a Picker Prism 2000. SPECT was obtained with high resolution collimators and 20 sec/stop for 180 deg each. SPECT images showed focal radiopharmaceutical accumulation in the medial proximal tibial shaft and medial femoral condyle, corresponding to the superficial layer of the medial collateral ligament (best seen on coronal images). Disruption of the deep layer and/or medial meniscus can be suspected with abnormal uptake in part or all of the meniscus (best seen on transverse images). We conclude that acute/chronic medial collateral ligament injury can be detected on bone scintigraphy with abnormal uptake at the predicted anatomic site of attachment

  4. Bone scintigraphy in traumas and stress injuries; Knoglescintigrafi ved traumer og belastningsskader

    Kanstrup Hansen, I.L.

    1998-01-01

    Bone scintigraphy is an easy and cheap diagnostic method for examination of stress injuries of lower extremities. A more specific diagnosis often has to be supplemented by MR scanning or X-radiography. (EG). 14 refs.

  5. Indeterminate lesions on planar bone scintigraphy in lung cancer patients: SPECT, CT or SPECT-CT?

    The objective of the present study was to compare the role of single photon emission computed tomography (SPECT), computed tomography (CT) and SPECT-CT of selected volume in lung cancer patients with indeterminate lesions on planar bone scintigraphy (BS)

  6. Bone mineral density and bone scintigraphy in children and adolescents with osteomalacia

    In order to demonstrate the role of bone mineral density (BMD) measurement and bone scans in the management of patients with osteomalacia, radioisotope bone scintigraphy using technetium-99m methylene diphosphonate (MDP) and BMD measurements of the lumbar spine and femur by means of dual X-ray absorptiometry (DXA) were performed at the time of diagnosis and 6 months after therapy in 26 Saudi patients (17 females and nine males). Their mean age was 13.5 years (range, 5-16). BMD measurements were compared with those of normal Saudi subjects matched for age and sex. Bone scan showed an increase in tracer uptake throughout the skeleton (''superscan'') in all children and demonstrated multiple stress fractures in eight. The mean BMD for the lumbar spine was 0.53 g/cm2(Z-score, -3.1) and for the femoral neck 0.55 g/cm 2(Z-score, -2.8). Repeated bone scan and BMD after 6 months of therapy with oral vitamin D, calcium and proper sun exposure demonstrated a significant increase (P <0.001) in BMD and healing of pseudofractures. In conclusion, as a non-invasive method with minimal radiation exposure, measurements of BMD in children with osteomalacia are to be recommended in the initial assessment of the severity of osteopenia and in the follow-up to monitor the response to therapy. Bone scintigraphy is valuable in demonstrating the site and severity of stress fractures. (orig.). With 2 figs., 1 tab

  7. Bone scintigraphy predicts the risk of spinal cord compression in hormone-refractory prostate cancer

    In prostate cancer, confirmation of metastatic involvement of the skeleton has traditionally been achieved by bone scintigraphy, although the widespread availability of prostate-specific antigen (PSA) measurements has tended to eliminate the need for this investigation. The potential of bone scintigraphy to predict skeletal-related events, particularly spinal cord compression, after the onset of hormone refractoriness has never been investigated. The aim of this study was to establish whether a new method of evaluating bone scintigraphy would offer a better predictive value for this complication of the metastatic process than is achieved with currently available grading methods. We studied 84 patients with hormone-refractory prostate cancer who had undergone bone scintigraphy at the time of hormone escape. Tumour grading and parameters of tumour load (PSA and alkaline phosphatase activity) were available in all patients. The incidence of spinal cord compression was documented and all patients were followed up until death. Bone scintigraphy was evaluated by the conventional Soloway grading and by an additional analysis determining total or partial involvement of individual vertebrae. In contrast to the Soloway method, the new method was able to predict spinal cord compression at various spinal levels. Our data suggest that there is still a place for bone scintigraphy in the management of hormone-refractory prostate cancer. (orig.)

  8. Comparison of diagnostic significance of scintigraphy of bone marrow and bones in Hodgkin's disease patients

    Diagnostic value of the bone marrow scintigraphy (BMS) and osteoscintigraphy (OSG) is studied and their potentialities as compared to common diagnostic methods-trepanobiopsy, magnetic-resonance tomography (MRT) of bone marrow are analysed. Data on 155 patients examined are presented. BMS was made using the emission computer Apex-SP6 (Elscint) tomograph using domestic colloid Koren radiopharmaceutical labelled with 99mTc. It is shown that sensitivity, specificity and total accuracy of BMS in patients with Hodgkin's disease are 91.4%, 94.8% and 92.9% correspondingly. Potentialities of BMS are comparable with MRT, while sensitivity and total accuracy are considerably higher then those of trepanobiopsy method

  9. SPECT-CT bone scintigraphy in cancer patients

    %) lesions caused by direct infiltration of bone structures was observed in 6 pts . 4. 21 (15%) lesions with prevailing 'cold' osteolytic component were observed in 8 pts with renal, endometrial, colorectal or urinary bladder cancer. 5. 17 (12%) 'mixed-type' lesions - osteolytic and osteosclerotic were obtained in 6 cases. 6. Two pts were with 2 (1.9%) single extraosseous lesions: one - with myositis ossificans and the second -with soft tissue calcified metastasis in the right abdomen due to appendicitis cancer Conclusion: SPECT-CT increases the value of bone scintigraphy avoiding false-positive interpretation of areas with physiological tracer uptake, also facilitating the exact location and extent of tumor involvement.

  10. Differentiation of malignant and degenerative bone lesions using dexamethasone interventional 3- and 24-hour bone scintigraphy

    Seventy-seven adult patients with suspected skeletal metastases were divided into two groups. In group A (n=30), following intravenous administration of 20 mCi (740 MBq) of technetium-99m methylene diphosphonate (99mTc-MDP), 3- and 24-h scintigraphy of bone lesions was performed. The 24/3 h lesion to bone background radiouptake ratio (RUR) was calculated for each lesion. In group B (n=47), the same procedure was followed with dexamethasone intervention (10 mg in 24 h) following the 3-h acquisition. In group A, after determination of the critical point, malignant and degenerative bone lesions could be separated with a sensitivity, specificity and accuracy of 0.76, 0.72 and 0.73, respectively. The mean RUR of the malignant lesions was 1.20± 0.23, and that of the benign lesions, 0.95± 0.15. In group B cases, significantly increased sensitivity, specificity and accuracy of 0.87, 0.94 and 0.92, respectively, were found (P<0.001). The mean RUR of the malignant lesions was 1.48± 0.34, and that of degenerative lesions, 0.88± 0.19. Dexamethasone interventional bone scintigraphy seems to be a new cost-effective method for differentiating malignant from degenerative bone lesions using the RUR. (orig.)

  11. Retrospective Analysis of Indication of Bone Scintigraphy Performed in Our Clinic

    Fusun Aydogan

    2014-03-01

    Full Text Available Aim: Bone scintigraphy is one of the commonly used radionuclide imaging and it is successfully used in the diagnosis and follow-up of many diseases. The aim of this study is to determine the indications and filming protocols of bone scintigraphy which was performed in our clinic. Material and Method: Two hundred and fifty two patients (132 male, 120 female who was performed bone scintigprapy in our clinic between December 2011 and June 2013 included the study. Mean age was 50.1±20.2 years. Scintigraphic protocols were made in two ways as late static whole body imaging and three-phase bone scintigraphy according to the type of the diseases. Indications of scintigraphies and scintigraphic protocols were detected. Results: Bone scintigraphy was performed for diagnosis and monitoring of metastatic bone disease to 102 patients (40,5 %, for orthopedic applications to 57 patients (22,6 %, for diagnosis and monitoring of primary bone tumors to 29 patients (11,5 %, for diagnosis of osteomyelitis to 17 patients (6,7 %, for differential diagnosis of infection and loosening of the prosthesis to 12 patients (4,8 %, investigate the viability of the graft in 14 patients (4,6 %, for rheumatologic diseases to 9 patients (3,6 %, for investigate the pathological vertebral fractures and osteoporosis to 4 patients (1,6 %, for diagnosis the metabolic bone disease to 2 patients (0,8 %, for diagnosis of otitis externa to 5 patients (1,98 % and for for suspicion of malignancy to 1 patient (0,4 %. Late static whole body imaging protocol was applied to 136 patients (54 % and three-phase imaging protocol was applied to 116 patients (46 %. Discussion: The most common use of bone scintigraphy is the diagnosis and follow-up of metastatic bone disease. It is followed by reasons such as orthopedic applications, monitoring and diagnosis of primary bone tumors and diagnosis of osteomyelitis.

  12. Assessment of functional displacement of bone marrow by osteoplastic metastases from prostatic carcinoma with bone marrow scintigraphy

    The detailed examination of the skeleton in prostate cancer has become more critical since surgical treatment requires the non-evidence of bone metastases. The data of 30 patients have been evaluated. All patients had a bone scan and a bone marrow scintigraphy with [99mTc[-anti-NCA95. In this study we compared the degree of bone marrow displacement with the extent of metastatic deposits identified on the bone scan. Six patients showing the criterias of a superscan (maximal avidity of the osteotrope radiatracer) had as a correlate a complete displacement of the hematopoesis in the bone marrow scintigraphy and an increased activity in liver and spleen. The degree of the peripheral extension correlated strongly with the decrease of the haemoglobin in blood samples. The grading was based upon the number of metastatic deposits identified on the scan (0=no metastases; 1≤6 metastases; 2=multiple metastases; 3=superscan). In 28 of 30 patients (93%) we found corresponding results in both the bone scan and the bone marrow scintigraphy. The bone marrow scintigraphy is a sensitive method in the detection of metastatic disease and gives additional information about the extent of bone marrow displacement by osteoplastic metastases. (orig.)

  13. Bone and bone marrow scintigraphy in a patient with sickle cell-thalassemia and recurrent pain attacks

    The case of an eight years old African boy who suffers from sickle cell-thalassemia is presented. In the course of the disease frequent pain attacks occurred within the abdomen and extremities, recently also within the trunk. Local pain, at some occasions in combination with local swelling and always positive laboratory parameters for inflammation, hindered a solely clinical differentiation between bone infarcts and osteomyelitis. Bone scintigraphy, eventually in combination with bone marrow scintigraphy, can assist the clinician in the differentiation of aseptic bone infarcts versus secondary osteomyelitis. Based on the presented case scintigraphic results for bone infarcts, osteomyelitis and special scintigraphic pattern seen in sickle cell disease are presented. Furthermore, problems regarding the interpretation of the scintigraphies in relation to the delayed time after the beginning of pain attacks are discussed. (author)

  14. Implications of three phase bone scintigraphy for the diagnosis of bisphosphonate related osteonecrosis of the jaw

    Bisphosphonate (BP) related osteonecrosis of the jaw (BRONJ) is a well known serious complication of BP treatment. This study was undertaken to evaluate the diagnostic usefulness of three phase bone scintigraphy in patients with BRONJ. Forty one patients (48 lesions)with clinically proven BRONJ (2 males, 39 females, age 74.3±6.7 years)under went Tc 99m HDP bone scintigraphy. Visual interpretation and semiquantitative analysis of uptakes using lesion to contralateral uptake ratios during the blood pool phase (BUR)and during the osseous phase (OUR)were performed, and relations were sought between these and various clinical parameters. Three phase bone scintigraphy showed increased perfusion and blood pooling in 21 (63.6%)and 27 (81.8%)of 33 lesions, respectively. The osseous phase was positive for 45 (93.8%)of the 48 lesions. Of the four inflammatory clinical parameters of BRONJ [pus discharge, pain, swelling, and erythrocyte sedimentation rate (ESR)], patients with three or more parameters had more positive findings in vascular and blood pool phase images (p=0.033, p=0.027). By semiquantitative analysis, patients with a positive ESR had statistically higher BUR and OUR (both p<0.001). Higher stage BRONJ lesions had higher OUR than lower stage lesions (p=0.003). In addition, bone scintigraphy revealed three clinically covert BRONJ lesions without bone exposure, and four patients were up staged based on bone scintigraphy. Bone scintigraphy provides a relatively sensitive means of detecting BRONJ, so it was helpful for accurate BRONJ staging. Furthermore, Increased uptakes in vascular and blood pool phases of three phase bone scintigraphy were related to the inflammatory activity of BRONJ

  15. The value of bone scintigraphy in the diagnosis and follow-up of Langerhans' cell histiocytosis

    Objective: To investigate the clinical value of bone scintigraphy in the diagnosis and follow-up of Langerhans' cell histiocytosis (LCH). Methods: Whole-body bone scintigraphy was performed on 23 LCH patients. Results: Nineteen of 23 patients (82.6%) showed positive in their bone scan. Eight cases were with cranial abnormal uptake, clavicle, rib and pelvis involvements were seen and each was of 3 cases, respectively, upper limb, lower limb and spinal abnormal uptakes were seen in 2, 4 and 5 patients, respectively, and 1 child had photon deficient area in the lower part of the sternum. Among 19 positive scintigrams, solitary bone lesion was shown in 9 patients (47.4%). Conclusion: Characters of bone scintigraphy in LCH are useful in the diagnosis and follow-up of this disease. (authors)

  16. The contribution of bone scintigraphy in occupational health or medical insurance claims: a retrospective study

    Patients with a suspicion of bone damage following an industrial or traffic accident are often referred for bone scintigraphy as part of an occupational health or medical insurance investigation. The aim of this study was to assess the contribution and the potential role of bone scintigraphy compared with X-ray investigations in the aforementioned situation. To this end we evaluated 70 consecutive patients referred for bone scintigraphy during 1996 and 1997 by occupational health or medical insurance physicians. The most common reasons for referral were the exclusion of occult fractures of hands and feet, whiplash injuries, reflex sympathetic dystrophy or avascular necrosis, or the differentiation between an old and a recent vertebral fracture. X-rays were only available for comparative review of 53 patients, so only those were analysed. The results of bone scintigraphy were compared with X-rays, and their contribution and potential role in occupational health or medical insurance investigations assessed. In 31 out of the 53 patients investigated, bone scintigraphy findings concurred with X-rays as to the number and location of abnormalities. For 19 of the 53 patients, bone scintigraphy showed clinically relevant additional foci when compared with X-rays, predominantly involving lesions to hands/wrists and feet/ankles. Among these 19 patients, scintigraphic diagnoses were subsequently confirmed in ten cases by means of X-ray or computed tomography. In four patients, supplementary radiological investigations revealed no abnormalities, and in five patients no further investigations were undertaken. Finally, in three of the 53 patients, X-rays revealed bone damage (burst fractures) whilst the corresponding bone scintigraphy was negative, thus excluding recent injury. In conclusion, in 22 patients, representing 42% of the cases analysed, bone scintigraphy was conclusive compared with X-ray imaging in the final diagnosis and in this way in detecting occult or excluding

  17. Evaluation of bone scintigraphy in differential diagnosis of benign bone tumors

    Bone scintigraphy with sup(99m)Tc-phosphate compounds was evaluated from the analysis of 71 consecutive cases of various benign bone tumors whether the scintigrams could be helpful in their differential diagnosis. The characteristics of the scintigraphic image at the site of bone lesions were noticed as being marked (++), moderate (+) and poor or minimal (-), according to the degree of accumulation of the radioactivity. Fibrous dysplasia (8 among 9 cases) as well as aneurysmal bone cyst (3 among 4 cases) had strong tendency of marked accumulation. Poor or minimal accumulation was observed in almost all of the lesions of nonossifying fibroma including fibrous cortical defect (6 all cases), solitary bone cyst (4 among 6 cases) and enchondroma (3 among 4 cases). Moderate accumulation was said to be non-specific, since it could be encountered in any types of benign bone tumors. But it was noticed that the majority of the bone lesions of eosinophilic granuloma (7 among 9 cases) showed moderate accumulation and the scintigraphic evidence of the skeletal disease appeared to be less extensive than the roentgenogram. These scintigraphic characteristics realized in some benign bone tumors occasionally played an important role in clinical diagnosis, especially in the cases atypical on roentgenographic findings. Several instructive cases whose final diagnosis was strongly linked to the scintigraphic informations were demonstrated. (author)

  18. Bone marrow scintigraphy and computed tomography in myloproliferative disease

    Goldsmith, S.J.; Gilbert, H.S.; Hermann, G.

    1985-05-01

    Peripheral bone marrow (BM) expansion in myeloproliferative disease (MPD) is demonstrated by scintigraphy (scint) with Technetium 99m sulfur colloid (TSC) or Indium III chloride (In). Computed tomography (CT) of the normal adult medullary cavity yields negative attenuation coefficients (AC) which become positive when BM fat is replaced. BM scint and CT of the medullary cavity are obtained in 23 studies in 21 pts: 6 polycythemia vera (PCV), 6 post PCV myeloid metaplasis (MyM), 4 agnogenic MyM, 3 myelodysplasia with refractory anemia, 1 acute myelocytic leukemia and 1 chronic myelocytic with acute leukemic transformation. AC were measured for BM cavity of lower extremities at each third of the femur and tibia. Values ranged from -89 to +289 Hounsfield units. The results are presented in this paper. There was agreement between SCINT and CT in 83% pts and segments. 80% of MB segments with + AC had scint identified BM. BM biopsy of the iliac crest demonstrated fibrosis or blast proliferation in pts with +AC rather than hypercellularity or osteosclerosis. The highest AC values (>200) were seen in pts with blast proliferation and fibrosis. Decreased BM scint visualization and +CT AC correlated with BM fibrosis and may reflect replacement of BM elements or decreased RES function. BM scint and CT are useful to monitor MPD and select BM sites for biopsy.

  19. Bone scintigraphy and clinical outcome in rheumatoid gonarthritis

    Aim: For evaluation of the effect of radiosynoviorthesis (RSO) on the early and delayed uptake of 99mTc-biphosphonates and its relation to clinical outcome we studied these variables before and after radiosynoviorthesis performed on 41 knees affected by rheumatoid arthritis. Method: Thirty-seven patients with rheumatoid gonarthritis were treated by intraarticular injection with 185 MBq yttrium-90 citrate. In four of them both knees were treated so that 41 therapies were evaluated. On the average 35 days before and 120 days after radiosynoviorthesis, the early and delayed uptake of 99mTc-diphosphonate (DPD) was measured with a planar gamma camera. Early and late DPD uptake was quantified as a ratio between count values derived from rectangular ROIs placed on the knee treated and on the ipsilateral thigh. The severity of clinical symptoms was assessed on two 3-point rating scales averaged. Results: 30 of the 41 cases favorably responded to radiosynoviorthesis. There was a significant correlation between clinical outcomeand pretherapeutic early DPD uptake (EDU) (p0.05). In 25 of the 30 responders EDU decreased; EDU increased or remained constant in five of the eleven non-responders. The correlation between outcome and the difference in EDU was significant (r = 0.344; p<0.05). There was no such significant relationship between the difference between pre- and posttherapeutic DDU and clinical course. Conclusion: Three-phase bone scintigraphy may contribute to predict and assess the success of radiosynoviorthesis in rheumatoid arthritis of the knee joint. (orig.)

  20. Contribution of sup(99m)Tc labelled sodium pyrophosphate bone scintigraphy to the diagnosis of bone metastases

    Bone scintigraphy, by its ease of application and the use of short-lived isotopes, has revolutionised the conditions of bone metastase diagnosis. Scintigraphy possesses two advantages, the possibility it offers of exploring the whole skeleton at once and its extreme simplicity. This technique should therefore find its place at the very beginning of the bone examination, an attitude which also has dosimetric repercussions: a 'whole skeleton' examination delivers 170 mrad to the marrow, whereas spinal and pelvic X-rays deliver 325 mrad. Unfortunately the sup(99m)Tc-labelled sodium pyrophosphate bone scintigraphy is not specific to any given lesion. Diagnosis can only be improved by the appearance of tracers taken up specifically on the neoplasic tissue, as is already the case of 131I for thyroid cancer metastases. Labelled bleomycine and 67Ga have so far given disappointing results

  1. Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis

    Duer, Anne; Østergaard, M; Hørslev-Petersen, K;

    2008-01-01

    OBJECTIVES: To investigate the value in clinical practice of hand magnetic resonance imaging (MRI) and whole body bone scintigraphy in the differential diagnosis of patients with unclassified arthritis. METHODS: 41 patients with arthritis (> or = 2 swollen joints, > 6 months' duration) which...... joints of the most symptomatic hand and whole body bone scintigraphy were performed. Two rheumatologists agreed on the most likely diagnosis and the patients were treated accordingly. A final diagnosis was made by another specialist review 2 years later. RESULTS: Tentative diagnoses after MRI and bone...

  2. Cause of focal uptake in the cervical vertebral column in routine bone scintigraphy

    Buell, U.; Winkler, U.

    1983-09-01

    Focal uptake was seen in the cervical vertebral column of 61 patients in the course of routine bone scintigraphy. These focal increases were subjected to close analysis. In 60 of these patients (98.4%) degenerative lesions became manifest as the cause of the scintigraphic finding already by the bone scintigraphy pattern (paravertebral localisation in the posterior and dorsal localisation in the lateral. Two typical examples of metastatic changes are presented to facilitate differentiation. The bone scintigraphic pattern in arthrosis of the intervertebral joint is so typical that X-ray control examinations to confirm the diagnosis can be omitted in many cases.

  3. Study on temporomandibular joint disorders by bone scintigraphy and bone metabolic markers (ICTP, PICP) in synovial fluid

    The aim of this study was to evaluate bone metabolic condition in imaging findings of temporomandibular joint disorders (TMD) using bone scintigraphy, which has a high sensitivity to bone metabolism, and two bone metabolic markers: pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP) and carboxy-terminal propeptide of type I procollagen (PICP) which influence both the formation and absorption of bone. The subjects were 92 patients (18 male, 74 female, mean age 40.3±18.2 years of age, 112 temporomandibular joints (TMJs)) with TMD who underwent bone scintigraphy using 99mTc-methylene diphosphonate sodium (MDP) and/or had their concentration of bone metabolic markers (ICTP and PICP) measured in synovial lavage fluid by a radioimmunoassay kit using competitive inhibition. Synovial lavage fluid was a mixture of synovial fluid and physiological saline, obtained by irrigation of the superior joint compartment of TMD patients. Sixteen female controls (mean age 42.7±15.7 years of age) with no symptoms of TMD, but who had other diseases and who underwent bone scintigraphy, were selected. The position and configuration of the articular disk of patients with TMD were diagnosed by MRI and/or double contrastarthrography. All patients were examined for morphological bone change of the TMJ by tomography and were evaluated using both a positive ratio and an accumulation ratio (radioactivity counts of TMJ region/radioactivity counts of neck soft tissue region) by bone scintigraphy. We obtained the following results and conclusions. All the temporomandibular joints with morphological bone change showed an increase in accumulation by bone scintigraphy. Some of the temporomandibular joints without morphological bone change also showed an increase in accumulation. There were no statistically significant differences between disk position, disk configuration and accumulation ratio. Most of the temporomandibular joints, which had an increase in accumulation

  4. The role of bone scintigraphy in Langerhans' cell histiocytosis; a case report

    We present one case of bone-Langerhans cell histiocytosis in a three-year-old male child presenting osseous lesions in the skull and the femur, which are very frequent localizations in histiocytosis. Bone scintigraphy is useful for both initial staging and follow-up associated with other imaging modalities. (authors)

  5. 99mTc-MDP bone scintigraphy in the diagnosis of stress fracture of the metatarsal bones mimicking oligoarthritis

    Jauković Ljiljana

    2008-01-01

    Full Text Available Background. Stress fractures are the injuries of soft tissues and bones caused by intensive and repeated stress on a bone. Repeated submaximal stress disturbs the balance between the processes of bone production and resorption that results in fracture. Case report. We presented a case of a patient with stress fracture of metatarsal bone. The patient was diagnosed and treated as having reactive oligoarthritis caused by Chlamydia trachomatis and administered antibiotics. Initial plain radiography was negative for bone fracture. Tc-99m bone scintigraphy suggested stress fracture of the second metatarsal. Plain radiography was became positive three weeks later, showing callus formation in the proximal part of the second metatarsal. Conclusion. Bone scintigraphy is a diagnostic test of choice in early diagnosis of stress fracture, and it is important to apply it timely in order to include the entire therapy and prevent complications, as well as to let a patient return to previous daily activites.

  6. The skeletal radiography vs bone scintigraphy in assessment of bone destruction in patients with multiple myeloma: a comparative study

    Objective: To evaluate the radiography and bone scintigraphy for bone destruction in patients with multiple myeloma. Methods: Skeletal radiographs and bone radionuclide images of 20 patients newly diagnosed as multiple myeloma were comparatively studied. Results: On radiograph, lytic bone destruction was seen in 90% cases, pathological fracture was revealed in 80% cases, and diffuse osteoporosis was shown in 80% cases. While the positive rate of the bone scintigraphy was 45%. Areas of increased uptake and filling defects were revealed on scintigraphic images. Conclusion: Radiography has higher sensitivity and specificity than radionuclide imaging in imaging bone destruction and pathological fracture in patients with multiple myeloma. Skeletal radiography is still the first choice of imaging modalities in assessing the bone destruction in patients with multiple myeloma

  7. Whole-body MRI of Langerhans cell histiocytosis: comparison with radiography and bone scintigraphy

    Goo, Hyun Woo; Yang, Dong Hyun [Asan Medical Center, Department of Radiology, University of Ulsan College of Medicine, Seoul (Korea); Ra, Young Shin [Asan Medical Center, Department of Neurosurgery, University of Ulsan College of Medicine, Seoul (Korea); Song, Joon Sup; Im, Ho Joon; Seo, Jong Jin; Ghim, Thad; Moon, Hyung Nam [Asan Medical Center, Department of Pediatric Oncology, University of Ulsan College of Medicine, Seoul (Korea)

    2006-10-15

    In Langerhans cell histiocytosis (LCH) evaluation of the extent of disease is one of the major predictors of patient outcome. Historically this is undertaken using plain radiography and bone scintigraphy. Recently, whole-body (WB) MRI has been reported to be useful in detecting skeletal and extraskeletal metastases in both adults and children. To evaluate the usefulness of WB MRI in patients with LCH in comparison with plain radiography and bone scintigraphy. In nine children (1-7 years of age; mean 3.3 years) who had a pathological diagnosis of LCH and had either plain radiography or bone scintigraphy for comparison, 43 WB MR examinations were performed. Skeletal and extraskeletal lesions of the disease on WB MRI were compared with those on plain radiography and bone scintigraphy. LCH showed unifocal single-system involvement in one patient, multifocal single-system involvement in three, and multifocal multisystem disease in five. WB MRI identified additional skeletal lesions in three (38%) of eight patients, compared with plain radiography, and in two (25%) of eight, compared with bone scintigraphy. WB MRI detected extraskeletal lesions of the disease in five (56%) of the nine patients exclusively, except for one patient whose lung lesions were also detected on plain radiography. In two patients, treatment was changed according to WB MRI findings. (orig.)

  8. Bone marrow accumulation in gallium scintigraphy in patients with adult still's disease

    Kanegae, Futoshi; Tada, Yoshifumi; Ohta, Akihide; Ushiyama, Osamu; Suzuki; Noriaki; Koarada, Syuichi; Haruta, Yoshio; Yoshikai, Tomonori; Nagasawa, Kohei [Saga Medical School (Japan)

    2002-12-01

    We investigated the features and the usefulness of gallium scintigraphy in the diagnosis and the assessment of Adult Still's disease (ASD) by retrospective case review. Gallium scintigraphy have been done for 11 cases of ASD (3 males and 8 females) and 4 females were positive. Among these, 67 Ga-citrate was accumulated to the bone marrow in all 4 cases and to the major joints in 2 cases. Positive cases were rather serious and administered more immunosuppressants than negative cases. In order to characterize gallium scintigraphy findings of ASD, i.e. bone marrow accumulation, we analyzed 130 cases of collagen vascular disease. Although 101 cases (77.7%) were positive, only 7 cases (5.4%) showed the accumulation of {sup 67}Ga-citrate to the bone marrow. These include 3 cases with ASD, and 1 case with systemic lupus erythematosus, polyarteritis nodosa, Wegener's granulomatosis and Sjogren's syndrome. We also accumulated 18 patients who exhibited bone marrow accumulation of {sup 69}Ga-citrate, and found that 7 patients had collagen vascular and their related diseases. In conclusion, bone marrow accumulation in gallium scintigraphy is a specific feature of collagen vascular diseases, especially ASD, and it is suggested that cases with positive gallium scintigraphy in ASD can be serious and resistant to treatment. (author)

  9. Whole-body MRI of Langerhans cell histiocytosis: comparison with radiography and bone scintigraphy

    In Langerhans cell histiocytosis (LCH) evaluation of the extent of disease is one of the major predictors of patient outcome. Historically this is undertaken using plain radiography and bone scintigraphy. Recently, whole-body (WB) MRI has been reported to be useful in detecting skeletal and extraskeletal metastases in both adults and children. To evaluate the usefulness of WB MRI in patients with LCH in comparison with plain radiography and bone scintigraphy. In nine children (1-7 years of age; mean 3.3 years) who had a pathological diagnosis of LCH and had either plain radiography or bone scintigraphy for comparison, 43 WB MR examinations were performed. Skeletal and extraskeletal lesions of the disease on WB MRI were compared with those on plain radiography and bone scintigraphy. LCH showed unifocal single-system involvement in one patient, multifocal single-system involvement in three, and multifocal multisystem disease in five. WB MRI identified additional skeletal lesions in three (38%) of eight patients, compared with plain radiography, and in two (25%) of eight, compared with bone scintigraphy. WB MRI detected extraskeletal lesions of the disease in five (56%) of the nine patients exclusively, except for one patient whose lung lesions were also detected on plain radiography. In two patients, treatment was changed according to WB MRI findings. (orig.)

  10. Bone remodelling after hip prostheses surgery: normal evolution patterns by bone scintigraphy

    Evaluation of hip prostheses is a common task in nuclear medicine practice. Physicians usually have problems to differentiate between changes in bone remodelling related to surgical procedures and complications like infection or loosening. Aim: To assess changes in bone remodelling after hip prostheses surgery by bone scintigraphy, and to determine normal evolution patterns of tracer uptake. To relate changes in bone remodelling with type of prostheses and clinical outcome. Materials and Methods: We studied 18 patients (6 males, mean age 68±10 years) who receipt a hip prostheses. Every patient underwent 3 bone scintigraphies, at 3 months, 1 year and 2 years after surgical implant of hip prostheses. Twelve prostheses were non-cemented, 3 were cemented and 3 hybrids. A semi-quantification of tracer uptake was performed, obtaining an uptake index from the average counts per pixel of regions of interest (ROIs) drawn around sacroiliac joints, acetabulum, greater trochanter, calcar, femur shaft, tip, and opposite normal femur. Sacroiliac joints and opposite normal femur were selected as reference areas. The uptake index was calculated by the formula: (ROI-reference)/reference. Clinical follow-up was performed at 3 months, 6 months, 1 year and 2 years. Results: While tracer uptake indexes of non-cemented prostheses decreased significantly in greater trochanter, calcar, femur shaft, and tip between 3 months-1 year studies, 1 year-2 years studies and between 3 months and 2 years studies (t-student, p<0.05), tracer uptake indexes did not decrease in acetabulum, opposite normal femur, and sacroiliac joint. On the contrary, cemented and hybrid prostheses did not show any significant difference in studied areas during the follow-up. All patients presented good clinical outcome, without pain and with correct mobility of the leg. Conclusion: These preliminary results indicate that, when non-cemented hip prostheses are implanted, there are important bone remodelling changes at 3

  11. Legg-Calve-Perthes disease. Comparison of conventional radiography, MR imaging, bone scintigraphy and arthrography

    In a prospective study of 22 patients (24 hips) with Legg-Calve-Perthes disease (LCPD) the findings at conventional radiography, arthrography, bone scintigraphy and MR imaging, obtained at the time of diagnosis, were compared. MR was superior to conventional radiography and bone scintigraphy in the detection of the extent of involvement in the femoral head. Arthrography was as good as or better than MR imaging in determining the shape of the articular surfaces and the occurrence of lateral subluxation. Conventional radiography was less sensitive in identifying the degree of lateral subluxation and the extent of the necrosis in the femoral head. MR imaging provided anatomical and pathophysiological information about the extent and location of head involvement as well as the degree of lateral subluxation. Revascularisation was more clearly demonstrated with MR than with bone scintigraphy, irrespective of symptom duration. (orig.)

  12. Increased cartilagenous uptake on bone scintigraphy in a patient with relapsing polychondritis

    Borg, E.J. ter; Piers, A.; Thijn, C.J.P.

    1988-09-01

    A patient with relapsing polychondritis and increased uptake on bone scintigraphy (using /sup 99m/Tc-MDP) in the cartilagenous parts of the ribs, the sternum and in the larynx region is described. A biopsy of a costochondral junction (where uptake on the bone scan was increased) was compatible with relapsing polychondritis. After treatment with prednisolone and azathioprine the patient improved and a repeated bone scan (after six years) showed less intensive uptake.

  13. Increased cartilagenous uptake on bone scintigraphy in a patient with relapsing polychondritis

    A patient with relapsing polychondritis and increased uptake on bone scintigraphy (using 99mTc-MDP) in the cartilagenous parts of the ribs, the sternum and in the larynx region is described. A biopsy of a costochondral junction (where uptake on the bone scan was increased) was compatible with relapsing polychondritis. After treatment with prednisolone and azathioprine the patient improved and a repeated bone scan (after six years) showed less intensive uptake. (orig.)

  14. Assessment of an evolutive tertiary syphilis by bone scintigraphy. A case report

    One patient complained of persisting diffuse bone pain, with greater intensity in the pelvis. HDP 99mTc bone scintigraphy showed increased uptake around the right sacro-iliac joint and in the right iliac area due to increased osteoblastic activity, thereby providing functional information about the evolutive nature of the bone lesion. The X-scanner only revealed osteolysis in the same location. A blood test confirmed the diagnosis of tertiary syphilis. (author)

  15. Back Pain in Children and Diagnostic Value of 99mTc MDP Bone Scintigraphy

    Alkhawaldeh, Khaled; Ghuweri, Ali AL; Kawar, Jane; Jaafreh, Amany

    2014-01-01

    ABSTRACT Aim: The aim of our study is to assess the diagnostic value of Technituim-99m-Methyle diphosphonate (99mTc-MDP) Bone scintigraphy in the assessment of children with back pain. Methods: Included in this retrospective study were 68 child referred to us complaining of back pain (mean age of 13+ 2). There were 45 boys and 23 girls. All children have been investigated with conventional x-ray which revealed normal or inconclusive result. All underwent bone scintigraphy after the injection ...

  16. Unusual Case of Occult Brucella Osteomyelitis in the Skull Detected by Bone Scintigraphy

    Brucellosis is a worldwide infectious disease of animals that can be transmitted to humans. Osteoarticular involvement is the most common complication of brucellosis. A 47-year-old man, who was a stock breeder, complained of myalgia with fever and chills for 2 weeks. The serology titers and blood cultures for brucellosis were positive. Bone scintigraphy demonstrated a focally increased uptake in the left supra orbital area. Plain radiographs showed an osteolytic lesion, and an MRI revealed signal abnormalities in the corresponding site. We present an unusual case of occult Brucella osteomyelitis in the frontal bone of the skull detected by done scintigraphy.

  17. Unusual Case of Occult Brucella Osteomyelitis in the Skull Detected by Bone Scintigraphy

    Sohn, Myung Hee; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Lee, Chang Seob [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2010-06-15

    Brucellosis is a worldwide infectious disease of animals that can be transmitted to humans. Osteoarticular involvement is the most common complication of brucellosis. A 47-year-old man, who was a stock breeder, complained of myalgia with fever and chills for 2 weeks. The serology titers and blood cultures for brucellosis were positive. Bone scintigraphy demonstrated a focally increased uptake in the left supra orbital area. Plain radiographs showed an osteolytic lesion, and an MRI revealed signal abnormalities in the corresponding site. We present an unusual case of occult Brucella osteomyelitis in the frontal bone of the skull detected by done scintigraphy.

  18. Quantitative bone and 67Ga scintigraphy in the differentiation of necrotizing external otitis from severe external otitis

    Qualitative technetium Tc 99m bone scintigraphy using phosphate compounds and gallium 67 scintigraphy were described as a helpful means in diagnosing necrotizing external otitis (NEO). They were, however, claimed to be nonspecific. Quantitative Tc 99m methylene diphosphonate bone scintigraphy and gallium 67 scintigraphy were performed in eight patients with NEO and in 20 patients with severe external otitis, in order to prove usefulness of scintigraphy in the diagnosis of NEO. Ratios of lesion to nonlesion for bone scintigraphy were 1.67 ± 0.16 in patients with NEO and 1.08 ± 0.09 in patients with severe external otitis, and for gallium 67 scintigraphy they were 1.35 ± 0.24 in NEO patients and 1.05 ± 0.03 in patients with severe external otitis. There was no difference in uptake between diabetic patients with severe external otitis and nondiabetic patients. The scintigraphic studies were also evaluated using a qualitative scoring method (scores 0 to +4), according to the intensity of the radiopharmaceutical uptake. This method was found to be inferior in the diagnosis of NEO compared with the quantitative method. We conclude that lesion-to-nonlesion ratios greater than 1.5 and 1.3 on bone and gallium 67 scintigraphy, respectively, are indicative of NEO. Quantitative bone scintigraphy, which is quicker to perform, may be used as a single imaging modality for the diagnosis of NEO

  19. The use of bone scintigraphy to detect active Hansen's disease in mutilated patients

    Mutilation of extremities was very frequent in patients affected by leprosy in the past; although it is now much less common, it is still seen, mainly in patients with long-term disease. In general, mutilation of the nose and ears is caused by the bacillus and mutilation of the hands and feet a consequence of chronic trauma. Leprosy must be chronically treated and any decision to interrupt therapy is based on laboratory tests and biopsy. Scintigraphy is a non-invasive procedure which could be of great value in to determining disease activity. We studied eight patients (five males and three females, aged 64-73 years) who presented with mutilation of the nose (2), ear (1), feet (3) or foot and hand (2). Conventional three-phase bone scintigraphy (750 MBq) and X-ray examinations of the affected areas were performed in all patients. Bone scintigraphy was abnormal in four patients (the presence of bacilli was confirmed by biopsy in two of them), and normal in the other four. In all patients except for the one with ear mutilation, radiography only showed the absence of bone. We conclude that bone scintigraphy is very useful to determine disease activity in cases of mutilation caused by leprosy. It seems to be superior to conventional radiography and may enable bone biopsies to be avoided. (orig.)

  20. Low-Dose Adefovir-Induced Hypophosphatemic Osteomalacia on Whole-Body Bone Scintigraphy

    Kim, Sung Hoon; Won, Kyoung Sook; Song, Bongil; Jo, Il; Zeon, Seok Kil [Keimyung Univ., Daegu (Korea, Republic of)

    2013-12-15

    While adefovir dipivoxil (ADV) effectively suppresses the hepatitis B virus, it can cause proximal renal tubular dysfunction leading to phosphate wasting. The safety of low-dose ADV (a dose of 10 mg/day), which does not induce clinically significant nephrotoxicity, is well recognized, but a few cases of hypophosphatemic osteomalacia (HO) caused by low-dose ADV therapy have recently been reported. Although HO induced by low-dose ADV therapy is rare, the presence of bone pain in patients treated with ADV should be monitored. Bone scintigraphy can be performed to confirm the occurrence of osteomalacia and to determine the disease extent. Bone scintigraphic and radiological image findings with a brief review of the literature are presented in this article. We report two cases of HO induced by low-dose ADV therapy that showed multifocal increased radiotracer uptakes in the bilateral bony ribs, spines, pelvic bones and lower extremities on whole-body bone scintigraphy. Bone pain gradually improved after phosphate supplementation and by changing the antiviral agent. Whole-body bone scintigraphy is a highly sensitive imaging tool and can show disease extent at once in the setting of the wide range of the clinical spectrum with nonspecific radiological findings. Furthermore, frequent involvement of the lower extremities, as a result of maximum weight bearing, could be an additional scintigraphic clue for the diagnosis of HO. These cases could be helpful for both clinicians prescribing ADV and nuclear physicians to prevent delayed diagnosis and plan further appropriate treatment.

  1. Low-Dose Adefovir-Induced Hypophosphatemic Osteomalacia on Whole-Body Bone Scintigraphy

    While adefovir dipivoxil (ADV) effectively suppresses the hepatitis B virus, it can cause proximal renal tubular dysfunction leading to phosphate wasting. The safety of low-dose ADV (a dose of 10 mg/day), which does not induce clinically significant nephrotoxicity, is well recognized, but a few cases of hypophosphatemic osteomalacia (HO) caused by low-dose ADV therapy have recently been reported. Although HO induced by low-dose ADV therapy is rare, the presence of bone pain in patients treated with ADV should be monitored. Bone scintigraphy can be performed to confirm the occurrence of osteomalacia and to determine the disease extent. Bone scintigraphic and radiological image findings with a brief review of the literature are presented in this article. We report two cases of HO induced by low-dose ADV therapy that showed multifocal increased radiotracer uptakes in the bilateral bony ribs, spines, pelvic bones and lower extremities on whole-body bone scintigraphy. Bone pain gradually improved after phosphate supplementation and by changing the antiviral agent. Whole-body bone scintigraphy is a highly sensitive imaging tool and can show disease extent at once in the setting of the wide range of the clinical spectrum with nonspecific radiological findings. Furthermore, frequent involvement of the lower extremities, as a result of maximum weight bearing, could be an additional scintigraphic clue for the diagnosis of HO. These cases could be helpful for both clinicians prescribing ADV and nuclear physicians to prevent delayed diagnosis and plan further appropriate treatment

  2. Role of computed tomography and radionuclide scintigraphy in the localization of osteomyelitis in flat bones

    The combined use of radionuclide scintigraphy and computed tomography is recommended for evaluating children with laboratory and clinical data suggestive of flat bone osteomyelitis despite normal conventional radiographs. In addition, computed tomography may be helpful in the presence of abnormal radiographs in determining the exact location of the focus of osteomyelitis and the most suitable route for appropriate drainage or to obtain culture material

  3. Bone Scintigraphy in a Patient With Giant Malignant Solitary Fibrous Tumor of the Pleura.

    Zhao, Long; Liu, JinJun; Li, Qiang; Wang, Huo-Qiang

    2016-06-01

    Chest radiograph performed in a 61-year-old woman to evaluate cough showed a large mass in the right lung. On chest CT images, the mass was measured approximately 8.5 cm. Malignancy was considered, and bone scintigraphy was performed to assess possible osseous metastases. The bone scan images demonstrated increased tracer uptake by the lung mass. The mass was surgically resected, and the pathologic examination confirmed the rare diagnosis of a malignancy solitary fibrous tumors of the pleura. PMID:26914570

  4. Colloid scintigraphy showing red bone marrow extension in patients with prostatic carcinoma

    In 25 of 30 patients with bone metastases from prostatic carcinoma, red bone marrow extension was observed by scintigraphy of the reticuloendothelial system (RES). The degree of bone marrow extension in the lower extremities increased with increasing number of bone metastases. In 8 patients, 15 peripheral metastases were detected, all located in areas with extended red bone marrow. The distal level of bone marrow extension coincided with that of the most distal metastases. This is of importance for the detection of peripheral metastases at risk for fracture. Bone marrow extension was also seen in 5 of 8 patients with prostatic carcinoma without bone metastases and was interpreted as a paramalignant activation of RES. (orig.)

  5. Bone scintigraphy in chronic knee pain: comparison with magnetic resonance imaging

    Boegard, T.; Rudling, O.; Dahlstrom, J.; Dirksen, H.; Petersson, I.; Jonsson, K.

    1999-01-01

    OBJECTIVE—To compare increased bone uptake of 99Tcm-MDP and magnetic resonance (MR) detected subchondral lesions, osteophytes, and cartilage defects in the knee in middle aged people with longstanding knee pain.
METHODS—Fifty eight people (aged 41-58 years, mean 50) with chronic knee pain, with or without radiographic knee osteoarthritis, were examined with bone scintigraphy. The pattern and the grade of increased bone uptake was assessed. On the same day, a MR examination on a 1.0 T imager was performed. The presence and the grade of subchondral lesions, osteophytes, and cartilage defects were registered.
RESULTS—The κ values describing the correlation between increased bone uptake and MR detected subchondral lesions varied between 0.79 and 0.49, and between increased bone uptake and MR detected osteophytes or cartilage defects the values were <0.54. The κ values describing the correlation between the grade of bone uptake and the grade of the different MR findings was <0.57.
CONCLUSIONS—Good agreement was found between increased bone uptake and MR detected subchondral lesion. The agreement between increased bone uptake and osteophytes or cartilage defects was in general poor as well as the agreement between the grade of bone uptake and the grade of the MR findings.

 Keywords: knee; osteoarthritis; magnetic resonance imaging; bone scintigraphy PMID:10343536

  6. SPECT/CT in the assessment of bone scintigraphy in staging of patients with oncologic diseases

    We aimed to assess the role of single photon emission computed tomography-computed tomography (SPECT/ CT) for characterizing nonconclusive lesions, observed by planar WB bone scintigraphy and to evaluate the impact of SPECT/CT on oncologic patient management. Data from 269 patients with oncologic diseases who had undergone WB BS for staging and 29 of them with nonconclusive lesions, passed SPECT/CT of a selected volume, were retrospectively analyzed. Planar scintigraphy and SPECT/CT images were independently evaluated in separate sessions to minimize recall bias. Among the 269 WB BS, in 37 patients multiple bone metastases were confirmed. In 161 patients degenerative lesions in the skeleton were defined, 42 patients were with normal bone scan and in 29 patients the results were nonconclusive for bone metastases. The fused scan after SPECT/CT imaging confirmed bone metastases in 11 (38%) patients with 27 new metastatic lesions and benign degenerative lesions in 18 patients. SPECT/CT is better than planar WB BS for characterizing equivocal lesions that are observed by bone scintigraphy, thus SPECT/CT can have a significant impact on patient management in staging the oncologic disease. (authors)

  7. Three-Phase 99mTc-MDP Bone Scintigraphy and SPECT/CT in Pediatric Pseudodystrophy.

    Usmani, Sharjeel; Panchadar, Satish; Banna, Anwar al

    2015-11-01

    Pseudodystrophy is a rare condition clinically resembling reflex sympathetic dystrophy. Distinction between both disorders is based on clinical features and bone scintigraphy. We report a case of 12-year-old girl presented with pain, swelling, and functional impairment of left foot after minor trauma. Clinical assessment revealed atrophy of left calf, cyanosis and coldness of left foot. Laboratory investigations were normal. X-ray and MRI of the foot were unremarkable. Bone scintigraphy showed hypoperfusion and diffusely reduced tracer uptake in the left lower leg and left foot. Diagnosis of pseudodystrophy was made on the basis of history, clinical examination, and bone scintigraphy findings. PMID:26252332

  8. Technetium-99m human immunoglobulin scintigraphy in patients with adhesive capsulitis. A correlative study with bone scintigraphy

    Adhesive capsulitis (AC) is a disorder that is characterized by shoulder pain and progressive limitation of both active and passive shoulder motion. Although the underlying pathological mechanisms of the disease are not well understood, the inflammatory reactions depending on the stage have been demonstrated histologically. The purpose of the study is to investigate the inflammatory changes that can be demonstrated with Tc-99m HIG in AC, and to determine the presence of correlations between scintigraphic findings and the clinical assessment. Twenty-one patients (12 females and 9 males) with a mean age of 50.57±8.49 were included in the study. AC was diagnosed according to recognized criteria. The planar X-ray images of the affected shoulders of all patients were normal. The patients were evaluated with the Constant Scoring System, and the functional and pain assessment parts of the American Shoulder and Elbow Surgeons' Form (ASES). Three phase bone scans and Tc-99m HIG scintigraphy were performed at least two days apart. Bone scan and Tc-99m HIG scintigraphy were evaluated visually and HIG uptake was evaluated in comparison with the contralateral normal shoulder. Bone scan demonstrated hypervascularity in 9 of the 21 patients (43%), whereas increased osteoblastic activity was detected in 19 (90%) in the affected shoulder. Tc-99m, HIG uptake was positive in 12 (57%), and negative in 9 (43%) patients. All patients with increased Tc-99m HIG accumulation in the affected shoulder, also had increased osteoblastic activity on Tc-99m bone scintigraphy. A significant correlation was found between HIG uptake and constant, functional and pain scores. The difference between these scores was also statistically significant in patients with HIG positive and negative uptake. This study indicates that there is a good correlation between Tc-99m HIG scan findings and clinical scores. Tc-99m HIG accumulation in the affected shoulder may be related to continuing inflammatory reaction

  9. Contribution of technetium 99m-labelled pyrophosphate bone scintigraphy in infectious spondylodiscitis

    This work examines the contribution of technetium 99m(sup(99m)Tc)-labelled pyrophosphate bone scintigraphy in infectious spondylodiscitis and attempts to define its importance in the diagnosis of lesions and their subsequent supervision in patients under treatment. 5 to 15 millicuries of sup(99m)Tc-labelled pyrophosphates are injected intraveinously. Bone uptake is strong and durable; 1.3% of the injected activity is found in the blood by the fifth hour. The skeleton may be explored: - either one segment at a tome with a scintillation camera, - or all at once and more quickly with a whole-body device taking front and black exposures. Bone scintigraphy appears as a basic technique in the study of infectious spondylodiscitis. Moreover the use of increasingly efficient equipment, the quantification of results and perhaps the development of new tracers augur well for a technique which is already acknowledged to be of fundamental interest

  10. Evaluation of follow-up bone scintigraphy for assessing the effects of hormone and chemotherapy of bone metastases from prostatic cancer

    To assess the clinical usefulness of bone scintigraphy for the osseous metastases of prostatic cancer after treatment, we attempted the correlative studies on laboratory data (TAP, PAP, ALP, and LDH) and scintigraphy. In 77 patients with prostatic cancer, bone scintigraphies were performed with sup(99m)Tc-phosphorous compounds to detect bone metastases. In 34 cases (44 %) bone metastases were detected. In 21 patients out of them, we assessed the effects of hormone and chemotherapy for bone metastases using serial bone scintigraphy. In 19 cases (24.7 %) of the bone scintigraphy showed equivocal results. Of 21 patients with bone metastases, 15 patients showed improvement on scintigram after hormone or chemotherapy. In much improved group (5 patients) and moderately improved group (5 patients). TAP and PAP levels were low and stable. On the other hand, in slightly improved group (5 patients) which showed partially effective on scintigram after treatment, serum TAP and PAP level were unstable. Some cases in the group of which the 1st scintigrams showed normal were turned to positive on scintigram, while TAP, PAP, ALP and LDH level were not elevated. Therefore, follow-up bone scintigraphies have value in evaluating the disease extent in patients with prostatic carcinoma. (author)

  11. Osteodystrophy in liver cirrhosis. Its demonstration by 99m Tc methylene diphosphonate bone scintigraphy

    Sezai, Shu-ichi; Ishizawa, Suguru; Yoshino, Katsumasa

    1987-10-01

    In order to investigate the osteodystrophy in liver cirrhosis, 21 liver cirrhotic patients having no malignancy and normal renal function were examined by 99m Tc Methylene Diphosphonate (MDP) bone scintigraphy. The cirrhotic subjects consisted of 14 males and 7 females. Their age was 31 - 80, average 55.7 years. The causes of their cirrhotic damage were 1 primary biliary cirrhosis, 9 alcoholic, 2 HB viral and 9 cryptogenic. The contents of their illness showed 9 cases in A, 4 in B and 8 in C of Child's classification. Abnormal hot spot(s) on bone in the cirrhotics could be observed very frequently in 99m Tc MDP bone scintigraphy (47.6 %; 10/21 cases). Those spots were seen more frequently in female and advanced stage of cirrhosis. The number of spot(s) increased also in advanced liver cirrhosis. Serum Ca, P and PTH were in normal range. All of three vitamin D/sub 3/ fractions decreased and especially 1,25 (OH)/sub 2/D/sub 3/ was depressed more in scinti-positive cases. Metacarpal bone X-p with an alumimum step wedge as a reference was analyzed by a microdensitometry (MD) method (Inoue T et al) and the pattern of osteopathy (i.e. porosis, malacia and poromalacia) was examined according to Sumi Y et al. MD method was not known yet if there was any definite correlation with bone scintigraphy and the osteopathic pattern belonged to border categories. In conclusion, more attension on hepatic osteodystrophy will be significantly necessary due to the fact that it has been found very frequently in liver cirrhosis. 99m Tc MDP bone scintigraphy is a good means for detection of the hepatic osteodystrophy.

  12. Comparative detectability of bone metastases and impact on therapy of magnetic resonance imaging and bone scintigraphy in patients with breast cancer

    Altehoefer, Carsten E-mail: alca@mrs1.ukl.uni-freiburg.de; Ghanem, Nadir; Hoegerle, Stefan; Moser, Ernst; Langer, Mathias

    2001-10-01

    Objective: to evaluate the comparative impact of magnetic resonance imaging and bone scintigraphy in bone metastases of breast cancer. Methods and patients: in 81 patients with histologically proven breast cancer magnetic resonance imaging of the axial skeleton and whole-body bone scintigraphy had been performed. Images were retrospectively reviewed and compared for detection of metastases, extent of metastatic disease and therapeutic implications according to the patients' records. Results: about 54/81 (67%) patients revealed bone metastases. In 7/54 (13%) patients with bone metastases, scintigraphy was false negative. In one patient a solitary sternal metastases was seen. In 26/53 [49%] patients with spinal metastases, magnetic resonance imaging showed more extensive disease. Local radiotherapy or surgery was indicated in ten patients with metastases not evident in bone scintigraphy, in 20 patients with positive results by both imaging modalities and in six patients with metastases of pelvis imaged by bone scintigraphy only. Conclusion: magnetic resonance imaging of the axial skeleton and pelvis appears superior for staging as only one patient had metastases merely outside the axial skeleton and local therapy was indicated even in spinal regions negative in bone scintigraphy.

  13. Bone metastasis in patients with para neoplastic myasthenic syndrome - Possible indication for bone scintigraphy

    injecting 750 MBq of technetium-99m labelled methylenediphosphonate. Static views were additionally performed when considered necessary. Results showed focal uptake consistent with bone metastasis in 13 cases, uncertain lesions (possible degenerative) in 6 cases and normal pattern in 9 cases. Most focal uptakes were suggestive of secondary lesions involving sternum and spine. Further investigations revealed the primary malignancy in 23 cases (11 thymoma, 3 lung cancer, 4 colonic cancer, 2 gastric cancer, 1 prostate carcinoma, 1 neoplasm of the cavum, 1 thyroid cancer). Based on our preliminary observations, we conclude that bone scan might be useful to detect secondary bone lesions in middle-aged and old aged patients with MG, under circumstances of clinical and biological suspicion of malignancy, even before confirmation of primary disease. Because of the usually small size of the primary lesions at the time of the PMS occurrence (for example, small thymoma), they are sometimes very difficult to diagnose by conventional procedures. Though metabolic imaging as PET scan is useful but in centres where this modality is not available, bone scintigraphy might be justified for selected patients and a positive yield in these patients can orient further investigation directed towards detecting the malignancy. (author)

  14. A study of healing process and prognosis of medial femoral neck fracture evaluated by bone scintigraphy

    As to healing process and prognosis of femoral neck fracture, radionuclide bone scintigraphy using sup(99m)Tc phosphorus compound was performed and the following results were obtained. 1. In cases of osteosynthesis, scintigraphical study showed a certain serial pattern until fracture was uneventfully healed. 2. On the other hand, in cases with non-union or late segmental collapse of the head, scintigraphy revealed defect at superolateral or central area in the head. This finding could be already noted prior to roentgenographical evaluation. 3. In the study of radionuclide uptake count on the femoral head of resected specimen, the higher value was observed in the area along medial fracture edge to medial margin of the head. Histological study showed feature of increased new bone formation at the area of higher radionuclide uptake. Vascular supply through the bone marrow of the neck and superior retinacular artery was thought to play an important role for the new bone formation. 4. From the aforementioned results, sup(99m)Tc phosphorus compound scintigraphy was considered as one of the quite useful methods for early diagnosis of complications after femoral neck fracture. (author)

  15. Usefulness of spatially adaptive noise reduction processing in computer-assisted diagnosis system for bone scintigraphy

    The goal of this study was to assess the diagnostic accuracy of Pixon-processed images in comparison with raw images for computer-assisted interpretation of bone scintigraphy (BONENAVI). Whole-body scans of 57 patients with prostate cancer who had undergone bone scintigraphy for suspected bone metastases were obtained approximately 3 h after intravenous injection of 740 MBq 99mTc-methylene diphosphonate. We obtained two image sets: raw images and images processed using the Pixon method. Artificial neural network (ANN) values, bone scan index (BSI), number of hotspots and regional ANN value of two images set were automatically calculated by the BONENAVI software. Areas under the receiver operator characteristic curves (AUC) were calculated in patient-based and lesion-based analyses. In ten cases with bone metastases, ANN, BSI and number of hotspots for processed images were equivalent to those in the raw images. However, in 47 cases without bone metastases, ANN, BSI and number of hotspots for processed images showed significantly lower values than those for the raw images (p < 0.05). Sensitivity, specificity and accuracy of the raw images were 90.2, 44.7 and 65.9%, and those of the processed images were 90.2, 57.4 and 72.7%, respectively. The AUC for processed images was equivalent to that for raw images. Specificity and accuracy in the detection of bone metastases showed the Pixon-processed images to have high diagnostic performance. We conclude that the precision of computer-assisted interpretation of bone scintigraphy can be enhanced by using Pixon processing. (author)

  16. Studies on 99Tcm-sulfur colloid bone marrow scintigraphy in myeloproliferative disorders

    Objective: To discuss the imaging features and changing patterns of bone marrow scintigraphy in myeloproliferative disorders (MPD) as well as its clinical significance. Methods: Bone marrow scintigraphy using 99Tcm-sulfur colloid 370-550 MBq was performed on 85 MPD patients, including 40 cases of idiopathic myelofibrosis (IMF), 15 of polycythemia vera (PV), 5 of essential thrombocythaemia (ET), 30 of chronic granulocytic leukemia. Also, 40 cases of myelodysplastic syndromes (MDS) were observed in this study. Results: Abnormal bone marrow imaging was found in 88.2% of the 85 patients. The suppression rate of central bone marrow (CBM) and expansion rate of peripheral bone marrow (PBM) in these MPD patients were 61.2% and 56.5%, respectively. The imaging patterns was classified into three types according to the distribution and activity of bone marrow. 1) reduced imaging (31.8%); 2) increased and expanded imaging (27.1%); 3) depressed and expanded imaging (29.4%). Splenomegaly with minimal residual marrow activity was typical for late stages of MPD. Expansion of PBM was the further feature, but of no major importance for improving hematopoiesis of MPD, and it tended to retract during clinical recovery in chronic granulocytic leukemia (CGL). With expanding PBM, unmatched peripheral blood decreasing was found in MDS. The expansion pattern of PBM in different MPD was of relatively definite features. Conclusions: The imaging pattern of bone marrow was correlated with blood work-up data and clinical course or stages of MPD. Bone marrow scintigraphy may be proven useful in differential diagnosis and evaluation of clinical staging and prognosis of MPD

  17. Dual-phase 99mTc-MIBI scintigraphy with delayed neck and thorax SPECT/CT and bone scintigraphy in patients with primary hyperparathyroidism. Correlation with clinical or pathological variables

    The purpose of this study was to assess the relationship between 99mTc-MIBI and 99mTc-MDP bone scintigraphy and clinical or pathological variables, including preoperative serum PTH levels and tumor diameter, in patients with newly diagnosed PHPT. Dual phase 99mTc-MIBI planar scintigraphy was performed in 244 patients with PHPT. Of these patients, 155 underwent 99mTc-MDP bone scintigraphy to detect bone changes before parathyroidectomy. Factors influencing 99mTc-MIBI scintigraphy and 99mTc-MDP bone scintigraphy detection rate were assessed using univariate and multivariate logistic regression analysis; optimal cutoff values for predicting positive 99mTc-MIBI and 99mTc-MDP bone scintigraphy were evaluated using ROC analysis. Among 244 patients, 174 (71.31%) patients with 181 foci had a positive 99mTc-MIBI planar scintigraphy; delayed neck and thorax SPECT/CT could identify and locate the 99mTc-MIBI lesions but could not find more lesions than planar scintigraphy. 70 (28.69%) patients had a negative 99mTc-MIBI planar scintigraphy. Tumor diameter, serum PTH level and symptoms were statistically significant predictive factors in predicting positive 9mTc-MIBI scintigraphy both univariate and multivariate logistic regression analyses. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.03 cm and 127.60 ng/L, respectively. Among 155 patients with bone scintigraphy, 99mTc-MDP bone scintigraphy showed positive finding in 80 (51.61%) patients and negative finding in 75 patients. Univariate logistic regression analysis showed that patient age, sex, tumor diameter and PTH level (≥150 ng/L) were statistically significant in predicting positive 99mTc-MDP bone scintigraphy. Multivariate logistic regression analysis showed both tumor diameter and PTH ≥150 ng/L were statistically significant in predicting positive 99mTc-MDP bone scintigraphy. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.96 cm and 163.85 ng

  18. A clinical study of temporomandibular disorder. The value of bone scintigraphy as an aid to diagnosis

    Temporomandibular disorder (TMD) is still not defined with respect to the point of an entity, terminological problems, and clinical classification and gradings. Moreover, diagnostic problems of internal deranegement and osteodeformity at the temporomandibular joint such as type IV and mechanism of bone remodeling at condylar head are also still not clear. In this investigation, we tried to classify the severity and progressive grading according to the symptoms and objective laboratory data taken from soft tissues such as muscles related to mastication, discs and ligaments, and hard tissues such as condylar head and temporal bone changes around the temporomandibular joint. Preliminary diagnostic clinical tool of the assessment of temporomandibular joint by maens of bone scintigraphy was attributed to the additional diagnostic procedure and research for the bone remodeling for the temporomandibular disorder because this can be defined between subjective and objective symptoms in this disorder. Bone scintigraphy will solve many problems concerning undefined degenerative bone changes in TMD, enable more accurate diagnosis, and the selection of treatment and prognosis in future investigation. Also, it is believed single photon emission computed tomography (SPECT) nuclear bone imaging is a highly accurate diagnostic method for craniomandibular disorders. (author)

  19. A clinical study of temporomandibular disorder. The value of bone scintigraphy as an aid to diagnosis

    Sugiura, Masashi [Nippon Dental Univ. (Japan). School of Dentistry at Niigata

    2000-07-01

    Temporomandibular disorder (TMD) is still not defined with respect to the point of an entity, terminological problems, and clinical classification and gradings. Moreover, diagnostic problems of internal deranegement and osteodeformity at the temporomandibular joint such as type IV and mechanism of bone remodeling at condylar head are also still not clear. In this investigation, we tried to classify the severity and progressive grading according to the symptoms and objective laboratory data taken from soft tissues such as muscles related to mastication, discs and ligaments, and hard tissues such as condylar head and temporal bone changes around the temporomandibular joint. Preliminary diagnostic clinical tool of the assessment of temporomandibular joint by maens of bone scintigraphy was attributed to the additional diagnostic procedure and research for the bone remodeling for the temporomandibular disorder because this can be defined between subjective and objective symptoms in this disorder. Bone scintigraphy will solve many problems concerning undefined degenerative bone changes in TMD, enable more accurate diagnosis, and the selection of treatment and prognosis in future investigation. Also, it is believed single photon emission computed tomography (SPECT) nuclear bone imaging is a highly accurate diagnostic method for craniomandibular disorders. (author)

  20. Usefulness of bone marrow magnetic resonance imaging and indium-111-chloride bone marrow scintigraphy in patients with various hematological diseases

    This study investigated the ability of magnetic resonance (MR) imaging and indium-111 chloride (In-111) scintigraphy to assess bone marrow in various hematological lesions. The subjects were 7 with aplastic anemia (AA), 4 with myelodysplastic syndrome (MDS), 3 with polycythemia (PC), 3 with essential thrombocythemia (ET), 2 with multiple myeloma (MM), 2 with monoclonal gammopathy of undetermined significance (MGUS), 3 with idiopathic thrombocytopenic purpura (ITP), one with acute lymphocytic leukemia (ALL), and one with secondary anemia due to chronic inflammation (SA). Bone marrow cellularity was assessed on MR images and both uptake and tissue distribution were assessed on In-111 scintigraphy. Hypo-cellularity was seen in all AA patients, but not seen in any other patient in each group. On the other hand, hyper-cellularity was seen in 3 MDS, one PC, all 3 ET, one ALL, and one SA patients. In the group of MM, the vertebral body was seen as heterogenous signal intensity on MR images. Bone marrow was seen as iso-intensity in one MDS, 2 PC, all 2 MGUS, and all 3 ITP patients. In-111 scintigraphy showed decrease or disappearance of tracer uptake and decreased tissue distribution in all 7 AA, one MDS, one PC, and one ALL patients. Increased tracer uptake and enlarged tissue distribution were seen in one MDS, one PC, and one SA patients. One MDS, one ET, all 2 MM, all 2 MGUS, all 3 ITP patients had tracer uptake and tissue distribution that were equal to those in the normal tissues. Since MR imaging and In-111 scintigraphy provided qualitatively different information, the combination of both modalities would contribute to the understanding of bone marrow condition in hematopoietic diseases. (N.K.)

  1. Usefulness of bone marrow magnetic resonance imaging and indium-111-chloride bone marrow scintigraphy in patients with various hematological diseases

    Kobayashi, Yutaka; Umekawa, Tsunekazu; Chikayama, Satoshi [Osaka General Hospital of West Japan Railway Compapy (Japan)] [and others

    1995-03-01

    This study investigated the ability of magnetic resonance (MR) imaging and indium-111 chloride (In-111) scintigraphy to assess bone marrow in various hematological lesions. The subjects were 7 with aplastic anemia (AA), 4 with myelodysplastic syndrome (MDS), 3 with polycythemia (PC), 3 with essential thrombocythemia (ET), 2 with multiple myeloma (MM), 2 with monoclonal gammopathy of undetermined significance (MGUS), 3 with idiopathic thrombocytopenic purpura (ITP), one with acute lymphocytic leukemia (ALL), and one with secondary anemia due to chronic inflammation (SA). Bone marrow cellularity was assessed on MR images and both uptake and tissue distribution were assessed on In-111 scintigraphy. Hypo-cellularity was seen in all AA patients, but not seen in any other patient in each group. On the other hand, hyper-cellularity was seen in 3 MDS, one PC, all 3 ET, one ALL, and one SA patients. In the group of MM, the vertebral body was seen as heterogenous signal intensity on MR images. Bone marrow was seen as iso-intensity in one MDS, 2 PC, all 2 MGUS, and all 3 ITP patients. In-111 scintigraphy showed decrease or disappearance of tracer uptake and decreased tissue distribution in all 7 AA, one MDS, one PC, and one ALL patients. Increased tracer uptake and enlarged tissue distribution were seen in one MDS, one PC, and one SA patients. One MDS, one ET, all 2 MM, all 2 MGUS, all 3 ITP patients had tracer uptake and tissue distribution that were equal to those in the normal tissues. Since MR imaging and In-111 scintigraphy provided qualitatively different information, the combination of both modalities would contribute to the understanding of bone marrow condition in hematopoietic diseases. (N.K.).

  2. Infantile choriocarcinoma: a case report with MRI, angiography and bone scintigraphy

    Infantile and maternal choriocarcinoma is a very rare disease. We report a case with the characteristic clinical features of infantile choriocarcinoma: developing anemia, hemorrhagic liver tumors, rapid progression to death and maternal choriocarcinoma. Bone scintigraphy showed increased uptake by the liver tumors. In this case there were two possible primary sites: the placenta of this pregnancy and a hydatidiform mole that had been present 2 years previously. (orig.). With 1 fig

  3. Infantile choriocarcinoma: a case report with MRI, angiography and bone scintigraphy

    Sashi, R. [Department of Radiology, Akita University School of Medicine, Akita City (Japan); Sato, K. [Department of Radiology, Akita University School of Medicine, Akita City (Japan); Hirano, H. [Department of Radiology, Akita University School of Medicine, Akita City (Japan); Tomura, N. [Department of Radiology, Akita University School of Medicine, Akita City (Japan); Watarai, J. [Department of Radiology, Akita University School of Medicine, Akita City (Japan); Ishida, A. [Department of Pediatrics, Akita University School of Medicine, Akita City (Japan); Morita, M. [Department of Pathology, Akita University School of Medicine, Akita City (Japan)

    1996-12-01

    Infantile and maternal choriocarcinoma is a very rare disease. We report a case with the characteristic clinical features of infantile choriocarcinoma: developing anemia, hemorrhagic liver tumors, rapid progression to death and maternal choriocarcinoma. Bone scintigraphy showed increased uptake by the liver tumors. In this case there were two possible primary sites: the placenta of this pregnancy and a hydatidiform mole that had been present 2 years previously. (orig.). With 1 fig.

  4. Evaluation of perfusion of the femoral head after femoral neck fracture using bone scintigraphy

    We treated 13 patients for femoral neck fracture. They consisted of 2 males and 11 females, and were classified according to Garden stage classification; Stage I, 3 cases; Stage II, 2 cases; Stage III, 2 cases; Stage IV, 4 cases. Two trochanteric fracture cases were used by control. We evaluated perfusion of the femoral head after femoral neck fracture using bone scintigraphy, which is considered useful for evaluation of perfusion of the femoral neck before operation. (author)

  5. Utility of bone scintigraphy in diagnosis of post- traumatic osteitis pubis

    Kalawat, Tek Chand; Narayan, Ravishwar; Ravi, Parthasarathi; Lakshmi, Amancharla Yadagiri

    2013-01-01

    Minor musculoskeletal injuries usually heal within few weeks with conservative treatment, but in pelvic injuries, symptoms may persist for long duration and patient need medical attention to get relief from disturbing pain symptoms. We present a case of post-trauma osteitis pubis in a 58-year-old female, who reported with lower abdominal and left side hip joint pain since 2 months, after an episode of trivial trauma to her pelvis. Technetium-99m methylene diphosphonate bone scintigraphy was p...

  6. A Multilingual Database for Bone Scintigraphy with Concept-Oriented Access Under the World Wide Web

    Baum, Matthias; Bernauer, Jochen; Benneke, Andreas; Fueseschi, Attila; Haake, Thomas; Mennecke, Lars; Urban, Martin; Pretschner, Dietrich-Peter

    1996-01-01

    A multi-lingual data base for bone scintigraphy with instructive patient cases which is accessible under the WWW will be presented. It includes structured case records based on images and clinical information provided in different European languages. In order to support the retrieval of cases clinical information is represented in a language independent way by means of a formalized compositional concept system. This design allows for accessing cases under various clinical aspects and detail u...

  7. Uterine doughnut by intrauterine device-induced photon attenuation on three-phase bone scintigraphy: artifact

    Sohn, Myung Hee; Jeong, Hwan Jeong; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2007-02-15

    A 44-year-old female underwent three-phase bone scintigraphy for an evaluation of right hip joint pain. The blood-flow and blood-pool images show a pelvic blush with a photopenic center (doughnut) prior to bladder filling. On the three hour delayed image, the pelvic uptake disappeared. The scintigraphic findings indicated the possibility of an early pregnancy. However, plain radiography demonstrated an intrauterine device. A uterine doughnut developed as a result of photon attenuation of intrauterine device.

  8. Conventional radiography and bone scintigraphy in the prognostic evaluation of Legg-Calve-Perthes disease

    Purpose: The role of conventional radiography and bone scintigraphy in predicting the outcome of Legg-Calve-Perthes disease was investigated. Material and Methods: The 75 children reviewed (86 hips) were followed up to the primary healing of the disease. The findings at conventional radiography (obtained at presentation, at the time of maximum capital head involvement, and at the end of the healing process of the disease) were compared to early bone scintigraphy features. Results and Conclusion: Bone scintigraphy provided more accurate information concerning the extent of the necrotic process than initial radiographs. Moreover if could determine revascularization and consequently the stage of the disease. The method was, however, unable to predict the outcome of the disease in some of the cases, particularly if it was performed late after the onset of symptoms. Conventional radiography provided important information about other parameters such as 'head-at'risk' signs which facilitated treatment selection. Of thse signs not only lateral subluxation but also metaphyseal changes strongly predispose to severe deformity of the hip joint. (orig.)

  9. Preliminary study on the basic pattern of bone marrow scintigraphy in acute leukemia

    98 cases of acute leukemia had been studied with technetium-99m sulfur colloid bone marrow scintigraphy. The basic pattern was: (1) The generalized depression of central bone marrow (CBM) is most striking and its extent and degree of the depression is closely related with clinical staging of the disease. It was also found that the activity of CBM gradually increased with prolongation of complete remission course. (2) 72.4% cases showed variable degrees of peripheral bone marrow cavity expansion. Most of the peripheral expansion foci are localized in epiphyses of the knee joint, or further extended to cavity of long bone in extremities. In conclusion, bone marrow imaging is helpful to: (1) the diagnosis and evaluation of the distribution of hemapoietic activity in acate leukemia; (2) evaluation of the effect of chemotherapy and judgement of the prognosis; (3) the activity of CBM can probably be also used as an index to judge the clinical situation of the patient

  10. Bone scintigraphy in acute myeloid leukemia patient with fungal vertebral osteomyelitis

    Zekiye Hasbek

    2013-09-01

    Full Text Available The result of the magnetic resonance imaging (MRI study was reported as “metastasis of primary disease on L2-L3 vertebrae” in a 63-year-old male patient, who developed a back pain after receiving four courses of treatment for AML. The patient, who did not respond to pain medication, was sent to nuclear medicine department for a bone scintigraphy. Diffuse increased osteoblastic activity was reported on L2-L3 vertebrae with a suspicion about infection or fracture, together with a focal osteoblastic activity involvement in the right sacroiliac joint in the bone scintigraphy which was made with Tc99m-MDP. In the mean time, the patient complained about progressive loss of strength on bilateral lower extremities and numbness in legs. Repeated MRI was reported as “irregularities in L2-L3 vertebral disc region concordant with infection, prominent thecal pressure, loss of height in L2-L3 vertebrae associated with osteomyelitis and a mass concordant with paravertebral abscess and granulation tissue”. The patient was operated and necrotic tissue was removed by curettage, relieving the compression on L2-L3 and on the disc distance. In culture examination of the sample “candida albicans” was isolated. Antifungal treatment with Amphotericin B was started. Patient's pain was reduced and MRI findings showed some regression in abscess following the treatment. There was improvement in neurological examination. However, relapse in AML was observed in bone marrow aspiration, performed during follow-up and chemotherapy was started again. On the second day of chemotherapy high fever started and cellulitis developed on the right leg. The patient received hemodialysis treatment due to increase in BUN and creatinine levels. Pulmonary edema and associated respiratory insufficiency was developed and the patient died. Fungal infections are one of the most important clinical problems in leukemia patients. However, vertebral osteomyelitis secondary to fungal

  11. Comparison of bone scintigraphy and radiography in multiple myeloma

    Radionuclide images and skeletal radiographs of 51 patients with multiple myeloma were compared to assess the sensitivity of scintigraphy in detecting radiographically evident disease. Comparable studies were available for 562 sites. The radionuclide image was relatively insensitive in detecting myeloma; it failed to show radiographically evident disease or underestimated its extent at 27% of the sites. On a limited number of serial images there were 7 sites at which a scintigraphic abnormality preceded the radiographic abnormality. No definite correlation was found between scintigraphic findings and hematologic parameters of myeloma activity. Although the radionuclide image may demonstrate a few sites of myeloma before the radiograph, radiography remains the primary method of evaluating skeletal involvement by myeloma

  12. The value of bone scintigraphy in diagnosing of langerhans cells histiocytosis

    Purpose: To investigate the clinical value of bone scintigraphy in the diagnosis of Langerhans cells histiocytosis (LCH). Methods: Whole-body bone scintigraphy was performed in 23 patients, 16 males and 7 females, average age was 4.5+1.4, with histologic diagnosis of LCH. The clinical presentation varied from local mass (10 cases), tenderness (12 cases), othemorrhea (1 case), limb fatigue (3 cases), restriction of spinal activity (2 cases) to irregular fever, cough and rash (4 cases). 99Tcm-MDP was injected intravenously , the dose modified as age, according to the formula of [ adult dosage x [(age+l)/(age+7)] ] , and sedation was given to the young children who could not cooperate well. After 3 hours of administration whole-body bone scan was performed. Images were acquired using GE Millennium SPR, with a high-resolution low-energy collimator, 8 min/m sweep speed, matrix 1024 x 256, zoom 1. Results: 19 of 23 patients (82.6%) showed positive in their bone scan. 8 cases with cranial abnormal uptake, some of them exhibited peripheral high and central low uptake; clavicle, rib and pelvis involvements were 3 respectively; 2 cases in upper limb, 4 in lower limb, most lesions of limb were located in the diaphysis; spinal abnormal uptakes were seen in 5 patients, and 1 child had photon deficient area in the lower of sternium. Among 19 positive scintigram, single bone lesion was shown in 9 patients (47.3%), the most common lesion located in cranium (5 cases). Conclusion: Some characters of bone scintigraphy in LCH are useful in the diagnosis of this disease, and accompanied with comprehensive sensation of clinical manifestation of LCH, the diagnostic accuracy will be promoted. (authors)

  13. Technetium bone scintigraphy in the diagnosis of osteomyelitis in children

    In a 5 1/2-year retrospective study of hospitalized children with osteomyelitis who had technetium bone scans, we found that 32 of 38 (84%) had increased radionuclide uptake, 4 (11%) had normal uptake and 2 (5%) had decreased uptake. The two patients with decreased uptake had a stormy course with extensive bone destruction and pathologic fractures in spite of prolonged courses of antibiotic therapy. Decreased uptake on bone scan in patients with clinical evidence of osteomyelitis could indicate a poor prognosis and early surgical drainage is indicated in order to decrease morbidity

  14. Fibrous dysplasia mimicking bone metastasis on both bone scintigraphy and 18F FDG PET CT: Diagnostic dilemma in a patient with breast cancer

    Bone is the most common distant site to which breast cancer metastasizes. Commonly used imaging modalities for imaging bone metastasis are bone scintigraphy, plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). Although bone scintigraphy gas high sensitivity for detecting bone metastasis, its specificity is low. This is because of the fact that bone scintigraphy images secondary changes in bone rather than just tumor cells 18F fluorodeoxyglucose (18F FDG) PET CT, on the other hand, directly images the tumor cells' glucose metabolism. Unfortunately, similar to bone scintigraphy, benign bone conditions can also show increased 18F FDG uptake on PET CT, and PET positive asymptomatic fibrous dysplasia can be misinterpreted as a metastasis. Fibrous dysplasia of bone has wide skeletal distribution, with variability of 18F FDG uptake and CT appearance. It is therefore important to recognize the characteristics of this skeletal dysplasia, to allow differentiation from skeletal metastasis. Bone lesions with 18F FDG uptake need to be carefully interpreted when evaluating patients with known malignancy. In doubtful cases, fibrous dysplasia should be given as a differential diagnosis and histopathological diagnosis may be warranted, as highlighted in the present case

  15. Fibrous dysplasia mimicking bone metastasis on both bone scintigraphy and {sup 18}F FDG PET CT: Diagnostic dilemma in a patient with breast cancer

    KC, Sud Hir Suman; Sharma, Punit; Singh, Har Man Deep; Bal, Chand Rasekhar; Kumar, Rake Sh [India Institute of Medical Sciences, New Delhi (India)

    2012-12-15

    Bone is the most common distant site to which breast cancer metastasizes. Commonly used imaging modalities for imaging bone metastasis are bone scintigraphy, plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). Although bone scintigraphy gas high sensitivity for detecting bone metastasis, its specificity is low. This is because of the fact that bone scintigraphy images secondary changes in bone rather than just tumor cells {sup 18}F fluorodeoxyglucose ({sup 18}F FDG) PET CT, on the other hand, directly images the tumor cells' glucose metabolism. Unfortunately, similar to bone scintigraphy, benign bone conditions can also show increased {sup 18}F FDG uptake on PET CT, and PET positive asymptomatic fibrous dysplasia can be misinterpreted as a metastasis. Fibrous dysplasia of bone has wide skeletal distribution, with variability of {sup 18}F FDG uptake and CT appearance. It is therefore important to recognize the characteristics of this skeletal dysplasia, to allow differentiation from skeletal metastasis. Bone lesions with {sup 18}F FDG uptake need to be carefully interpreted when evaluating patients with known malignancy. In doubtful cases, fibrous dysplasia should be given as a differential diagnosis and histopathological diagnosis may be warranted, as highlighted in the present case.

  16. Sacroiliac Indicis Increase the Specificity of Bone Scintigraphy in the Diagnosis of Sacroiliitis

    Zehra Pınar Koç

    2015-02-01

    Full Text Available Objective: Bone scintigraphy is a highly sensitive method in the evaluation of sacroiliitis. Aim of this study is firstly to evaluate interobserver variation of partial and whole sacroiliac indicis, secondly investigation of clinical importance of these indicis in the diagnosis of sacroiliitis. Methods: Fourty-six subjects (24 female: 35.4±11.9; 22 male: 43.1±12.4 without sacroiliitis 45 subjects with low back pain (33 female: 43.3±11.5, 11 male: 35.5±17.2 were included in the study. For right (R and left (L whole indices (WSI irregular region of interest (ROI, for partial indices superior (S and inferior (I rectangular ROI were used. For background activity, rectangular ROI was drawn from the sacral region. Indices were calculated from ratio of average counts of sacroiliac and background regions. Two independent observers calculated sacroiliac indices. Interobserver agreement was evaluated by Pearson analysis. Results: There was no significant interobserver difference (p>0.05. Significant correlation existed between all calculated indices. Among 45 patients with suspicion of sacroiliitis 15 had final diagnosis of sacroiliitis and all of the Tc-99m methilenediphosphonate planar and SPECT bone scintigraphy results of these patients were concordant with sacroiliitis. There were 8 false positive results in other 30 patients. Seven of these eight patients had normal index values. If the scintigraphy would be evaluated in conjuction with indicis the specificity would increase from 73% to 97% but sensitivity decreases from 100% to 80%. There was significant correlation between the observers calculated indicis (p<0.001. Conclusion: Superior and inferior sacroiliac index values can be used with confidence. If we use sacroiliac index values to confirm positive results; index values can increase the specificity of bone scintigraphy.

  17. Bone Scintigraphy and CT Findings in Transverse Process Apophysitis.

    Dua, Sumeet G; Ali, Amjad

    2016-07-01

    A 14-year-old avid gymnast presented with recent onset of increasing lower thoracic back pain. Clinical examination revealed point tenderness at about T10 level. Focal uptake was seen to the left of the midline on a bone scan ordered to exclude stress fracture. Spine CT when read in conjunction with the bone scan revealed apophysitis of the transverse process. Apophysitis of the posterior elements of the vertebrae is a rare cause of back pain in adolescents. PMID:26914575

  18. The features of HPOA on dynamic bone scintigraphy: A reflection of underlying pathophysiology

    Full text: Hypertrophic pulmonary osteoarthropathy (HPOA) is the clinical syndrome of clubbing, arthritis and periostitis which may accompany a spectrum of underlying disease processes. Increased blood flow through involved extremities is an invariable accompaniment of the syndrome and it is hypothesised that the chronic increase in peripheral blood flow results in the known pathological changes of periosteal inflammation and proliferation, oedema, synovial congestion and exudation and hyperplasia of the finger pulp. The dynamic and blood pool phases of bone scintigraphy provide a unique tool for examining the vascular changes in bone and soft tissues and we describe the previously unreported features of the dynamic bone scan in HPOA. We performed three-phase bone scans on two adolescent patients with cystic fibrosis with knee discomfort. Both studies showed marked hyperaemia to the knees. On the blood pool phase, hyperaemia was seen to the tissues closely related to the periosteum of the long bones in upper and lower limbs, periarticular tissues and finger pulps. The delayed images showed the classic features of HPOA with linear uptake of tracer in the shafts and metaphyseal regions of the long bones and minor periarticular uptake of tracer. A WBC scan performed in one patient showed WBC accumulation in the periosteum of the metaphyseal regions, extending in the shafts, of the distal femurs and proximal tibias. Negligible WBC accumulation was seen in the synovium of the knees reflecting the non-inflammatory nature of the articular changes as is described in most patients with HPOA. In conclusion, the dynamic phases of the bone scan examination in HPOA reflect the pivotal underlying pathophysiological process of abnormally increased blood flow to the periosteal and periarticular tissues of involved long bones and finger pulps and further expands the known diagnostic features of this disease on bone scintigraphy

  19. The features of HPOA on dynamic bone scintigraphy: A reflection of underlying pathophysiology

    Bernard, E.J.; Howman-Giles, R.; Macauley, D.I.; Uren, R.F. [Royal Alexander Hospital for Children, Sydney, NSW (Australia)

    1998-03-01

    Full text: Hypertrophic pulmonary osteoarthropathy (HPOA) is the clinical syndrome of clubbing, arthritis and periostitis which may accompany a spectrum of underlying disease processes. Increased blood flow through involved extremities is an invariable accompaniment of the syndrome and it is hypothesised that the chronic increase in peripheral blood flow results in the known pathological changes of periosteal inflammation and proliferation, oedema, synovial congestion and exudation and hyperplasia of the finger pulp. The dynamic and blood pool phases of bone scintigraphy provide a unique tool for examining the vascular changes in bone and soft tissues and we describe the previously unreported features of the dynamic bone scan in HPOA. We performed three-phase bone scans on two adolescent patients with cystic fibrosis with knee discomfort. Both studies showed marked hyperaemia to the knees. On the blood pool phase, hyperaemia was seen to the tissues closely related to the periosteum of the long bones in upper and lower limbs, periarticular tissues and finger pulps. The delayed images showed the classic features of HPOA with linear uptake of tracer in the shafts and metaphyseal regions of the long bones and minor periarticular uptake of tracer. A WBC scan performed in one patient showed WBC accumulation in the periosteum of the metaphyseal regions, extending in the shafts, of the distal femurs and proximal tibias. Negligible WBC accumulation was seen in the synovium of the knees reflecting the non-inflammatory nature of the articular changes as is described in most patients with HPOA. In conclusion, the dynamic phases of the bone scan examination in HPOA reflect the pivotal underlying pathophysiological process of abnormally increased blood flow to the periosteal and periarticular tissues of involved long bones and finger pulps and further expands the known diagnostic features of this disease on bone scintigraphy.

  20. Bone scintigraphy for the investigation of lameness in small animals; Einsatz der Skelettszintigrafie in der Lahmheitsdiagnostik beim Kleintier

    Bolln, G.; Franke, C. [Tieraerztliche Klinik fuer Kleintiere, Norderstedt (Germany)

    2010-03-15

    Bone scintigraphy has been used as a helpful method in diagnosing lameness in small animals. It is a sensitive, non-invasive method to evaluate bone lesions and orthopaedic disorders. It provides a functional image of the skeleton and thereby aiding in the localisation and diagnosing of obscure lameness. Compared to human medicine one important difference is the inability of an animal to characterize its pain to the examiner. Another difference is the lacking cooperation of an animal during bone scintigraphy. Before this background are shown on the basis of 5 examples the advantages, the method and the different indication of bone scintigraphy. The technique of this method arrives from a human medicine protocol of a 2-phase-bone-scintigraphy and has to be done under light anaesthesia, to avoid artefacts of movement during acquisitions. The authors are convinced that bone scintigraphy is a very useful and diagnostic method for evaluation of obscure lameness because it can give a quick diagnosis and aimed therapy. Therefore secondary changes and additional costs can be avoided for the animal and its owner. (orig.)

  1. Different findings in bone scintigraphy between ulnar impaction syndrome and Kienbock's disease

    Objectives: There is an ethnic variance on the length of the ulnar and radius. In Caucasian the length of the radius is relatively longer than the ulnar, but in Oriental the length of the ulnar is longer. This difference results in the different ethnic prevalence of ulnar impaction syndrome and Kienbock's disease, avascular necrosis of the lunate. It is important to differentiate ulnar impaction syndrome from Kienbock's disease, because they show similar symptoms but need different treatment and different method of operation. Methods: Seventeen patients with the wrist pain were enrolled in this study (mean age: 45+/-13yrs M:F=12:5). Nine patients were diagnosed as Kienbock's disease and Eight patients were diagnosed as ulnar impaction. Three to four hours after injection of 20mCi of Tc-99m MDP, bone scintigraphy images of the both hands were obtained and analyzed visually. Results: In Kienbock's disease, 8 patients showed increased uptake in the lunate with or without other carpal bones. One patient showed photon defect in the lunate. Otherwise in all patients with ulnar impaction syndrome, increased uptakes were found in the lunate, with or without increase uptake in the triquetrum or the distal ulnar, which are related to triangular fibrocartilage complex. Pin hole scintigraphy and pin hole SPECT demonstrated more precise structure of the wrist. Conclusion: We could differentiate ulnar impaction syndrome from Kienbock's disease in bone scan. We should carefully evaluate bone scintigraphic findings in patients with wrist pain

  2. Bone scintigraphy screening for osteonecrosis of the shoulder in patients with non-traumatic osteonecrosis of the femoral head

    In patients with non-traumatic osteonecrosis of the femoral head (ONFH), the shoulder is one of the major affected sites secondary to the proximal and distal femur in cases of multiple osteonecrosis. The present study attempted to investigate whether technetium bone scintigraphy is useful for screening of non-traumatic osteonecrosis of the shoulder (ONS).Design and patients. A total of 170 shoulder joints in 85 patients with ONFH were evaluated by bone scintigraphy and the findings compared with those of magnetic resonance imaging (MRI). The MR diagnosis was used as the gold standard.Results. Based on the diagnosis by MRI, ONS was detected in 43 shoulders of 27 patients (25%). All necrotic lesions were located in the humeral head. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of bone scintigraphy for ONS detection were 65%, 81%, 77%, 54% and 87%, respectively. When the necrotic angle of the lesions on the mid-coronal MRI was more than 40 , the sensitivity of bone scintigraphy for ONS detection increased to 88% (21/24 shoulders).Conclusion. Bone scintigraphy may be useful for demonstrating medium or large ONS lesions on screening of patients with ONFH. (orig.)

  3. The Agreement Between Blood Pool - Delayed Bone Scintigraphy and Tc-99m Human Immunoglobulin G (HIG Scintigraphy in the Determination of the Presence and Severity of Inflammatory Arthritis

    Gulizar Kacar

    2011-08-01

    Full Text Available Objective: In this study, it was aimed to investigate the agreement between early phase of bone scintigraphy – human immunoglobulin scintigraphy (EPBS-HIG and late phase bone scintigraphy – HIG (LPBS-HIG in the determination of the presence and also the severity of inflammatory arthritis. Material and Methods: Twenty-eight patients (23 female, 5 male; between 19 to 80 years of age with inflammatory arthritis were included in the study. Tc-99m HIG and blood pool/late phase bone scintigraphies were performed in all patients. In scintigraphic examinations, the joints were scored with the degree of accumulation of the radiopharmaceutical by the semiquantitative analysis (0=Background activity, 1=Faint uptake, 2=Moderate uptake, 3=Marked uptake which is called as visually active joint score as severity index of the disease. To estimate the agreement between EPBS – HIG and LPBS - HIG in the determination of the presence and severity of inflammatory arthritis, 2x2 kappa coefficients were calculated. Results: Our results showed good agreement between EPBS - HIG for the presence of inflammation (kappa: 0.72 but not for the severity of the disease (kappa: 0.29, poor agreement between LPBS - HIG for both the presence (kappa: 0.51 and severity (kappa: 0.01 of inflammatory arthritis. Conclusion: The blood pool scintigraphy could be used in the investigation of the presence of inflammatory arthritis because the good agreement with HIG and the lower cost but not for the severity of the disease. (MIRT 2011;20:45-51

  4. Study on renal osteodystrophy using 2-compartment model analysis of bone scintigraphy, 1

    The dynamic analyses of bone scintigraphy were performed in 30 cases of hemodialysed patients. The regression analyses between biochemical data or duration and K indexes obtained from the 2-compartment model analysis in the maxillofacial region were carried out. The obtained results were as follows. The duration and K indexes were significantly correlated with 1 or 2% of significance level in the parietal bone and the zygomatic bone. Serum Ca K indexes were highly correlated in every settled ROI. The correlation coefficients were distributed from 0.58 to 0.79. In the cranial bone the correlation were more higher than in maxilla and mandibular bone. Serum ALP and K indexes have more higher significant level of correlation than the results of Ca. The correlation coefficients were distributed from 0.48 to 0.83. The level of significance were changed by location. The highest correlation coefficient was 0.83 in the parietal bone. Serum C-PTH and K indexes have significant correlation in every settled ROI with the correlation coefficient from 0.59 to 0.69. The significance level were nearly equal in every location. In the case of subtotal parathyroidoectomy the K indexes which were abnormally high in preoperation showed the tendancy to decrease toward normal range in postoperation. These results indicated that K indexes reflected the bone change caused by renal osteodystrophy. And the K indexes considered to be useful to estimate the bone improvement. (author)

  5. Biologic evaluation of radiocolloids for bone marrow scintigraphy

    The validity of a primate animal model for studying the in vivo distribution of various colloids was established. Computerized images from two adult baboons injected with technetium-99m labeled sulfur colloid, stannous phytate and microaggregated albumin were analyzed to give the relative uptake of radioactivity in the liver, spleen and bone marrow. These values were in good agreement with those previously established in several animal species and in man. Antimony sulfide colloid and minimicroaggregated albumin, each having a significantly smaller particle size than Tc-99m sulfur colloid were evaluated. Compared with sulfur colloid the minimicroaggregated albumin showed three times the bone marrow uptake (15 to 20%) whereas microaggregated albumin and antimony sulfide gave somewhat lower values (8 to 12%). The stannous phytate showed no improvement over Tc-99m sulfur colloid

  6. Radiography and bone scintigraphy in multiple myeloma: a comparative analysis

    The sensitivity of radionuclide imaging for detecting skeletal lesions was compared with that of radiography by evaluating 573 different anatomical sites in 41 patients with multiple myeloma. Radiography revealed a significantly greater number of myeloma-related bone lesions than did radionuclide imaging. Of the 179 myeloma-related bone lesions detected when both techniques were applied, 163 were seen by radiography and 82 by radionuclide imaging. Ninety-seven lesions were detected by radiography alone and 16 lesions seen by scintiscanning only, yielding a sensitivity of 91% for the former and of 46% for the latter technique. Radionuclide imaging proved superior to radiography only occasionally in the rib cage, and rarely in other anatomical sites. These findings suggest that radiography is the method of first choice in obtaining a skeletal survey in patients with multiple myeloma. In cases with continued pain, unexplained by standard radiography, the skeletal survey should be supplemented by tomography and radionuclide imaging. (author)

  7. Can bone scintigraphy predict the final outcome of pasteurized autografts?

    Eid, Ahmed Shawky [Ain Shams University, Department of Orthopedic Surgery, Cairo (Egypt); Jeon, Dae-Geun; Cho, Wan Hyeong [Korea Cancer Center Hospital, Department of Orthopedic Surgery, Seoul (Korea)

    2010-10-15

    As pasteurization is becoming more widely used in limb salvage reconstruction, more study is required to understand about host-graft junction healing, graft revascularization and incorporation, and the incidence and type of complications among pasteurized autografts. This was mainly achieved by follow-up radiography. We aimed to clarify whether Tc99m bone scanning can be considered a reliable method in determining these three parameters. Twenty-seven osteosarcoma patients with pasteurized autograft reconstructions were retrospectively reviewed using available scintigraphic and radiographic follow-up every 6 months postoperatively for 36 months. Follow-up of the unhealed cases was continued for the maximum follow-up period available for each case beyond the original study period, ranging from 1 to 15 months. Tc99m uptake was classified as cold, faint, moderate and high uptake. Junction healing was classified as none, partial and complete healing. Seventy percent of junctions united with a mean of 22 months. Ninety to 100% of junctions showed increased uptake (high or moderate) at one time of the study regardless of final outcome. 85% of the pasteurized grafts showed the characteristic ''tramline appearance''. Four grafts (15%) were complicated: pseudoarthrosis and implant failure (1), fractured plate (1), intramedullary nail (IMN) fracture (1), and prosthesis stem loosening in the host bone (1), with underlying unhealed junctions in all cases. Bone scanning can determine the stages of the graft's rim revascularization and incorporation; however, it cannot detect or predict junction healing or occurrence of complications. Supplementary treatment of unhealed junctions showing either decreased junctional uptake or graft quiescence may be warranted. Otherwise, detection of distant metastasis and early local recurrence remains the main application of Tc99m scanning in the management of bone sarcomas. (orig.)

  8. Two-Dimensional Image Fusion of Planar Bone Scintigraphy and Radiographs in Patients with Clinical Scaphoid Fracture: An Imaging Study

    Henriksen, O.M.; Lonsdale, M.N.; Jensen, T.D.;

    2008-01-01

    experienced nuclear medicine physicians. In addition to the diagnosis, the degree of diagnostic confidence was scored in each case. Results: The addition of fusion images changed the interpretation of each of the three observers in seven, four, and two cases, respectively, reducing the number of positive....... Bone scintigraphy is highly sensitive for the detection of fractures, but exact localization of scintigraphic lesions may be difficult and can negatively affect diagnostic accuracy. Purpose: To investigate the influence of image fusion of planar bone scintigraphy and radiographs on image interpretation...... in patients with suspected scaphoid fracture. Material and Methods: In 24 consecutive patients with suspected scaphoid fracture, a standard planar bone scintigraphy of both hands was supplemented with fusion imaging of the injured wrist. Standard and fusion images were evaluated independently by three...

  9. Two-dimensional fusion imaging of planar bone scintigraphy and radiographs in patients with clinical scaphoid fracture: an imaging study

    Henriksen, Otto Mølby; Lonsdale, Markus Georg; Jensen, T D;

    2009-01-01

    experienced nuclear medicine physicians. In addition to the diagnosis, the degree of diagnostic confidence was scored in each case. RESULTS: The addition of fusion images changed the interpretation of each of the three observers in seven, four, and two cases, respectively, reducing the number of positive....... Bone scintigraphy is highly sensitive for the detection of fractures, but exact localization of scintigraphic lesions may be difficult and can negatively affect diagnostic accuracy. PURPOSE: To investigate the influence of image fusion of planar bone scintigraphy and radiographs on image interpretation...... in patients with suspected scaphoid fracture. MATERIAL AND METHODS: In 24 consecutive patients with suspected scaphoid fracture, a standard planar bone scintigraphy of both hands was supplemented with fusion imaging of the injured wrist. Standard and fusion images were evaluated independently by three...

  10. Technetium 99m pyrophosphate bone scintigraphy in the exploration of breast cancer bone metastases (analysis of 311 examinations)

    Sodium pyrophosphate was chosen for its ease of application and the quality of the images it gives. The aim of this study, in the context of breast cancer exploration, is to examine: - its reliability for the detection of bone metastases, - the correlation of its results with other factors. The first part reviews the properties of sup(99m)Tc-labelled sodium pyrophosphate and the current hypotheses on the mechanism of its bone fixation, essential for an understanding of the image formation mechanism and for the interpretation of anomalies. Part two gives an analysis of 311 examinations carried out on 223 patients, obtained by the use of a coded file and modern data processing methods. The following are dealt with in turn: - material and methods, - the results themselves and especially their reliability for the whole skeleton and for one bone at a time, - discussion and comparison with published data. Sup(99m)Tc pyrophosphate bone scintigraphy is a simple examination easy to interpret and allows the whole skeleton to be explored. Abnormal scintigraphic images are: - seldom hypofixing lacunae, - usually 'hyperfixing centres' which point to a perilesional bone reaction and depend on: vascular factors, the affinity of technetium for the immature collagen fibres of the forming bone matrix, the affinity of pyrophosphate for the bone mineral substance

  11. A comparison of standard radiological examinations, computed tomography, scintigraphy and angiography in the recidivistic diagnostic of bone tumors

    In a retrospective study the diagnostic efficiency of standard radiography, computed tomography (CT), bone scintigraphy and angiography in the diagnosis of tumor recidivism was studied using 54 patients with an operatively treated bone tumor. The highest diagnostic sensitivity (100%) was achieved with the help of CT. For the determination or exclusion of a recidivistic bone tumor, the diagnostic strength of the individual procedures lies in their combinations, but these combinations should be made on the basis of the tumor type and disease. (MBC)

  12. Utility of bone scintigraphy in diagnosis of post- traumatic osteitis pubis

    Minor musculoskeletal injuries usually heal within few weeks with conservative treatment, but in pelvic injuries, symptoms may persist for long duration and patient need medical attention to get relief from disturbing pain symptoms. We present a case of post-trauma osteitis pubis in a 58-year-old female, who reported with lower abdominal and left side hip joint pain since 2 months, after an episode of trivial trauma to her pelvis. Technetium-99m methylene diphosphonate bone scintigraphy was performed, which confirmed the site of injury in symphysis pubis and left hip joint, by increased radiotracer localization at both of these symptomatic sites

  13. Metastatic superscan on 99mTc-methylene diphosphonate bone scintigraphy in pediatric neuroblastoma

    Excessive skeletal radioisotope uptake in relation to soft tissues along with absent or faint activity in the genitourinary tract on bone scintigraphy (BS) is known as a “superscan.” However the association of pediatric solid tumor malignancy with metastatic superscan has not been reported previously. We here describe two such cases of neuroblastoma who presented with metastatic superscan on 99mTc-methylene diphosphonate BS. Presence of a superscan usually indicates an advanced stage of the disease. The patient prognosis is usually poor. Though extremely rare superscan can be associated with pediatric solid tumor malignancies and should be kept in mind while reporting such cases

  14. Tc-MDP bone scintigraphy in a case with sporodical tumoral calcinosis

    Tumoral calcinosis is an uncommon and benign condition characterized by the presence of large calcific soft tissue deposits occurring predominantly in a periarticular location. It generally occurs as a complication of renal dialysis or trauma, and is rarely seen in familial and sporadic cases. Bone scintigraphy is a sensitive method for diagnosing tumoral calcinosis. A 28-year-old female patient with a history of operation due to tumoral calcinosis located bilateral hips, referred to our department. She had a tender palpable mass in the right knee and a fistulized incisional scar overlying the bilateral hip joints. A sporadic case of tumoral calcinosis with relapses was presented. (author)

  15. Usefulness of bone scintigraphy with HMDP 99mTc in one case of atypical tuberculosis

    We present a case of atypical osseous tuberculosis mimicking multiple secondary metastases on radiological and nuclear imaging. A multi-bacterial spondylitis of Ti was first diagnosed on a 56 year-old patient presenting with dorsal pain and neurological deficit of the left arm (fine needle aspiration was negative for Mycobacterium tuberculosis). Whole-body bone scintigraphy identified additional sites, including an asymptomatic sacroiliac lesion, which was accessible to biopsy that gave the final diagnosis of osseous tuberculosis. We propose, in the discussion, a practical review of imaging patterns in cases of typical or atypical osseous tuberculosis. (author)

  16. Utility of bone scintigraphy in diagnosis of post- traumatic osteitis pubis.

    Kalawat, Tek Chand; Narayan, Ravishwar; Ravi, Parthasarathi; Lakshmi, Amancharla Yadagiri

    2013-04-01

    Minor musculoskeletal injuries usually heal within few weeks with conservative treatment, but in pelvic injuries, symptoms may persist for long duration and patient need medical attention to get relief from disturbing pain symptoms. We present a case of post-trauma osteitis pubis in a 58-year-old female, who reported with lower abdominal and left side hip joint pain since 2 months, after an episode of trivial trauma to her pelvis. Technetium-99m methylene diphosphonate bone scintigraphy was performed, which confirmed the site of injury in symphysis pubis and left hip joint, by increased radiotracer localization at both of these symptomatic sites. PMID:24163517

  17. Bone scintigraphy, radiography and MRI in the diagnosis and evaluation of treatment response of calcaneal tuberculosis

    Aim: We describe the role of various imaging modalities in the diagnosis and follow up of calcaneal tuberculosis. Materials and methods: Six patients (5 males, 1 female; age range 16-49 years) presented with heel pain. All patients underwent routine laboratory and radiological investigations e.g. radiographs, MRI and skeletal scintigraphy as part of initial diagnostic work-up. In all patients the diagnosis of tuberculosis was confirmed based on histopathology or culture. Standard multi-drug anti-tubercular therapy (ATT) was administered for 15 months. All patients were subsequently followed up with clinical evaluation, laboratory investigations and imaging. Skeletal scintigraphy, MRI and radiographs were repeated at 12 to 15 months from the initiation of anti-tubercular treatment in all patients. Results: Five out of six patients had lytic lesions at presentation on radiographs. Four of these 5 patients also had surrounding sclerosis. Follow-up radiographs obtained 12-15 months after starting ATT, showed an increase in surrounding sclerosis with progressive reduction in area of osteopenia in four and mild sclerotic changes in one. In the remaining one patient radiograph were normal both at presentation and follow up. Three phase bone scintigraphy revealed increased blood flow and blood pool activity and 'hot spots' in 5 and a central photopenic area in the calcaneum in one patient at the time of diagnosis. After starting ATT, significant reduction in vascularity and reactive bone changes in 5 patients and mild improvement in one patient. MRI was done in three patients, which revealed hyperintense lesion with erosion of the superior articular surface in 2 and 'Bull's eye' lesion with a hypointense centre and a surrounding hyperintense rim on post contrast T1W images in one patient. Follow-up MRI showed intermediate signal intensity on T2 weighted images that corresponded to caseous necrosis and high signal intensity related to granulomas or effusion. Conclusion

  18. Vascular calcification of the lower extremities demonstrated by Tc-99m MDP bone scintigraphy in a patient with diabetes mellitus

    Lim, Seok Tae; Sohn, Myung Hee [Chonbuk National University Medical School, Chonju, l (Korea, Republic of)

    2001-06-01

    The femoral vessels are sometimes visualized on bone scintigraphy. This is almost always caused by calcification of the femoral artery associated with atherosclerotic changes of the arterial wall. Vascular calcification is frequently seen in the elderly and in diabetics. A 78 year old woman was admitted for non-insulin dependent diabetes mellitus. In this patient with diabetes mellitus, tibial arteries as well as femoral arteries were visualized onTc-99m MDP bone scintigraphy in contrast with visualization of femoral artery alone observed in the elderly.

  19. Three-Phase 99mTc MDP Bone Scintigraphy and SPECT-CT in Sinus Tarsi Syndrome.

    Usmani, Sharjeel; Abu Al Huda, Fawaz; Al Kandari, Farida

    2016-04-01

    Sinus tarsi syndrome is a pain in the lateral side of the hind foot that is responsive to injection of local anesthetic agents. We report a case of a 42-year-old man who presented with pain over the lateral aspect of the right foot. Laboratory investigations and x-ray were normal. Bone scintigraphy showed hyperemia and increase tracer uptake in right hind foot. SPECT-CT localizes this uptake at the inferior aspect of the talus and superior aspects of the calcaneus. Diagnosis of sinus tarsi syndrome was made on the basis of history, clinical examination, and bone scintigraphy findings. Local conservative therapy was initiated. PMID:26673237

  20. Vascular calcification of the lower extremities demonstrated by Tc-99m MDP bone scintigraphy in a patient with diabetes mellitus

    The femoral vessels are sometimes visualized on bone scintigraphy. This is almost always caused by calcification of the femoral artery associated with atherosclerotic changes of the arterial wall. Vascular calcification is frequently seen in the elderly and in diabetics. A 78 year old woman was admitted for non-insulin dependent diabetes mellitus. In this patient with diabetes mellitus, tibial arteries as well as femoral arteries were visualized onTc-99m MDP bone scintigraphy in contrast with visualization of femoral artery alone observed in the elderly

  1. Bone marrow scintigraphy using 111Indium chloride in patients with aplastic anemia

    Bone marrow scintigraphy using 111Indium chloride (111In-chloride) was performed in 18 patients with aplastic anemia. The scintigrams were taken 48 hours after an intravenous injection of 111In-chloride 3 mCi. The distribution patterns on scintigram were classified into 5 types: Type I (4 cases) showed no accumulation, Type II (6 cases) showed low accumulation in usual bone marrow sites. Type III (7 cases) showed island-like distribution in bone marrow sites. Type IV, although no case was included in the 18 patients, shows uneven distribution between pelvis and sternum or vertebrae. Type V (one case) showed almost normal accumulation in usual bone marrow sites. Bone marrow uptake of 111In-chloride correlated well with the cellularity of bone marrow. There was a tendency for the cases of markedly increased saturated iron-binding capacity to show increased renal activity. In type III, both the percentage of cases who had been treated and the count of reticulocytes were higher than those in the other types, which suggested that island-like distribution on scintigram showed the regeneration responded to the therapy, and related to the erythropoietic function. (author)

  2. The role of bone scintigraphy in determining the etiology of heel pain

    In this study we aimed to determine the role of bone scintigraphy as an objective diagnostic method in patients with heel pain. Sixty-seven heels of 50 of 182 patients with defined features who attended the orthopedics outpatient clinic with heel pain over a 3-year period, were treated with combined methods such as nonsteroidal anti-inflammatory drugs (NSAID) and contrast baths, stretching exercises and changing of footwear habits. A one year follow-up was established. The criteria identified by Wolgin et al. were used in assessing the results of the treatment. Subcalcaneal spur was demonstrated by radiography in 44 of the 67 heels. There were two different imaging patterns observed on three phase bone scintigraphy. Type I imaging pattern: Focal increased activity in the heel region or normal activity on dynamic and the blood pool phases and focal increased activity at the inferior calcaneal surface in the late static phase. Type II imaging pattern: Diffuse increased activity along the plantar fascia in the dynamic and the blood pool phase, and focal increased activity at the inferior calcaneal surface in the late static phase. There were 34 (50.7%) type I and 18 (26.8%) type II imaging patterns on the scans. Type I and type II imaging patterns were described as osseous and fascial respectively. At the final examination, the results for pattern type I were good in 16 patients (66.7%), fair in 6 patients (25%) and poor in 2 patients (8.3%), whereas in pattern type II results were good in 12 patients (80%) and fair in 3 patients (20%). The recurrence frequency was 4.1% and 6.6%, respectively. Subcalcaneal spur was determined in 70.5% of the patients with osseous pathology and 55.5% of the patients with fascial pathology. Based on this result, it can be ascertained that calcaneal spurs develop during the pathological process causing heel pain. Other findings supporting this claim were the differences in symptom periods of the patients with type I and type II imaging

  3. The role of the bone scintigraphy in 3 phases in knee algodystrophy

    Full text: The neuro-algodystrophy appears, classically, as a syndrome of diffuse pain in a member, frequently with a burn symptom and as a consequence of a noxious impulse or lesion, without major nervous attaining and associated to variable trophic, autonomic, motor and sensitive alterations. The authors present 3 cases of neuro-algodystrophy after surgery of the anterior crossed ligament, detected 3 to 10 months later, during the evolution period. They intend to detach the following points: scarce in the literature on the neuro-algodystrophy after-surgery of the anterior crossed ligament; diagnosis difficulty by frequent lack of major clinic criterion on this pathology. The objective of this work is demonstrate the image acuity and the importance of the bone scintigraphy in 3 phases with technetium-99m MDP (methylenediphosphonate) in the ratification of the clinic suspect of neuro-algodystrophy of the knee and in the control of the disease evolution and therapy efficiency, as well. Conclusions: Relevant role of the bone scintigraphy in 3 phases with technetium-99m MDP (methylene diphosphonate) in the neuro-algodystrophy diagnosis and follow-up and importance of a therapeutic program suitability

  4. Defects of uptake on bone scintigraphy in two patients with lung cancer

    Defects of fixation can be observed on bone scintigraphy of the thorax in patients with lung cancer. One extensive form is reported in one case of Pancoast -Tobias syndrome with a complete disappearance of 3 ribs and 2 hemivertebrae due to tumoral invasion which was evident on CT scan. In the second case, a solitary defect was discovered in the right median part of the sternum, adjacent to the tumor, while the CT scan did not show any abnormality of the sternum. This observation raises the question of the mechanism of some cold lesions which may be due to compression of vessels supplying blood to the bone, rather than to tumoral invasion or metastases

  5. Aspects of osteo-articular complications in sickle-cell disease on planar bone scintigraphy (infection excluded). Apropos of three cases; Aspects des complications osteoarticulaires de la drepanocytose en scintigraphie osseuse planaire (infection exclue). A propos de trois observations

    Oufroukhi, Y.; Biyi, A.; Zekri, A.; Doudouh, A. [HMI Med-V, Service de Medecine Nucleaire, Rabat (Morocco)

    2008-06-15

    Skeletal complications of sickle-cell anemia are multiple and can appear on the acute (osseous infarction, acute osteomyelitis) or chronic mode (osteonecrosis, chronic osteomyelitis). The radio-labelled diphosphonate bone scintigraphy remains an important tool in the early diagnosis and in the follow-up of these complications and must form part of the initial assessment of the disease. Through clinical observations, the authors undertake to sum up the bone scintigraphy aspects of these complications. (author)

  6. 99m technetium-MDP bone scintigraphy in evaluation of painful joint prosthesis

    In addition of clinical evaluation and x-ray radiography, the diagnosis of a loose joint prosthesis is often made by nuclear medicine imaging techniques. Differentiation between loosening and infected prosthesis is important for better treatment of those patients. Aim: The aim of this study was to reevaluate the scintigraphic patterns in patients with painful hip of knee arthroplasty. Material and Method: From 1996. to 2003. forty patients aged 49-78 years were referred for evaluation of possible loosening/infection joint prosthesis: 36 pts with 39 total/ partial hip prosthesis, 1 pt with knee prosthesis and 3 pts with history of previously extracted hip prosthesis due to infection. Whole body acquisition had been performed with a single head gamma camera three hours after the injection of 740 MBq 99mTc-MDP. Scans were classified as: positive for loosening if abnormal uptake was shown at the tip of the prosthesis; positive for infection if diffuse abnormal uptake was shown around the implant; negative and indeterminate scans. Scintigraphic findings were compared to clinical follow up, histology or cultures. Results: Positive findings were found in 17 bone scans strongly suggesting loosening in 10 cases, infection of prosthesis in 4 cases and both loosening/infection in 3 cases. Bone scintigraphy was normal in 11pts. Scans of three pts with previously extracted hip prosthesis and scheduled for reimplatation, showed inhomogeneously and mildly increased uptake in femur. Most of scans classified as indeterminate (n=12) showed slightly increased tracer uptake in region of acetabular roof, greater or lesser tho chanter, suggesting bone remodeling due to the presence of implant, rather than loosening. Conclusion: 99mTc-MDP bone scintigraphy had a significant role in assessing the painful joint prosthesis. Complementary diagnostic procedures should be considered in indeterminate scintiscans. (authors)

  7. Early diagnosis of Legg-Calve-Perthes disease: Value of bone scintigraphy and magnetic resonance imaging in comparison to radiography

    The value of conventional radiology, bone scintigraphy and magnetic resonance imaging (MRI) in the early diagnosis of Legg-Calve-Perthes disease (LCPD) was assessed. The initial results were compared with the clinical and radiological findings of long-term follow-up in 43 children. Radiological and scintigraphic examination resulted in a relatively high number of equivocal findings (16% and 10%, respectively). MRI findings were less equivocal (3%). Depending on whether such findings were classified as normal or as pathological, the diagnostic accuracy ranged as follows: Radiography 88-93%, bone scintigraphy 88-91%, and MRI 97-99%. Therefore, MRI by itself seems to be sufficient to detect or exclude LCPD. The results of this study and the radiation exposure associated with radiography and scintigraphy raise the question whether MRI should be the diagnostic method of choice in patients with suspected LCPD. (orig.)

  8. Non-ossifying fibroma mimicking distant metastasis of osteosarcoma on 99mTc-methylene diphosphonate bone scintigraphy: Diagnosis with single photon emission tomography/computed tomography

    Non-ossifying fibromas (NOFs) are benign bone lesions with variable appearance on bone scintigraphy. Single photon emission tomography/computed tomography (SPECT/CT) can help in accurate characterization of these lesions. We present a case of 14-year-old boy with recurrent osteosarcoma where NOF was mimicking distant metastasis on 99mTc-methylene diphosphonate bone scintigraphy. SPECT/CT was able to correctly characterize the lesion as NOF, thereby altering the management

  9. Novel esophageal squamous cell carcinoma bone metastatic clone isolated by scintigraphy, X ray and micro PET/CT

    Zhao, Bi-Zeng; Cao, Jie; Shao, Jin-chen; Sun, Yan-Bing; Fan, Li-Min; Wu, Chun-Yu; Liang, Sheng; Guo, Bao-Feng; Yang, Guang; Xie, Wen-Hui; Yang, Qing-cheng; Yang, Shun-Fang

    2014-01-01

    AIM: To establish a Chinese esophageal squamous cell carcinoma (ESCC) cell line with high bone metastasis potency using 99mTc-methylene diphosphonate (99mTc-MDP) micro-pinhole scintigraphy, X ray and micro-positron emission tomography/computed tomography (PET/CT) for exploring the mechanism of occurrence and development in esophageal cancer.

  10. Indications of 99mTc-MDP scintigraphy bone scan in the evaluation of painful hip arthroplasties

    The purpose of this study was to determine the indication of bone scintigraphy in hip prosthesis complications. Thirty-six patients and 38 hip prosthesis have had a 99Tc-MDP scintigraphy in our laboratory between 1995 and 1997. It concerns 32 cemented total prosthesis, 3 intermediate prosthesis and 3 non-cemented total prosthesis. For 14 prosthesis, complication (loosening or infection) was confirmed by surgical operation in 12 cases (4 isolated acetabular complications, 2 isolated femoral loosening, 3 global loosening and 3 infections) or by concordant data from different examinations in 2 cases (global loosening) where intervention was unrealizable. About other patients, absence of complication was confirmed by a favourable evolution lasting at least 12 months. A cetabular and femoral complications were detected by scintigraphy respectively with a sensitivity of 100 % and 90 %, a specificity of 85 % and 78 %, a PPV of 75 % and 60 % and NPV of 100 % and 96 %. High negative predictive value allows to eliminate a prosthesis complication in the case of a normal scintigraphy and to override decision when the clinic and the radiography are doubtful. Scintigraphy may recognize other bone fixation abnormalities which may be responsible of clinical symptomatology. (authors)

  11. Utility of bone scintigraphy in the study of hereditary disorders of the connective tissues (HDCT)

    Introduction: Collagen fiber genetic alterations predispose to pain and instability of joints, with a tendency to osteoarthritis, and may also cause fragility of other tissues. Objective: To demonstrate that Bone Scintigraphy is useful in the diagnosis of Heritable Disorders of Connective Tissues (HDCT). Material and methods: We studied the scintigraphic changes of wrists, carpal bones and hands of 22 adult patients with HDCT who were diagnosed clinically using both the Brighton Criteria(1), as well as own criteria**. We compared them to 22 controls with similar age and sex, who had a bone scintigram done for other purposes. Results: Statistically significant scintigraphic positivity was found in the areas studied in the patients as compared to controls (p ≤ 0.05), with a sensitivity of 95% and specificity of 73%. There was no correlation of the degree of positivity with age, sex or type of HDCT studied. A scintigraphic positivity was seen both in patients with lax joints, as well as in those with a lesser degree of joint mobility. Conclusions: We concluded that bone scintigraphic studies are useful in the diagnosis of adult HDCT patients (including Benign Joint Hyper mobility Syndrome (BJHS) and other forms of Ehlers-Danlos). We suggest that not only hypermobility of joints, but also cartilage fragility are important pathogenic factors in the genesis of these alterations. We formulate a new hypothesis of the importance of low folic acid intake during pregnancy, as a cause for mutations that would give rise to HDCT (Au)

  12. The value of bone scintigraphy on the determination of the full extent of tumor involvement in jaw bones%核素骨显像在预测颌骨肿瘤范围中的应用

    Jiawei Xie; Chao Ma; Guoming Wang; Shuyao Zuo; Ningyi Li; Muyun Jia

    2009-01-01

    Objective: To prospectively investigate the value of bone scintigraphy on determining the full extent of tumor involvement in jaw bones and to assess the presence of metastases. Methods: This study had local ethical committee ap-proval, and all patients gave written informed consent. Thirty seven consecutive patients with primary malignant tumor in jaw bones were recruited for the study. Bone scintigraphy was performed in all patients before surgery to measure the full extent of bony involvement, which was compared with histologic findings. Results: Whole body scan revealed one case with multiple bony metastases. Resection specimens of 36 bone neoplasms were pathologically analyzed to identify type and size of each tumor. The lengths of the tumor involvement in jaw bones defined by bone scintigraphy and pathology were 5.62 ± 1.58 cm, 4.48 ± 1.57 cm, respectively (P < 0.05). The tumor negative margins from removed specimens according to bone scintigraphy were pathologically confirmed. With histologic findings as the standard of reference, the accuracy of bone scintigraphy was 100% (36 of 36 patients) in determining the full extent of tumor involvement in jaw bones. Conclusion: Bone scintigraphy tends to offer specific guidelines in determining the appropriate extent of bone resection while entirely clearing the tumor cells and preserving functions whenever possible and in establishing the bony metastases.

  13. Bone scintigraphy as cornerstone in the diagnosis of Erdheim-Chester disease.

    García-Gómez, F J; Cambil-Molina, T; Ríos-Martín, J J; de la Riva-Pérez, P A; Calvo-Morón, C; Castro-Montaño, J

    2016-01-01

    The Erdheim-Chester disease (ECD) is an extremely rare form of non-Langerhans cell histiocytosis. The main difficulty for its diagnosis lies in the wide variety of non-specific symptoms and signs that can occur in the disease process, leading, therefore, to there being no clear-cut algorithm as a guide for an optimal biopsy to confirm the diagnosis. An 81-year-old male with history of diabetes insipidus was admitted due to non-specific respiratory signs. Imaging techniques revealed osteoblastic lesions in the lumbar spine. Whole-body bone-scintigraphy (BS) was performed, in which lesions involving the axial and appendicular skeleton, with different rates of osteoblastic activity, were observed. This highlighted a symmetrical severely intense uptake in the knees, leading to an accurate biopsy specimen that enabled making the definitive diagnosis. BS is a widely available, safe, and inexpensive technique that shows a characteristic pattern of uptake for ECD, thus its use is highly recommended for screening and guiding biopsy if clinical suspicion exists. Furthermore, when the scintigraphy pattern is incidentally observed, biopsy of increased uptake areas (tibia preferably) is mandatory in order to rule out the disease. PMID:26750553

  14. Evaluation of mandibular bone involvement by oral malignant tumors using scintigraphy of Tc-99m MDP and Ga-67 citrate

    Ten patients with intensely invaded malignant tumors at the mandibles were studied with bone scintigraphy (Tc-99m MDP) and Ga-67 citrate scintigraphy. All patients were classified by type of accumulation of both radionuclide pharmaceuticals. In almost all patients with invaded malignant tumors, bone scintigraphy revealed decreasing uptake in the center of the lesion and increasing uptake in the peripheral region. Ga-67 citrate scintigram showed increasing concentrated accumulation which was smaller than the area of Tc-99m MDP uptake in almost all cases. These types of accumulation were compared with those of other oral and maxillo-facial diseases. The patterns of accumulation of both radionuclide pharmaceuticals in ameloblastoma (3 cases), radicular cyst (3 cases), bone fracture (2 cases), diffuse sclerosing osteomyelitis (2 cases), and one sagittal ramus osteotomy case were different from that of bone involvement of malignant tumor cases. From the types of accumulation, we may be able to differentiate the oral and maxillo-facial diseases to some extent. In addition, the intensity of accumulation of Tc-99m MDP was measured by using bone to soft tissue ratio (4 hrB/St ratio). The mean 4 hrB/St ratio was higher in moth-eaten absorbed type than in permeated type of resorption in roentgenogram. However, we could not obtain a definitive conclusion because of too few cases. The mean 4 hrB/St ratio in the bone involvement by malignant tumor was higher than that in radicular cyst, and lower than that of diffuse sclerosing osteomyelitis. Unfortunately, we could not differentiate each disease of the involved malignant tumor, ameloblastoma, or bone fracture by only the 4 hrB/St ratio. The Tc-99m MDP accumulated beyond the region where the radiolucencies exist in roentgenograms. We consider that both scintigraphies have a great role in planning surgical treatment, especially in selecting osteotomy. (author)

  15. The usefulness of Tc-99m-MDP bone scintigraphy in detection of articular involvement of Behcet's disease

    Articular involvement was reported to be present in approximately 5-76% of Behcet patients. Therefore, we need a useful non-invasive method to detect articular involvement early in Behcet patients with nonspecific complaints. We aimed to evaluate the usefulness of 99mTc-methylene diphosphonate (Tc-99m-MDP) bone scintigraphy in the detection of the articular involvement of Behcet's disease (BD). Bone scintigraphy with Tc-99m-MDP was performed in 32 (17 male, 15 female) consecutive patients with BD. The sacroiliac (SI) joints with SI index higher than 1.34 were diagnosed as having sacroiliitis. Although joint complaints were present in only 8 (25%) patients, we detected joint involvement by scintigraphy in 27/32 (84.4%) Behcet patients mostly affecting the knees (62.5%), ankles (59.4%), SI joints (25%), wrists (21.9%), shoulders (18.7%), elbows (12.5%) and hips (3.1%). The articular involvement was monoarticular in four cases (12.5%) and was oligoarticular in the remaining. There was no correlation between joint involvement and age, gender, disease duration, drug usage or other clinical manifestations. Despite the fact that our patients were clinically asymptomatic and had normal pelvis radiography, sacroiliitis was found in 8 patients (25%). Bone scintigraphy is sensitive in the diagnosis of joint involvement allowing earlier diagnosis and showing the presence of articular involvement, especially in SI joints. (author)

  16. Study of 201Tl uptake by bone and bone marrow on 201Tl scintigraphy

    Thallium-201 (Tl-201) uptake in the bone and bone marrow was examined in a total of 93 patients with various diseases. Sternal uptake of Tl-201 was observed when patients had bone marrow abnormality especially associated with hematopoietic disease. It was associated with proliferation of immature cells and of various types of bone marrow cells, especially erythroblastic and plasma cells. Whole-body Tl-201 scanning showed a high uptake (82%) in the sternum, chest, lumbar vertebrae, and pelvis. Thallium-201 was definitively taken up by the sternum in polycythemia (5/41), hemolytic anemia (2/2), iron deficiency anemia (2/2), and multiple myeloma (2/5). For leukemia, Tl-201 uptake was slight or negative. Thallium-201 scanning proved useful in visualizing bone marrow abnormality, although careful interpretation of bone and bone marrow uptake is required. (Namekawa, K)

  17. Bone scintigraphy as a process control with hemi-alloarthroplasty of the hip joint

    For the diagnostic of prosthesis complications in the treatment of femur fractures near the hip joint ('intermediate prostheses') 216 skeletal scintigrams with 99mTc MDP were made of 143 patients from 1977 to 1982, partially retrospective and partially prospective. The evaluation of the photoscan was achieved visually and photodensitometrically and divided into 10 intensity levels with the following results: 1. Increased activity concentration in the acetabulum is pathological (activated arthrosis); 2. Increased activity concentration-temporary or also continuous - in the trochanter region is pathological (loosening process); 3. Non-pathological metabolic activity as a result of the bone healing process may last longer than 1 year postoperatively; 4. Heterotopic ossification, non-fixed bone fragments and pseudoarthrosis cause continuous or newly appearing concentrations; 5. Skeletal scintigraphy is an important supplement to radiological diagnostic and a sensitive method for the recognition of metabolic activities in bone. It is recommended for progress control after hemi-alloarthrosculpture of the hip joint. (orig./TRV)

  18. Pattern recognition in five-phase bone scintigraphy: diagnostic patterns of reflex sympathetic dystrophy in adults

    Leitha, T. [University Clinic of Nuclear Medicine, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Staudenherz, A. [University Clinic of Nuclear Medicine, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Korpan, M. [University Clinic of Nuclear Medicine, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Fialka, V. [University Clinic of Nuclear Medicine, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    1996-03-01

    The objective of this study was to assess qualitative and quantitative patterns of tracer accumulation to increase the diagnostic utility of bone scintigraphy in reflex sympathetic dystrophy (RSD). Of 120 patients with high clinical suspicion for RSD, 96 were confirmed as having RSD during follow-up, while the remaining 24 were used as controls. Clinical parameters were measured and correlated to five activity ratios (0-30 s, 0.5-5 min, 5-15 min, 3 h, 24 h) and five scintigraphic signs. Monitoring three dynamic phases revealed different tracer kinetics of potential diagnostic utility; however, the 24-h bone phase offered no additional diagnostic contribution and can be omitted. Quantification provided objective parameters for the duration of symptoms, pain and impairment of movement but not for surface temperature differences, swelling and impairment of physical force. It is of limited use for diagnosis except for the exclusion of disease. Discriminant analysis revealed the combination of three signs (diffuse uptake in carpus/tarsus+diffuse uptake in all small joints+increased activity ratio in the late blood pool phase) to be the pattern with the highest diagnostic accuracy independent of localisation, sex, age and precipitating factors. It is concluded that the scintigraphic confirmation of RSD is based on lateralisation in the late blood pool phase and the described pattern in the early bone phase. (orig.). With 4 figs., 4 tabs.

  19. Pattern recognition in five-phase bone scintigraphy: diagnostic patterns of reflex sympathetic dystrophy in adults

    The objective of this study was to assess qualitative and quantitative patterns of tracer accumulation to increase the diagnostic utility of bone scintigraphy in reflex sympathetic dystrophy (RSD). Of 120 patients with high clinical suspicion for RSD, 96 were confirmed as having RSD during follow-up, while the remaining 24 were used as controls. Clinical parameters were measured and correlated to five activity ratios (0-30 s, 0.5-5 min, 5-15 min, 3 h, 24 h) and five scintigraphic signs. Monitoring three dynamic phases revealed different tracer kinetics of potential diagnostic utility; however, the 24-h bone phase offered no additional diagnostic contribution and can be omitted. Quantification provided objective parameters for the duration of symptoms, pain and impairment of movement but not for surface temperature differences, swelling and impairment of physical force. It is of limited use for diagnosis except for the exclusion of disease. Discriminant analysis revealed the combination of three signs (diffuse uptake in carpus/tarsus+diffuse uptake in all small joints+increased activity ratio in the late blood pool phase) to be the pattern with the highest diagnostic accuracy independent of localisation, sex, age and precipitating factors. It is concluded that the scintigraphic confirmation of RSD is based on lateralisation in the late blood pool phase and the described pattern in the early bone phase. (orig.). With 4 figs., 4 tabs

  20. The role of bone scintigraphy in Langerhans' cell histiocytosis; a case report; Interet de la scintigraphie osseuse dans l'histiocytose langerhansienne: a propos d'un cas

    Razzouk, M.; Carrier, P.; Darcourt, J. [Centre TEP, Hopital de l' Archet-1, Service Universitaire de Medecine Nucleaire, 06 - Nice (France); Razzouk, M.; Carrier, P.; Darcourt, J. [Federation interhospitaliere, CHU, CAL universitaire de Nice, 06 - Nice (France); Deville, A. [Hopital de l' Archet, Service d' Hemato-Oncologie Pediatrique, 06 - Nice (France); Cadet, G. [Centre Hospitalier intercommunal de Grasse, Service de Pediatrie, 06 - Grasse (France)

    2008-09-15

    We present one case of bone-Langerhans cell histiocytosis in a three-year-old male child presenting osseous lesions in the skull and the femur, which are very frequent localizations in histiocytosis. Bone scintigraphy is useful for both initial staging and follow-up associated with other imaging modalities. (authors)

  1. Aspects of osteo-articular complications in sickle-cell disease on planar bone scintigraphy (infection excluded). Apropos of three cases

    Skeletal complications of sickle-cell anemia are multiple and can appear on the acute (osseous infarction, acute osteomyelitis) or chronic mode (osteonecrosis, chronic osteomyelitis). The radio-labelled diphosphonate bone scintigraphy remains an important tool in the early diagnosis and in the follow-up of these complications and must form part of the initial assessment of the disease. Through clinical observations, the authors undertake to sum up the bone scintigraphy aspects of these complications. (author)

  2. Two-Dimensional Image Fusion of Planar Bone Scintigraphy and Radiographs in Patients with Clinical Scaphoid Fracture: An Imaging Study

    Henriksen, O.M.; Lonsdale, M.N.; Jensen, T.D.; Weikop, K.L.; Holm, O.; Duus, B.; Friberg, L. (Dept. of Clinical Physiology/Nuclear Medicine, Glostrup Hospital, Glostrup (Denmark))

    2009-01-15

    Background: Although magnetic resonance imaging (MRI) is now considered the gold standard in second-line imaging of patients with suspected scaphoid fracture and negative radiographs, bone scintigraphy can be used in patients with pacemakers, metallic implants, or other contraindications to MRI. Bone scintigraphy is highly sensitive for the detection of fractures, but exact localization of scintigraphic lesions may be difficult and can negatively affect diagnostic accuracy. Purpose: To investigate the influence of image fusion of planar bone scintigraphy and radiographs on image interpretation in patients with suspected scaphoid fracture. Material and Methods: In 24 consecutive patients with suspected scaphoid fracture, a standard planar bone scintigraphy of both hands was supplemented with fusion imaging of the injured wrist. Standard and fusion images were evaluated independently by three experienced nuclear medicine physicians. In addition to the diagnosis, the degree of diagnostic confidence was scored in each case. Results: The addition of fusion images changed the interpretation of each of the three observers in seven, four, and two cases, respectively, reducing the number of positive interpretations of two of the observers from 11 and nine cases to six and seven cases, respectively. The degree of diagnostic confidence increased significantly in two observers, and interobserver agreement increased in all three pairs of observers from 0.83, 0.57, and 0.73 to 0.89, 0.8, and 0.9, respectively. Conclusion: Image fusion of planar bone scintigrams and radiographs has a significant influence on image interpretation and increases both diagnostic confidence and interobserver agreement

  3. Prospective evaluation of bone and leukocyte scintigraphy for diagnosis of chronic osteomyelitis in patients with coexistent soft-tissue pathology

    This paper reports on a study involving twenty-four patients with soft-tissue infections or wounds and radiographic abnormalities in contiguous bones possibly representing osteomyelitis who underwent three-phase Tc-99 m methylene diphosphonate (MDP) bone scanning, followed by In-111 leukocyte scintigraphy (22 patients) and bone biopsy (21 patients). Chronic osteomyelitis was confirmed in 12 patients by means of biopsy cultures and in one by means of histologic findings following amputation. Four patterns of leukocyte uptake in bone were identified: definitely increased, possibly increased, normal, and decreased. The prevalence of osteomyelitis for these four leukocyte scan patterns was as follows: 89% (eight of nine patients), 40% (two of five), 20% (one of five), and 67% (two of three), respectively. A definite increase in bone uptake of In-111-labeled leukocytes usually reflects osteomyelitis, but bone biopsy may be necessary to establish the diagnosis when other scan patterns are present

  4. Bone mineral density and bone scintigraphy in adult Saudi female patients with Osteomalacia

    This prospective study was conducted to demonstrate the role of bone mineral density (BMD) and bone scan in the management of adult Saudi female patients with established diagnosis of osteomalacia. Bone scan using Tc99m methylene diphosphate (MDP) and BMD of the lumbar spine and femoral neck using dual x-ray absorptiometry (DXA) were performed at the time of diagnosis 6 months and one year after therapy in 96 Saudi female patients attending the metabolic bone disease clinic at King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia, between January 1997 through to June 1999, aged between 20 and 73 years (mean 42 years). Alkaline phosphates, calcium and inorganic phosphorus were measured for all patients before and after treatment. 25 Hydroxy vitamin D was only measured with the first BMD measurements. A bone profile showed typical biochemical abnormalities of osteomalacia.The bone scan showed features of superscan in all patients and pseudofractures in 43 patients. BMD measures were compared with that of normal Saudi subjects matched for age and sex. The BMD was low at diagnosis and showed significant improvement after therapy. The improvement of bone density in response to therapy was more evident in lumbar spine than in femoral neck bone.Our results showed that BMD in adult Saudi female patients with osteomalacia was markedly affected probably due to specific constitutional and environmental factors ( inadeqate exercise, lack of sun exposure and lack of intake of milk and dairy products). In addition, lumbar BMD and serum calcium appeared to be better markers to monitor therapy.Bone scan helped in demonstrating disease activity, the presence of pseudofractures. (author)

  5. An osteomalacia related to phosphate diabetes - bone scintigraphy with SPECT/CT contribution

    We report the case of a 59-year-old woman, investigated for disabling pain of the left thigh, unrelated to any traumatic event. Interrogation had found diffuse pain of myalgia-type and arthralgia-type for approximately a year without local inflammatory signs and insufficiency fractures of both calcaneus two years before. The Technetium 99m-labeled hydroxy-methylene diphosphonate (99mTc-H.D.P.) whole-body bone scintigraphy evidenced multiple hot spots on the higher third of left femur, rib cage, sternum, scapula, pelvis, right hip and both calcaneus. Moreover, a more diffuse and heterogeneous prominent uptake appeared on rib cage, spine and pelvis. These images suggested a diffuse metastatic disease of the skeleton. The single photon emission computerized tomography guided by computerized tomography (SPECT/CT), centered on lumbar spine, pelvis and the upper end of femurs showed that the multiple hot spots were in fact bone fractures. These findings pointed diagnosis to a metabolic disease. The clinical context was in favour of an osteomalacia. Further explorations showed an osteomalacia related to phosphate diabetes. A thorough work-up did not reveal any known aetiology. To date, idiopathic phosphate diabetes seems the most likely diagnosis. Nuclear medicine input in osteomalacia is discussed. (authors)

  6. Studies on the clinical usefulness of the 111indium chloride bone marrow scintigraphy in patients with aplastic anemia

    111Indium chloride (111In-Cl3) appears to be a radionuclide appropriate for a bone marrow scanning because of its physical and chemical characteristics; it is, like iron, bound to and transported by transferrin and it has a photopeak suitable for scintigraphy. This study was undertaken to assess the bone marrow function by 111In-Cl3 bone marrow scintigraphy in patients with asplastic anemia. Bone marrow scintigraphy was performed in 21 patients with aplastic anemia with varying degrees of severity including 15 who had no previous treatments. The scintigrams were taken 48 hours after intravenous injection of 111 MBq(3 mCi) of 111In-Cl3. All of them showed various degrees of reduction in uptake of 111In-Cl3 by the marrow. The abnormal scan grade was classified into 3 types: Type I, non-accumulation (5); Type II, low-accumulation (15); Type III, uneven accumulation (1). In type III, degree of radioisotope accumulation between the sternum and the ilium was different, and this difference correlated with that of bone marrow cellularity. In 2 patients of type II, hematological improvement occurred after treatment, which was also accompanied by simultaneous increase of 111In-Cl3 uptake by the marrow. These findings suggested that the degree of radioisotope accumulation in the marrow reflects that of bone marrow cellularity. Type I patients were clinically severe and poor in prognosis as compared to type II and type III patients; four out of 5 died within 2 months. Bone marrow transplantation may be the treatment of choice in type I patients when feasible. (author)

  7. Femoral head vascularisation in Legg-Calve-Perthes disease: comparison of dynamic gadolinium-enhanced subtraction MRI with bone scintigraphy

    Heading AbstractBackground. It has been reported that MRI using a dynamic gadolinium-enhanced subtraction technique can allow the early identification of ischaemia and the pattern of revascularisation in Legg-Calve-Perthes (LCP) disease with increased spatial and contrast resolution. Therefore, dynamic gadolinium-enhanced subtraction (DGS) MRI may be a possible non-ionising substitute for bone scintigraphy.Objective. The purpose of this prospective study was to compare DGS MRI and bone scintigraphy in the assessment of femoral head perfusion in LCP disease.Materials and methods. Twenty-six DGS MR images and bone scintigraphies of 25 hips in 23 children were obtained at different stages of LCP disease; three stage I, 12 stage II, six stage III and five stage IV (Waldenstroem classification). The extent of necrosis, epiphyseal revascularisation pathways (lateral pillar, medial pillar, and/or transphyseal perfusion) and metaphyseal changes were analysed.Results. Total agreement between both techniques was noted in the depiction of epiphyseal necrosis (kappa=1), and metaphyseal abnormalities (kappa=0.9). DGS MRI demonstrated better revascularisation in the lateral (kappa=0.62) and medial pillars (kappa=0.52). The presence of basal transphyseal reperfusion was more conspicuous with MRI.Conclusions. DGS MRI allows early detection of epiphyseal ischaemia and accurate analysis of the different revascularisation patterns. These changes are directly related to the prognosis of LCP disease and can aid therapeutic decision making. (orig.)

  8. Measurement of 153Sm-EDTMP bone uptake by whole-body scintigraphy and its application to individualized treatment dosimetry of bone metastasis

    To calculate a safe and effective 153Sm-EDTMP therapy dose, a whole-body scintigraphy technique for prospective individual dosimetry was developed and the results were compared with 5 h urine collection method in 20 patients with bone metastases. Anterior and posterior whole-body images were obtained 10 min and 5 h after intravenous injection of 740 MBq 153Sm-EDTMP and the bone uptake value was determined. There is a close correlation between the bone uptake value obtained from the whole-body scintigraphy and 5 h urine collection method (r = 0.93). The radiation absorption dose to red marrow was limited to 1.4 Gy and the administered activity calculated from bone uptake value by whole-body scintigraphy was 1.40-2.27 GBq (mean 1.90 GBq). If the activity was calculated according to the standard body weight of 37 MBq·kg-1, the administered activity would be 1.75-2.41 GBq (mean 2.18), the radiation absorption dose to red marrow would be 1.37-2.27 Gy (mean 1.63 Gy), but at these doses significant myelotoxicity would be anticipated, thus emphasizing the need for individual prospective dosimetry

  9. Pathologic changes in the maxillary sinus wall after conservative therapy in odontogenic maxillary sinusitis. Examination using bone scintigraphy

    Single photon emission computed tomographic bone scintigraphy (bone SPECT) was performed in 16 patients with odontogenic maxillary sinusitis to compare inflammatory changes in the maxillary sinus wall including the alveolar process (bony lesions) before and after conservative therapy. Morphologic changes in bony lesions as evaluated by bone SPECT images correlated with those of the maxillary sinus mucosa (mucosal lesions) as evaluated by CT images. Morphologic changes in the bony lesions also correlated with changes in inflammatory activity in the maxillary alveolar process as functionally evaluated by bone SPECT before and after conservative therapy. Odontogenic maxillary sinusitis is considered a disease in which maxillary alveolitis causes mucosal lesions as well as bony lesions. Changes in alveolitis are associated with morphologic changes in bony lesions after conservative therapy, and these changes affect the pathophysiologic nature of odontogenic maxillary sinusitis. Bone SPECT is valuable for predicting outcome and treatment planning in patients with odontogenic maxillary sinusitis. (author)

  10. 99mTc-sestamibi and 99mTc-tetrofosmin scintigraphy in myeloma bone disease

    Full text: Evaluation of the role of scintigraphy with 99mTc-Sestamibi (99mTc-MIBI) and 99mTc-Tetrofosmin (99mTc-TF) in the detection of bone marrow involvement in patients (pts) with multiple myeloma (MM) and in follow-up. 62 pts with MM and 38 pts with monoclonal gammopathy of undetermined significance (MGUS) were enrolled in this study. Forty-seven out sixty-two MM pts had active disease (AD), 10/62 were in complete remission (CR) and 5/62 in partial remission (PR) after chemotherapy. Whole-body scans were obtained 10 min after the i.v. injection of 740 MBq of 99mTc-MIBI in anterior and posterior view. The scans were scored semiquantitatively according to extension and intensity of tracer uptake. All 38 MGUS pts had a negative 99mTc-MIBI scan. As to the MM pts, 49/62 pts (44 with AD, 4 with PR and 1 with CR) had a positive 99mTc-MIBI scan, while the 99mTc-MIBI scan was negative in 13/62 pts (9 with CR, 1 with PR and 3 with AD). The overall sensitivity of the scintigraphic procedure was 92 % while specificity was 97 %. A total of 42 follow-up scans with 99mTc-MIBI were performed in 30 MM pts after high-dose chemotherapy, with an average follow-up duration of 14.6 ± 8.9. The follow-up 99mTc-MIBI scintigraphy was positive in 14/15 of the AD pts, while 6/8 negative scans were observed in the CR pts; the seven PR pts exhibited in five cases a negative scan and in two a mild scintigrafic positivity. The overall sensitivity and specificity of the follow-up scan were, respectively, 86 % and 75 %. In six patients, one at the diagnosis and five showing a positive 99mTc-MIBI scan during the follow-up, 740 MBq of 99mTc-TF was administered within two days with the same acquisition protocol. The scans provided substantially identical information. 99mTc-TF provided a mildly higher contrast between lesion and background activities. The results obtained in this study provide additional evidence indicating that 99mTc-MIBI scintigraphy closely reflects myeloma disease activity in

  11. Assessment of an evolutive tertiary syphilis by bone scintigraphy. A case report; Evaluation d'une syphilis tertiaire evolutive en scintigraphie osseuse. A propos d'un cas

    Andriamisandratsoa, N.; Scheiber, C.; Grucker, D. [Faculte de Medecine, Service de Medecine Nucleaire, Institut de Physique Biologique, 67 - Strasbourg (France); Dery, M. [Medecine Generale, Geriatrie, 67 - Strasbourg (France)

    2003-10-01

    One patient complained of persisting diffuse bone pain, with greater intensity in the pelvis. HDP {sup 99m}Tc bone scintigraphy showed increased uptake around the right sacro-iliac joint and in the right iliac area due to increased osteoblastic activity, thereby providing functional information about the evolutive nature of the bone lesion. The X-scanner only revealed osteolysis in the same location. A blood test confirmed the diagnosis of tertiary syphilis. (author)

  12. SPECT/CT bone scintigraphy to evaluate low back pain in young athletes: common and uncommon etiologies.

    Matesan, M; Behnia, F; Bermo, M; Vesselle, H

    2016-01-01

    Low back pain of various etiologies is a common clinical presentation in young athletes. In this article, we discuss the utility of SPECT/CT bone scintigraphy for the evaluation of low back pain in young athletes. The spectrum of lower spine lesions caused by sports injuries and identifiable on bone scan is presented along with strategies to avoid unnecessary irradiation of young patients. Also covered are pitfalls in diagnosis due to referred-pain phenomenon and normal skeletal variants specific to this age group. PMID:27387155

  13. Bone marrow imaging with MR and indium-111-chloride scintigraphy in patients with myelodysplasia and aplastic anemia

    This paper reports twenty-one patients with myelodysplasia and aplastic anemia studied with MR and bone marrow radionuclide imaging to determine the roles of these imaging modalities, with seven normal patients serving as controls. All patients underwent In-111 chloride bone marrow scintigraphy prior to MR imaging. MR studies of the lumbar spine were acquired at 0.6 T with a T1-weighted (500/24 [repetition time (TR) msec/echo time (TE) msec]) spin-echo technique and an inversion-recovery technique (200/26/148 [TR msec/TE msec/inversion time msec])

  14. Comparison of planar scintigraphy and bone SPECT with clinical findings and other imaging modalities in temporomandibular disorder patients

    This study was performed to evaluate the diagnostic value of both planar and SPECT imagings by comparing the results with the clinical and other imaging modalities findings. A total of 578 joints with TMJ complaints were examined using planar scintigraphy and SPECT. The planar scintigraphy and SPECT findings were analyzed and compared to the clinical findings of pain, clicking, crepitus and limitation of mouth opening. Moreover we compared the accuracy of the planar scintigraphy and SPECT methods with the one of the panoramic, transcranial, tomographic and MR imaging methods. The planar scintigraphy and SPECT methods showed a high sensitivity of 0.76-0.84 and low specificity of 0.25-0.45 toward the clinical findings : pain, clicking, crepitus and mouth opening restriction. Simple radionuclide uptake ratio was high in each group of patients with pain, crepitus, limitation of mouth opening (p<0.05) complaints, in each group with positive bone changes on panoramic, transcranial or tomographic images, and in disc displaced group. Although both planar and SPECT imagings have limited specificity, these techniques are sensitive for detection of internal derangement of the TMJ.

  15. Usefulness of 99mTc-depreotide scintigraphy for the diagnosis of bone metastases in non-small cell lung cancer stage 3-4

    Objective In non-small cell lung cancer (NSCLC), metastatic bone involvement is usually assessed using conventional 99mTc-HMDP bone scintigraphy, which has a high sensitivity but a poor specificity. The purpose of this study was to assess the usefulness of the 99mTc-D scintigraphy for the detection of malignant bone metastases in patients with NSCLC stage III or IV and to compare these results with 99mTc-HMDP bone scan findings. Methods Nineteen patients (13 M and 6 F, mean age 59 years) with proven NSCLC, suspected to have stage III or IV were enrolled prospectively. All patients underwent whole body 99mTc-HMDP and 99mTc-D scintigraphy to detect bone metastases within a mean interval of 14 days. Each focal uptake of 99mTc-D or 99mTc-HMDP was considered benign or malignant, leading to positive or negative diagnosis for bone involvement. The final diagnosis of bone metastases was established by a lung specialist, on the basis of additional imaging modalities and of 12 months follow-up. Results Twelve bone lesions were identified by 99mTc-D scintigraphy, 10 were classified as bone metastases and two were classified as inflammatory bone lesions. Four patients were metastatic. Fifty eight bone lesions were detected by 99mTc-HMDP scintigraphy, 26 of whom were considered malignant, eight patients were thus considered metastatic. Thereby, the two nuclear medicine modalities were concordant for 13 patients, that is 68% of cases and were discordant for six patients, representing 32% of cases. Diagnostic sensitivity, specificity and accuracy of depreotide scintigraphy and 99mTc-HMDP bone scintigraphy were 75% for both, 93.3 and 73.3%, and 89.5 and 73.3% respectively. Conclusion Our data suggest that depreotide scintigraphy with the same sensitivity, a better accuracy and specificity than those of 99mTc-HMDP bone scan can detect metastatic bone lesions in patients with NSCLC suspected to have stage III or IV disease. (authors)

  16. Contribution of the bone scintigraphy in unexplained pains of the thigh; Apport de la scintigraphie osseuse dans le cadre de douleurs inexpliquees de la cuisse

    Oufroukhi, Y.; Ech Charraq, I.; Ben Rais, N. [Centre Hospitalier Universitaire Ibn Sina Rabat (Morocco)

    2006-05-15

    Mr. R.N. 32 year's old, high level sportsman, without particular pathological antecedents, consults for pains of the area above the knee of the left thigh, of mechanical pace being exacerbated with the effort. The clinical examination notes pains induced by the deep of the left thigh. The biological assessment, in particular blood cell formula and CRP were normal. The standard radiography of the femurs did not find an anomaly of the osseous structure. Because of the persistence of the pains, an osseous scintiscan was carried out and orientated towards pathology of soft tissues. The doppler and the TDM made it possible to pose the diagnosis of intra-tissues muscular hemangioma. The early times of the bone scintigraphy appears important in the approach diagnosis of many osseous disease of the sportsman. (author)

  17. Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using {sup 18F} FDG PET/CT and {sup 99mT}c HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation

    Seo, Hyo Jung; Choi, Yun Jung; Kim, Hyun Jeong; Jeong, Youg Hyu; Cho, Arthur; Lee, Jae Hoon; Yun, Mijin; Choi, Hye Jin; Lee, Jong Doo; Kang, Won Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    Bone metastasis from hepatocellular carcinoma (HCC) can present with soft tissue formation, resulting in oncologic emergency. Contrast enhanced FDG PET/CT and bone scintigraphy were compared to evaluate characteristics of bone metastases with of without soft tissue formation from HCC. of 4,151 patients with HCC, 263 patients had bone metastases. Eighty five patients with bone metastasis from HCC underwent contrast enhanced FDG PET/CT. Fifty four of the enrolled subjects had recent {sup 99mT}c HDP bone scintigraphy available for comparison. Metastatic bone lesions were identified with visual inspection on FDG PET/CT, and maximum standardized uptake value (SUVmax) was used for the quantitative analysis. Confirmation of bone metastasis was based on histopathology, combined imaging modalities, or serial follow up studies. Forty seven patients (55%) presented with soft tissue formation, while the remaining 38 patients presented without soft tissue formation. Frequent sites of bone metastases from HCC were the spine (39%), pelvis (19%), and rib cage (14%). The soft tissue formation group had more frequent bone pain (77 vs. 37%, p<0.0001), higher SUVmax (6.02 vs. 3.52, p<0.007), and higher incidence of photon defect in bone scintigraphy (75 vs. 0%) compared to the non soft tissue formation group. FDG PET/CT had higher detection rate for bone metastasis than bone scintigraphy both in lesion based analysis (98 vs. 53%, p=0.0015) and in patient based analysis (100 vs. 80%, p<0.001). Bone metastasis from HCC showed a high incidence of soft tissue formation requiring emergency treatment. Although the characteristic findings for soft tissue formation such as photon defect in bone scintigraphy are helpful in detection, overall detectability of bone metastasis is higher in FDG PET/CT. Contrast enhanced PET/CT will be useful in finding and delineating soft tissue forming bone metastasis from HCC.

  18. Detection of Unknown sites of multiple enchondroma (Ollier′s Disease mimicking like metastasis using bone scintigraphy

    Koramadai Karuppusamy Kamaleshwaran

    2015-01-01

    Full Text Available Ollier′s disease characterized by multiple skeletal enchondroma is a rare noninherited disease of unknown etiology. Majority of the skeletal enchondroma are present in the metaphyses and diaphysis of tubular limb bones. Ollier′s disease has a predilection for unilateral distribution. Malignant changes in Ollier′s disease may occur in adult patients. Radionuclide bone scanning is one method used to assess lesions depicted on radiographs or magnetic resonance images that are presumed to be enchondromas. Furthermore, a bone scan may give a clue to the multifocality of the disease. We report a case of right first phalangeal enchondroma in a 23-year-old male, who underwent bone scintigraphy detected multifocal asymmetric right side involvement of radius, humerus, femur, and tibia which confirm a diagnosis of Ollier′s disease.

  19. Hypertrophic pulmonary osteoarthropathy on bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography in a patient with lung adenocarcinoma.

    Cengiz, Arzu; Eren, Mine Şencan; Polatli, Mehmet; Yürekli, Yakup

    2015-01-01

    Hypertrophic pulmonary osteoarthropathy (HPOA) is not an uncommon paraneoplastic syndrome that is frequently associated with lung cancer. A 54-year-old male patient with lung adenocarcinoma underwent bone scintigraphy and fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scanning for initial staging. Bone scintigraphy revealed increased periosteal activity in lower extremities. FDG PET/CT revealed hypermetabolic right lung mass, mediastinal lymph nodes, and mildly increased periosteal FDG uptake in both femurs and tibias. The findings in lower extremities on bone scan and FDG PET/CT were interpreted as HPOA. PMID:26170569

  20. Hypertrophic pulmonary osteoarthropathy on bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography in a patient with lung adenocarcinoma

    Hypertrophic pulmonary osteoarthropathy (HPOA) is not an uncommon paraneoplastic syndrome that is frequently associated with lung cancer. A 54-year-old male patient with lung adenocarcinoma underwent bone scintigraphy and fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scanning for initial staging. Bone scintigraphy revealed increased periosteal activity in lower extremities. FDG PET/CT revealed hypermetabolic right lung mass, mediastinal lymph nodes, and mildly increased periosteal FDG uptake in both femurs and tibias. The findings in lower extremities on bone scan and FDG PET/CT were interpreted as HPOA

  1. 111In-Octreotide and 99mTc-MDP scintigraphy in the detection of bone lesions in Langerhans cell histiocytosis

    Aim: Langerhans cell histiocytosis (LCH) is a granulomatous disease which can involve multiples sites of the body. Diagnostic imaging is of utmost importance in the management of these patients. Since now radiographic skeletal survey and bone scintigraphy (BS) have been used to assess bone involvement (both with low specificity). Magnetic resonance and CT have been used to assess visceral involvement but with the limitation that can not give information about the functional status. Recently two groups of investigators (Lastoria et al. and Calming et al.) have proposed somatostatin receptor scintigraphy (SSRS) to detect active lesions and for monitoring the response to treatment, due to the somatostatin analogue octreotide binds to the cell membrane of activated lymphocytes expressing somatostatine receptors. The aim of this study is to assess bone and somatostatine receptor scintigraphy in the detection of bone involvement in LCH in children. Visceral involvement has not been assessed due to none of the patients presented it at the moment of the SRS. Methods: 17 scintigraphies (11 SSRS and 6 BS) were performed in seven patients (3 girls and 4 boys) aged at diagnosis: 18 month- 12 years (mean age 6,2 years). The findings obtained in the scintigraphies were compared with clinical evolution and other imaging techniques. Results: All the BS detected the diagnosed lesions, that decreased the uptake after the treatment. In three cases BS detected one unknown bone lesion. Two SSRS could not detect a lesion on right rib in two patients, both at the moment of diagnosis. SSRS was true negative in one patient (clinical and other imaging remission) and true positive in the other four cases. SSRS detected three new unknown bone lesions. SRSS showed decreased uptake after treatment and increased uptake in the relapses. Conclusions: Somatostatin receptor and Bone scintigraphy can be used to detect active LCH bone lesions in children and can help in monitoring the response to

  2. sup(99m)Tc-sulfur-rhenium-colloid and 111In-indiumcitrate in the bone marrow scintigraphy

    Bone marrow scintigraphy using 111In-Indium-citrate and sup(99m)Tc-sulfur rhenium colloid was compared with each other in 6 male and 3 female patients. Our results in all patients were in favour of 111In-citrate which caused a better delineation of morphological details than sup(99m)Tc-sulfur rhenium colloid did. In the first days after intravenous administration of 111In-citrate, radioindium accumulated markedly in the pudendal region, this finding being more distinct in male patients than in female ones. On account of these results a considerable radiation dose has to be assumed in bone marrow scintigraphy using 111In-citrate as long as the absorbed dose from 111In has not been estimated under consideration of the radioindium accumulation in the pudendal region. 111In-citrate should be applied in bone marrow scanning only exceptionally and sup(99m)Tc-sulfur rhenium colloid be preferred in the routine diagnostics of bone marrow. (orig.)

  3. Contribution of technetium pyrophosphate bone scintigraphy in the evaluation of prostate cancer extension based on 100 cases

    The aim of this work was to compare the results of technetium 99m pyrophosphate bone scintigraphy with those of the standard radiographic exploration of the skeleton in order to find out whether scintigraphic data allow an earlier and more accurate diagnosis of the presence of bone metastases. The dose administered is about 10MCi per patient; the recording is made 4 hours after intraveinous injection of the tracer. The documents are obtained in two stages: - first of all a whole-body scintigraph is carried out by means of an 'omniview' system adapted to the Picker dynacamera. This instrument gives an image of the entire body by translation of the patient's bed before the detection head of the camera; - immediately after the whole-body scan a series of static views is taken, especially on abnormal or doubtful areas. These documents have a better resolution than the reduced whole-body image and supply complementary data all the more valuable as they are directed towards the zones of interest. Analysis of our observations underlines the advantages of technetium 99m pyrophosphate bone scintigraphy in the evaluation of prostate neoplasm extension. This particularly sensitive method of investigation enables bone metastases to be detected earlier and more precisely in a patient presenting a neoplasm

  4. Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin's lymphoma by whole-body MRI: comparison with bone and {sup 67}Ga scintigraphies

    Iizuka-Mikami, Masami; Nagai, Kiyohisa; Yoshida, Koji; Tamada, Tsutomu; Imai, Shigeki; Kajihara, Yasumasa; Fukunaga, Masao [Department of Radiology, Kawasaki Medical School, 577 Matsushima, 701-0192, Kurashiki, Okayama (Japan); Sugihara, Takashi; Suetsugu, Yoshimasa; Mikami, Makoto [Department of Hematology, Kawasaki Medical School, 577 Matsushima, 701-0192, Kurashiki, Okayama (Japan)

    2004-06-01

    The aim of this study was to evaluate the diagnostic potential of whole-body MRI (WB-MRI) for the detection of bone marrow and extramedullary involvement in patients with non-Hodgkin's lymphoma. WB-MRI, which was performed on 34 patients, consisted of the recording of T1-weighted spin-echo images and a fast STIR sequence covering the entire skeleton. The WB-MRI findings for bone marrow and extramedullary involvement were compared with those from {sup 67}Ga and bone scintigraphies and bone marrow biopsy results. Two MRI specialists reviewed the WB-MRI results and two expert radiologists in the field of nuclear medicine reviewed the bone and {sup 67}Ga scintigraphy findings. Bone marrow and extramedullary involvement of non-Hodgkin's lymphoma were confirmed by follow-up radiographs and CT and/or a histological biopsy. The detection rate of WB-MRI was high. More bone marrow involvement was detected by biopsy, and more lesions were detected by scintigraphies. In total, 89 lesions were detected by WB-MRI, whereas 15 were found by biopsy, 5 by {sup 67}Ga scintigraphy, and 14 by bone scintigraphy. WB-MRI could also detect more extramedullary lesions than {sup 67}Ga scintigraphy; i.e., 72 lesions were detected by WB-MRI, whereas 54 were discovered by {sup 67}Ga scintigraphy. WB-MRI is useful for evaluating the involvement of bone marrow and extramedullary lesions throughout the skeleton in patients with non-Hodgkin's lymphoma. (orig.)

  5. Indications of {sup 99m}Tc-MDP scintigraphy bone scan in the evaluation of painful hip arthroplasties; Place actuelle de la scintigraphie osseuse dans l'evaluation des protheses de hanches douloureuses

    Eder, V.; Baulieu, F.; Secchi, V.; Gautier, B.; Pottier, J.M. [Centre Hospitalier Universitaire, Sce de Medecine Nucleaire et Echographie, 37 - Tours (France); Rosset, P. [Centre Hospitalier Universitaire, Sce de Chirurgie Orthopedique et Traumatologique, 37 - Tours (France)

    2000-01-01

    The purpose of this study was to determine the indication of bone scintigraphy in hip prosthesis complications. Thirty-six patients and 38 hip prosthesis have had a {sup 99}Tc-MDP scintigraphy in our laboratory between 1995 and 1997. It concerns 32 cemented total prosthesis, 3 intermediate prosthesis and 3 non-cemented total prosthesis. For 14 prosthesis, complication (loosening or infection) was confirmed by surgical operation in 12 cases (4 isolated acetabular complications, 2 isolated femoral loosening, 3 global loosening and 3 infections) or by concordant data from different examinations in 2 cases (global loosening) where intervention was unrealizable. About other patients, absence of complication was confirmed by a favourable evolution lasting at least 12 months. A cetabular and femoral complications were detected by scintigraphy respectively with a sensitivity of 100 % and 90 %, a specificity of 85 % and 78 %, a PPV of 75 % and 60 % and NPV of 100 % and 96 %. High negative predictive value allows to eliminate a prosthesis complication in the case of a normal scintigraphy and to override decision when the clinic and the radiography are doubtful. Scintigraphy may recognize other bone fixation abnormalities which may be responsible of clinical symptomatology. (authors)

  6. Method of quantification of bone scintigraphy using technetium labelled stannous pyrophosphate. Results concerning 882 whole-body scintigraphy

    Considerable progress was made in isotope bone imaging with strontium 85 after the principle of quantification was introduced by Rosenthall in 1965. In 1971, Subramanian and McAffee reported that excellent visualization could be obtained with polyphosphates labelled with sup(99m)Tc. In the present study, imaging was performed 4 hours after injection of sup(99m)Tc pyrophosphate. An Elscint dual head wole body scanner and a VDP 2 off-line calculator were used. Counts were collected over selected regions of interest, each measuring 4.5 x 3.5 cm, and over the whole body. After checking reproducibility by double counting (SD of the mean = 15%), two methods of quantification were studied, the counts being expressed as: the ratio of the number of counts in the bone segment to the number of counts in the knee, the ratio of the number of counts in the bone segment/the number of counts in the whole body. In these operations, the whole body count was multiplied by 2.10-3 in order to have a ratio whole body count.2.10-3/knee = 1. The ratios calculated from the different bone diseases under study were then compared

  7. The role of bone scintigraphy in the evaluation of the suspected abused child

    Sty, J.R.; Starshak, R.J.

    1983-02-01

    A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children who were suspected victims of abuse. Radiography was positive in 105 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused.

  8. The role of bone scintigraphy in the evaluation of the suspected abused child

    A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children who were suspected victims of abuse. Radiography was positive in 105 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused

  9. The role of bone scintigraphy in the evaluation of the suspected abused child

    A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused

  10. Metastatic superscan on 99mTc-MDP bone scintigraphy in a case of carcinoma colon: Common finding but rare etiology

    Bone scintigraphy in which there is excessive skeletal radioisotope uptake in relation to soft tissues along with absent or faint activity in the genitourinary tract is known as a ‘superscan’. Prostate cancer is the most common malignancy associated with superscan along with others such as lung cancer, breast cancer and haematological malignancies. Here we present the case of a 41 year old woman with carcinoma colon with metastatic superscan on 99mTc-MDP bone scintigraphy, a very rare cause for metastatic superscan

  11. The relationship between malignant skeletal involvement and hypertrophic pulmonary osteoarthropathy in patients with bronchogenic carcinoma as evaluated by bone scintigraphy

    Aim: Several studies have shown that bone scintigraphy could assist in the diagnosis of hypertrophic pulmonary osteoarthropathy (HPOA) in patients with bronchogenic carcinoma. HPOA can present as a triad of periostitis, synovitis and clubbing, but variation in the appearance is possible. Periostitis is seen on bone scintigraphy as increased periosteal activity, also known as the 'double track sign', while synovitis presents as increased peri-articular activity. Clinical clubbing is not necessarily visible on a bone scan. The objective of this study was to evaluate the hypothesis that patients with the typical pattern of periostitis in the clinical subset of bronchogenic carcinoma have less distant skeletal metastases than patients with synovitis or those without HPOA. Methods: In this study 206 bone scans performed on 189 consecutive patients with bronchial carcinoma were retrospectively analysed. All the scans were evaluated for the presence or absence of signs of HPOA and malignant skeletal involvement, either local infiltration or distant skeletal metastases, which was correlated with the scintigraphic class and grade of HPOA. Results: The incidence of distant skeletal metastases was found to be significantly lower in the group with periostitis (7%), compared to the groups with synovitis (58%), mixed periostitis and synovitis (50%) and patients with no scintigraphic sign of HPOA (51%). Conclusion: We found a significantly lower incidence of distant skeletal metastases in patients with the periostitis type of HPOA when compared to patients with the other types of HPOA or patients without HPOA. A relevant application of our findings could relate to the interpretation of distant focal abnormalities on the bone scans of patients with only the periostitis form of HPOA. Given our results, such abnormalities are much more likely to represent benign pathology than metastatic disease

  12. Comparison of diffusion-weighted whole body MRI and skeletal scintigraphy for the detection of bone metastases in patients with prostate or breast carcinoma

    Gutzeit, Andreas; Doert, Aleksis; Froehlich, Johannes M.; Eckhardt, Boris P.; Meili, Andreas; Scherr, Patrick; Schmid, Daniel T.; Weymarn, Constantin A. von; Willemse, Edwin M.M.; Binkert, Christoph A. [Kantonsspital Winterthur, Department of Radiology, Winterthur (Switzerland); Graf, Nicole [University of Zurich, Clinical Trials Center, Center for Clinical Research, Zurich (Switzerland)

    2010-04-15

    To prospectively compare the diagnostic accuracy of diffusion-weighted whole body imaging with background whole body signal suppression (DWIBS) with skeletal scintigraphy for the diagnosis and differentiation of skeletal lesions in patients suffering from prostate or breast cancer. A diagnostic cohort of 36 patients was included in skeletal scintigraphy and 1.5 T DWIBS MRI. Based on morphology and signal intensity patterns, two readers each identified and classified independently, under blinded conditions, all lesions into three groups: (1) malignant, (2) unclear if malignant or benign and (3) benign. Finally, for the definition of the gold standard all available imaging techniques and follow-up over a minimum of 6 months were considered. Overall, 45 circumscribed bone metastases and 107 benign lesions were found. DWIBS performed significantly better in detecting malignant skeletal lesions in patients with more than 10 lesions (sensitivity: 0.97/0.91) compared to skeletal scintigraphy (sensitivity: 0.48/0.42). No statistical difference could be found between DWIBS (0.58/0.33) and skeletal scintigraphy (0.67/0.58) in the sensitivity values for malignant skeletal lesions in patients with less than 5 lesions. For benign lesions, scintigraphy scored best with a sensitivity of 0.93/0.87 compared to 0.20/0.13 for DWIBS. Interobserver agreement with Cohen's kappa coefficient was calculated as 0.784 in the case of scintigraphy and 0.663 for DWIBS. With respect to staging, in prostate and breast carcinoma, the DWIBS technique is not superior to skeletal scintigraphy, but ranks equally. However, in the cases with many bone lesions, markedly more metastases could be discovered using the DWIBS technique than skeletal scintigraphy. (orig.)

  13. Scintigraphy in equine practice

    The most common use for nuclear medicine in equine practice is bone imaging using technetium 99m as the radionuclide. This article will describe establishment of a facility to perform equine scintigraphy, the peculiarities associated with nuclear medicine and horses and describe a variety of the pathology we identify using scintigraphy. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  14. Indeterminate lesions on planar bone scintigraphy in lung cancer patients: SPECT, CT or SPECT-CT?

    Sharma, Punit; Kumar, Rakesh; Singh, Harmandeep; Bal, Chandrasekhar; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Julka, Pramod Kumar [All India Institute of Medical Sciences, Department of Radiation Oncology, New Delhi (India); Thulkar, Sanjay [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India)

    2012-07-15

    The objective of the present study was to compare the role of single photon emission computed tomography (SPECT), computed tomography (CT) and SPECT-CT of selected volume in lung cancer patients with indeterminate lesions on planar bone scintigraphy (BS). The data of 50 lung cancer patients (53 {+-} 10.3 years; range 30-75; male/female 38/12) with 65 indeterminate lesions on planar BS (January 2010 to November 2010) were retrospectively evaluated. All of them underwent SPECT-CT of a selected volume. SPECT, CT and SPECT-CT images were independently evaluated by two experienced readers (experience in musculoskeletal imaging, including CT: 5 and 7 years) in separate sessions. A scoring scale of 1 to 5 was used, in which 1 is definitely metastatic, 2 is probably metastatic, 3 is indeterminate, 4 is probably benign and 5 is definitely benign. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each modality, taking a score {<=}2 as metastatic. With receiver operating characteristic (ROC) curve analysis, areas under the curve (AUC) were calculated for each modality and compared. Clinical and imaging follow-up and/or histopathology were taken as reference standard. For both readers SPECT was inferior to CT (P = 0.004, P = 0.022) and SPECT-CT (P = 0.003, P = 0.037). However, no significant difference was found between CT and SPECT-CT for reader 1 (P = 0.847) and reader 2 (P = 0.592). The findings were similar for lytic as well as sclerotic lesions. Moderate inter-observer agreement was seen for SPECT images ({kappa} = 0.426), while almost perfect agreement was seen for CT ({kappa} = 0.834) and SPECT-CT ({kappa} = 0.971). CT alone and SPECT-CT are better than SPECT for accurate characterisation of indeterminate lesions on planar BS in lung cancer patients. CT alone is not inferior to SPECT-CT for this purpose and might be preferred because of shorter acquisition time and wider availability. (orig.)

  15. Indeterminate lesions on planar bone scintigraphy in lung cancer patients: SPECT, CT or SPECT-CT?

    The objective of the present study was to compare the role of single photon emission computed tomography (SPECT), computed tomography (CT) and SPECT-CT of selected volume in lung cancer patients with indeterminate lesions on planar bone scintigraphy (BS). The data of 50 lung cancer patients (53 ± 10.3 years; range 30-75; male/female 38/12) with 65 indeterminate lesions on planar BS (January 2010 to November 2010) were retrospectively evaluated. All of them underwent SPECT-CT of a selected volume. SPECT, CT and SPECT-CT images were independently evaluated by two experienced readers (experience in musculoskeletal imaging, including CT: 5 and 7 years) in separate sessions. A scoring scale of 1 to 5 was used, in which 1 is definitely metastatic, 2 is probably metastatic, 3 is indeterminate, 4 is probably benign and 5 is definitely benign. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each modality, taking a score ≤2 as metastatic. With receiver operating characteristic (ROC) curve analysis, areas under the curve (AUC) were calculated for each modality and compared. Clinical and imaging follow-up and/or histopathology were taken as reference standard. For both readers SPECT was inferior to CT (P = 0.004, P = 0.022) and SPECT-CT (P = 0.003, P = 0.037). However, no significant difference was found between CT and SPECT-CT for reader 1 (P = 0.847) and reader 2 (P = 0.592). The findings were similar for lytic as well as sclerotic lesions. Moderate inter-observer agreement was seen for SPECT images (κ = 0.426), while almost perfect agreement was seen for CT (κ = 0.834) and SPECT-CT (κ = 0.971). CT alone and SPECT-CT are better than SPECT for accurate characterisation of indeterminate lesions on planar BS in lung cancer patients. CT alone is not inferior to SPECT-CT for this purpose and might be preferred because of shorter acquisition time and wider availability. (orig.)

  16. Langerhans cell histiocytosis of the mandible in bone scintigraphy and CT

    The authors present a case of a 4-year old boy with a quickly growing tumor of the jaw. The CT examination revealed a destructive tumor in the body of the mandible involving soft tissues. A diagnosis of eosinophilic granuloma of the mandible was confirmed by a biopsy of the tumor. Skeletal scintigraphy showed areas of increased and decreased radiotracer uptake. The fusion of CT and scintigraphy images showed that the cold focus corresponds with the osteolytic area and the hot focuses are larger than the areas of osseous reconstruction shown in CT. Conclusion: In cases of histiocytosis skeletal scintigraphy and CT are complementary methods that enable one to make an assessment of the extent of the disease. (author)

  17. Comparison of 18F-FDG PET/CT with bone scintigraphy for detection of bone metastasis: a meta-analysis

    Background. The skeleton is one of the favorable sites for the metastasis of almost all human malignant neoplasms. An accurate diagnosis of bone metastasis is crucial for the patient's staging and management. Purpose. To investigate and compare diagnostic performance of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and bone scintigraphy (BS) for detection of bone metastasis in malignancies using meta-analysis. Material and Methods. PubMed (Medline included) was searched for relevant articles. We assessed the methodological quality with Quality Assessment of Diagnosis Accuracy Studies (QUADAS) score tool, and used statistical software to obtain pooled estimates of sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver-operating characteristic (SROC) curve. Results. Six studies met inclusion criteria. For 18F-FDG PET/CT, the pooled sensitivity and specificity were 0.934 and 0.975, respectively. The pooled positive likelihood ratio (LR+), negative likelihood ratio (LR-) and diagnostic odds ratio (DOR) were 34.990, 0.068 and 559.02, respectively. The area under the SROC curve was 0.9854. For BS, the pooled sensitivity, specificity, LR+ , LR- and DOR were 0.706 (0.642-0.764), 0.911 (0.896-0.926), 13.982 (2.419-80.817), 0.319 (0.143-0.712), and 60.420 (21.393-170.64), respectively. The area under the SROC curve was 0.9386. Conclusion. The results indicate that 18F-FDG PET/CT do have both higher sensitivity and specificity than bone scintigraphy for detecting metastatic bone tumor. However, further research is needed to evaluate the diagnostic performance of 18F-FDG PET/CT and BS in each common malignancy

  18. Massive Pelvic Lymphadenopathy Due to Recurrent Non-Hodgkin Lymphoma Incidentally Revealed on a 99mTc-MDP Bone Scintigraphy.

    Huang, Jianmin; Xie, Peng

    2016-06-01

    A 58-year-old man underwent Tc-MDP bone scintigraphy to evaluate the cause of diffuse bone pain. The images did not identify the exact cause of his symptoms. However, a "light bulb"-shaped urinary bladder and diffused increased activity in the scrotal region and left thigh were noted, which suggest a mass effect in the pelvis. A CT scan of the pelvis revealed soft tissue compressing the urinary bladder. A diagnosis of recurrent lymphoma was made. PMID:26828142

  19. Diagnostic role of whole body bone scintigraphy in atypical skeletal tuberculosis resembling multiple metastases: a case report

    Assadi Majid

    2009-11-01

    Full Text Available Abstract Introduction Osseous tuberculosis can be present with unifocal or multifocal bony involvement. Although multifocal involvement of the skeletal system in areas where tuberculosis is endemic is not a rare presentation, its exact prevalence is not well known. A case of atypical skeletal tuberculosis mimicking multiple secondary metastases on radiologic and scintigraphic imaging is presented to emphasize the contribution of bone scintigraphy in the assessment of osseous tuberculosis in typical and atypical presentations. Case presentation A 73-year-old cachectic Asian man (Iranian presented with a general feeling of being unwell and an acute loss of vision in his left eye accompanied by a severe headache. A Tc-99 m-methylene diphosphonate bone scan demonstrated multiple regions of intense activity in the appendicular and axial skeleton, suggesting metastatic involvement. Tumor markers (PSA, CA125, CA 19-9 and AFP were within normal ranges. Based on clinical presentation and laboratory, radiological and scintigraphic findings, a presumptive diagnosis of tuberculosis was made. Quadruple antituberculous chemotherapy was consequently started and the patient later showed marked improvement. Conclusion Scintigraphic bone scanning should be kept in mind when assessing bone pain in patients at a high risk of tuberculosis infection or reactivation. We present this unusual case of multifocal skeletal tuberculosis, and stress the related clinical and diagnostic points with the aim of stimulating a high index of suspicion that could facilitate early diagnosis and appropriate treatment.

  20. Skeletal scintigraphy

    Skeletal scintigraphy, using phosphates or diphosphonates labeled with technetium 99m, is a sensitive method of detecting bone abnormalities. The most important and most frequent role of bone scanning is evaluating the skeletal areas in patients who have a primary cancer, especially a malignant condition that has a tendency to spread to bone areas. The bone scan is superior to bone radiographs in diagnosing these abnormalities; 15 percent to 25 percent of patients with breast, prostate or lung cancer, who have normal roentgenograms, also have abnormal scintigrams due to metastases. The majority of bone metastases appear as hot spots on the scan and are easily recognized. The incidence of abnormal bone scans in patients with early stages (I and II) of breast cancer varies from 6 percent to 26 percent, but almost invariably those patients with scan abnormalities have a poor prognosis and should be considered for additional therapies. Progression or regression of bony lesions can be defined through scanning, and abnormal areas can be identified for biopsy. The incidence of metastases in solitary scan lesions in patients with known primary tumors varies from 20 percent to 64 percent. Bone scintigraphy shows positive uptake in 95 percent of cases with acute osteomyelitis. Stress fractures and trauma suspected in battered babies can be diagnosed by scanning before there is radiological evidence. The procedure is free from acute or long-term side effects and, except in cases of very young patients, sedation is seldom necessary. Although the test is sensitive, it is not specific and therefore it is difficult to overemphasize the importance of clinical, radiographic, biochemical and scanning correlation in each patient

  1. Comparison of whole-body STIR-MRI and {sup 99m}Tc-methylene-diphosphonate scintigraphy in children with suspected multifocal bone lesions

    Mentzel, Hans-J.; Sauner, D.; Fleischmann, C.; Vogt, S.; Kaiser, W.A. [University of Jena, Institute of Diagnostic and Interventional Radiology, Jena (Germany); Kentouche, K.; Zintl, F. [University of Jena, Department of Pediatrics, Jena (Germany); Gottschild, D. [University of Jena, Department of Nuclear Medicine, Jena (Germany)

    2004-12-01

    The study was performed to compare whole-body short time inversion recovery (STIR) MR imaging and {sup 99m}Tc-methylene diphosphonate planar scintigraphy in the examination of children with suspected multifocal skeletal malignant lesions. Sixteen patients with known or suspected malignant skeletal disease underwent both whole-body STIR MR imaging and bone scintigraphy. The lesions were described and numbered according to scintigraphic evaluation criteria. Thus, 16 regions were analyzed in each patient for the comparison between the two modalities. Histology was proven in the primary malignant regions. Follow-up MRIs were registered. Scintigraphy and MRI follow-up were evaluated as gold standard. A total of 139 different lesions was observed by both modalities. Baseline whole-body MRI revealed 119 bone lesions in 256 possible sites (46.5%); scintigraphy revealed only 58 lesions (22.6%). Congruence was observed in only four patients (25%). According to the location of the lesion, correlation was observed in 39/139 lesions (28%). In all, 57.5% of the lesions were detected only by MRI and 14.5% of the lesions were detected only by scintigraphy. Whole-body MRI was more sensitive (P<0.001). Of all lesions numbered which could be separated in the initial MRI, whole-body MRI detected 178 lesions in the patients. The results suggest that whole-body MRI using a STIR sequence is an effective radiation free method for examination of children with suspected multifocal bone lesions. MRI showed more lesions than conventional {sup 99m}Tc-methylene diphosphonate scintigraphy. Therefore, whole-body MRI may be feasible as a screening modality for metastatic and skip lesions in osteosarcoma, PNET, Ewing sarcoma and Langerhans cell histiocytosis in children. (orig.)

  2. Assessment of vascularization within hydroxyapatite ocular implant by bone scintigraphy: compartive analysis of planar and SPECT imaging

    Complete fibrovascular ingrowth within the hydroxyapatite ocular implant is necessary for peg drilling which is performed to prevent infection and to provide motility to the ocular prosthesis. We compared planar bone scintigraphy and SPECT for the evaluation of the vascularization within hydroxyapatite ocular implants. Seventeen patients (M:F=12:5, mean age: 50.4±17.5 years) who had received a coralline hydroxyapatite ocular implant after enucleation surgery were enrolled. Patients underwent Tc-99m MDP planar bone and SPECT imaging by dual head gamma camera after their implant surgery (interval: 197±81 days). Uptake on planar and SPECT images was graded visually as less than (grade 1), equal to (grade 2), and greater than (grade 3) nasal bridge activity. Quantitative ratio of implanted to non-implanted intraorbital activity was also measured. Vascularization within hydroxyapatite implants was confirmed by slit lamp examination and ocular movement. All but three patients were considered to be vascularized within hydroxyapatite implants. In visual analysis of planar image and SPECT, grade 1 was noted in 9/18 (50%) and 6/18 (33%), respectively. Grade 2 pattern 7/18 (39%) and 4/18 (22%), and grade 3 pattern was 2/18 (11%) and 8/18 (44%) respectively. When grade 2 or 3 was considered to be positive for vascularization, the sensitivity of planar and SPECT imaging were 60% (9/15) and 80% (12/15), respectively. In 3 patients with incomplete vascularization, both planar and SPECT showed grade 1 uptake. The orbital activity ratios on planar imaging were not significantly different between complete and incomplete vascularization (1.96±9.87 vs 1.17±0.08 , p>0.05), however, it was significantly higher on SPECT in patients with complete vascularization (8.44±5.45 vs 2.20±0.87, p<0.05). In the assessment of fibrovascular ingrowth within ocular implants by Tc-99m MDP bone scintigraphy, SPECT image appears to be more effective than planar scintigraphy

  3. Diagnostic imaging of musculoskeletal infection. Roentgenography; Gallium, indium-labeled white blood cell, gammaglobulin, bone scintigraphy; and MRI

    A great deal of effort has been made to evaluate and define the role of various diagnostic imaging techniques in various clinical settings that complicate the diagnosis of osteomyelitis. Except possibly in neonates, bone scintigraphy remains generally recommended when there has been no previous osseous involvement. In other cases of chronic disease, previous fracture or trauma, prosthesis, and diabetic foot, In-WBC scintigraphy is generally accepted as an appropriate imaging technique. MRI will play an increasingly important role in diagnosing osteomyelitis and may prove to be an important adjunct in these cases. Research continues to improve our current diagnostic armamentarium. In-IgG appears to avoid practical deficiencies encountered with 67Ga and In-WBC; it remains to be seen what role this agent will play in routine clinical practice. All agents to date image inflammation, not infection, and most require delayed imaging sessions, usually at 24 hours. These shortcomings necessitate further research to develop new radiotracers that can provide useful images within several hours and that are specific for infection, perhaps ultimately delineating the particular microorganism involved.84 references

  4. Clinical evaluation of patients showing renal hyperconcentration of Tc-99m pyrophosphate (hot kidney sign) on bone scintigraphy

    We evaluated clinical and follow-up findings for 59 patients in whom diffuse increased uptake of Tc-99m pyrophosphate in both renal parenchyma ('hot kidney sign') had been noted on bone scintigraphy. In more than half the patients, the cause of hyperconcentration was the administration of antitumor drugs. The period during which antitumor drugs affect renal uptake is thought to exceed that reported previously in the literature. In most patients, standard laboratory test results did not show any values indicative of renal dysfunction, and thus, in most cases 'hot kidney sign' apparently reflects subclinical and transient renal damages. However, it was noted that patients with more increased renal uptake tended to have more severe renal dysfunction than did patients with less increased uptake. Moreover, post-scintigraphy follow-up study revealed that 4 (20%) of 20 patients with 'hot kidney sign' subsequently developed more severe renal dysfunction, and two patients died due to renal failure. We therefore recommend that the renal function of patients who show 'hot kidney sign' is monitored and followed up. Tc-99m-hydroxy methylene diphosphate (HMDP) renograms of patients with 'hot kidney sign' showed smaller slope angle of both up- and down-slope than did that of controls. Tc-99m HMDP renograms may be useful in the quantitative evaluation of renal function. (author)

  5. Abnormal gastrointestinal accumulation of radiotracer by gastric bleeding during 99mTc-MDP bone scintigraphy

    We present a case in which a patient with acute hemorrhagic gastritis demonstrated abnormal gastrointestinal accumulation of radiotracer during 99mTc-methylene diphosphonate (MDP) skeletal scintigraphy. A hemorrhagic gastritis was subsequently demonstrated by endoscopy. The mechanism for the intestinal localization of 99mTc-MDP in this patients 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

  6. 18F-Fluoride PET/CT is highly effective for excluding bone metastases even in patients with equivocal bone scintigraphy

    Bone scintigraphy (BS) has been used extensively for many years for the diagnosis of bone metastases despite its low specificity and significant rate of equivocal lesions. 18F-Fluoride PET/CT has been proven to have a high sensitivity and specificity in the detection of malignant bone lesions, but its effectiveness in patients with inconclusive lesions on BS is not well documented. This study evaluated the ability of 18F-fluoride PET/CT to exclude bone metastases in patients with various malignant primary tumours and nonspecific findings on BS. We prospectively studied 42 patients (34-88 years of age, 26 women) with different types of tumour. All patients had BS performed for staging or restaging purposes but with inconclusive findings. All patients underwent 18F-fluoride PET/CT. All abnormalities identified on BS images were visually compared with their appearance on the PET/CT images. All the 96 inconclusive lesions found on BS images of the 42 patients were identified on PET/CT images. 18F-Fluoride PET/CT correctly excluded bone metastases in 23 patients (68 lesions). Of 19 patients (28 lesions) classified by PET/CT as having metastases, 3 (5 lesions) were finally classified as free of bone metastases on follow-up. The sensitivity, specificity, and positive and negative predictive values of 18F-fluoride PET/CT were, respectively, 100 %, 88 %, 84 % and 100 % for the identification of patients with metastases (patient analysis) and 100 %, 82 % and 100 % for the identification of metastatic lesions (lesion analysis). The factors that make BS inconclusive do not affect 18F-fluoride PET/CT which shows a high sensitivity and negative predictive value for excluding bone metastases even in patients with inconclusive conventional BS. (orig.)

  7. {sup 18}F-Fluoride PET/CT is highly effective for excluding bone metastases even in patients with equivocal bone scintigraphy

    Bortot, Daniel C.; Amorim, Barbara J.; Oki, Glaucia C.; Santos, Allan O.; Lima, Mariana C.L.; Etchebehere, Elba C.S.C.; Ramos, Celso Dario [State University of Campinas (UNICAMP), Division of Nuclear Medicine, Department of Radiology, Avenue Zeferino Vaz, S/N., PO Box 6149, Campinas (Brazil); Gapski, Sergio B. [Medicina Nuclear Diagnostico e Terapia, Nuclear Medicine Clinic, Campinas (Brazil); Barboza, Marycel F.; Mengatti, Jair [Nuclear and Energy Research Institute (IPEN)-CNEN, Radiopharmacy Directory, Sao Paulo (Brazil)

    2012-11-15

    Bone scintigraphy (BS) has been used extensively for many years for the diagnosis of bone metastases despite its low specificity and significant rate of equivocal lesions. {sup 18}F-Fluoride PET/CT has been proven to have a high sensitivity and specificity in the detection of malignant bone lesions, but its effectiveness in patients with inconclusive lesions on BS is not well documented. This study evaluated the ability of {sup 18}F-fluoride PET/CT to exclude bone metastases in patients with various malignant primary tumours and nonspecific findings on BS. We prospectively studied 42 patients (34-88 years of age, 26 women) with different types of tumour. All patients had BS performed for staging or restaging purposes but with inconclusive findings. All patients underwent {sup 18}F-fluoride PET/CT. All abnormalities identified on BS images were visually compared with their appearance on the PET/CT images. All the 96 inconclusive lesions found on BS images of the 42 patients were identified on PET/CT images. {sup 18}F-Fluoride PET/CT correctly excluded bone metastases in 23 patients (68 lesions). Of 19 patients (28 lesions) classified by PET/CT as having metastases, 3 (5 lesions) were finally classified as free of bone metastases on follow-up. The sensitivity, specificity, and positive and negative predictive values of {sup 18}F-fluoride PET/CT were, respectively, 100 %, 88 %, 84 % and 100 % for the identification of patients with metastases (patient analysis) and 100 %, 82 % and 100 % for the identification of metastatic lesions (lesion analysis). The factors that make BS inconclusive do not affect {sup 18}F-fluoride PET/CT which shows a high sensitivity and negative predictive value for excluding bone metastases even in patients with inconclusive conventional BS. (orig.)

  8. Value of bone scintigraphy in the search for metastases of primary bronchial carcinomas (relative to 8 observation)

    99m-technetium-labelled pyrophosphates are used at present. This technique combines the tropism of inorganic phosphates for the skeleton with the particularly suitable physical characteristics of technetium. The bone receives on irradiation of 0.5 rads for 10 millicuries of technetium, i.e. the equivalent of three lung X-rays, which means that the examination can safety be carried out on children. The scintigraph is performed with a two-head scanner giving a frontal image, showing in particular the shoulders, sternum, ribs and pelvic belt, and a dorsal image giving a better view of the spine and especially the sacro-iliac joints. When bone metastases are investigated by scintigraphic as compared to radiographic examination it should be remembered that 99mTc-labelled pyrophosphate scintigraphy, while revealing bone metastases at a pre-radiological stage in some cases, cannot distinguish between a benign and a malignant hyperfixing lesion nor show whether or not several lesions on the same scintigram are similar in origin. In this respect these two paraclinical examinations are complementary and give excellent results when used together

  9. Is 18F-FDG PET/CT more reliable than 99mTc-MDP planar bone scintigraphy in detecting bone metastasis in nasopharyngeal carcinoma?

    Bone metastasis occurs frequently in naso-pharyngeal carcinoma (NPC) patients. The aim of this study was to compare the clinical value of 18F-FDG PET/CT with that of 99mTc-MDP planar bone scintigraphy (PBS) for detecting bone metastasis in NPC patients. Thirty-five histologically proven NPC patients were enrolled in this retrospective study. They underwent both 18F-FDG PET/CT and PBS within 7 days in our department. In a lesion-based analysis, the skeletal system, excluding the head, was divided into four regions: the spine, the pelvis, the thorax, and the appendix. Bone metastasis was considered to be present by either biopsy or clinical follow-up for at least 6 months. PET/CT and PBS were compared by McNemar's paired-sample test. A total of 50 lesions were confirmed to be malignant (spine 27, thorax 11, pelvis 8 and appendix 4). Although PET/CT was found to be more sensitive on lesion level than PBS (sensitivity 70.0 versus 42.0%; P=0.044), there were still 14 metastatic (28.0%) lesions that could be detected by PBS while negative in PET/CT imaging. In a patient-based analysis, fifteen (42.9%) of 35 eligible patients were found to have bone metastasis. The sensitivity, specificity and accuracy of PET/CT was 60.0% (9/15), 100% (20/20) and 82.9% (29/35); as for PBS, it was 66.7% (10/15), 85.0% (17/20) and 77.1% (27/35), respectively. There was no statistical difference between PET/CT and PBS (P > 0.05). PBS, as a conventional imaging, should be used as an important complement for detecting bone metastasis in NPC patients. (author)

  10. Incremental value of single photon emission tomography/computed tomography in 3-phase bone scintigraphy of an accessory navicular bone

    Accessory navicular bone is one of the supernumerary ossicles in the foot. Radiography is non diagnostic in symptomatic cases. Accessory navicular has been reported as a cause of foot pain and is usually associated with flat foot. Increased radio tracer uptake on bone scan is found to be more sensitive. We report a case highlighting the significance of single photon emission tomography/computed tomography in methylene diphosphonate bone scan in the evaluation of symptomatic accessory navicular bone where three phase bone scan is equivocal

  11. Paget's disease diagnosed on bone scintigraphy: Case report and literature review

    Paget's disease of bone is a chronic bone remodeling disorder. Although most patients are asymptomatic, a variety of symptoms and complications may develop directly from bone involvement or secondarily due to compression by the expanded bone. It is usually diagnosed from radiological and biochemical abnormalities or in advanced cases it becomes clinically evident due to the expanded bone. We report a case of Paget's disease which was detected incidentally during evaluation of nephrolithiasis and polyarthritis but had normal radiographs and normal biochemical markers

  12. Post-traumatic changes of the temporo-mandibular joint by bone scintigraphy

    13 patients who sustained mandibular trauma were investigated with radiographs and scintiscans. The scintiscans showed abnormal uptake of radiopharmaceutical in the temporomandibular joint (TMJ). In patients with a long history of traumatic arthrosis, there was more positive correlation between the scintiscans, and clinical symptoms and histology than between radiographs, and symptoms and histology. In patients with mandibular body fractures and no TMJ symptoms, the scans showed abnormal uptake in the TMJ in 7/8 joints, in the absence of radiographic abnormality. The significance of the abnormal uptake and the value of scintigraphy is discussed. (author)

  13. Post-traumatic changes of the temporo-mandibular joint by bone scintigraphy

    Harris, S.A.; Rood, J.P.; Testa, H.J.

    1988-01-01

    13 patients who sustained mandibular trauma were investigated with radiographs and scintiscans. The scintiscans showed abnormal uptake of radiopharmaceutical in the temporomandibular joint (TMJ). In patients with a long history of traumatic arthrosis, there was more positive correlation between the scintiscans, and clinical symptoms and histology than between radiographs, and symptoms and histology. In patients with mandibular body fractures and no TMJ symptoms, the scans showed abnormal uptake in the TMJ in 7/8 joints, in the absence of radiographic abnormality. The significance of the abnormal uptake and the value of scintigraphy is discussed.

  14. Triphase scintigraphy with osteotropic radiopharmaceuticals in aseptic necrosis of tight bone

    Three-phase scintigraphy with 99mTc-diphosphonate complexes (pyrophosphate and diphosphonate) of hip joints has been carried out in patients with Perthes' and Chandler's diseases by investigation of selected zones from the pathologically altered and symmetric intact joints. Semiquantitative indices have been derived for perfusion, tissue and mineral metabolism and the ratio perfusion/mineral metabolism. The combination of decreased perfusion with slightly to moderately increased mineral metabolism is a typical indication of aseptic necrosis of the femoral head. The method allows early diagnosis of the disease in about 64% of the cases. 1 tab., 1 fig., 5 refs

  15. Comparison of single photon emission computed tomography-computed tomography, computed tomography, single photon emission computed tomography and planar scintigraphy for characterization of isolated skull lesions seen on bone scintigraphy in cancer patients

    The purpose of this study is to evaluate the added value of single photon emission computed tomography-computed tomography (SPECT-CT) over planar scintigraphy, SPECT and CT alone for characterization of isolated skull lesions in bone scintigraphy (BS) in cancer patients. A total of 32 cancer patients (age: 39.5 ± 21.9; male: female - 1:1) with 36 isolated skull lesions on planar BS, underwent SPECT-CT of skull. Planar BS, SPECT, CT and SPECT-CT images were evaluated in separate sessions to minimize recall bias. A scoring scale of 1-5 was used, where 1 is definitely metastatic, 2 is probably metastatic, 3 is indeterminate, 4 is probably benign and 5 is definitely benign. With receiver operating characteristic analysis area under the curves (AUC) was calculated for each modality. For calculation of sensitivity, specificity and predictive values a Score ≤3 was taken as metastatic. Clinical/imaging follow-up and/or histopathology were taken as reference standard. Of 36 skull lesions 11 lesions each were on frontal, parietal and occipital bone while three lesions were in the temporal bone. Of these 36 lesions, 16 were indeterminate (Score-3) on planar and SPECT, five on CT and none on SPECT-CT. The AUC was largest for SPECT-CT followed by CT, SPECT and planar scintigraphy, respectively. Planar scintigraphy was inferior to SPECT-CT (P = 0.006) and CT (P = 0.012) but not SPECT (P = 0.975). SPECT was also inferior to SPECT-CT (P = 0.007) and CT (P = 0.015). Although no significant difference was found between SPECT-CT and CT (P = 0.469), the former was more specific (100% vs. 94%). SPECT-CT is better than planar scintigraphy and SPECT alone for correctly characterizing isolated skull lesions on BS in cancer patients. It is more specific than CT, but provides no significant advantage over CT alone for this purpose

  16. Combined bone scintigraphy and indium-111 leukocyte scans in neuropathic foot disease

    Schauwecker, D.S.; Park, H.M.; Burt, R.W.; Mock, B.H.; Wellman, H.N.

    1988-10-01

    It is difficult to diagnose osteomyelitis in the presence of neurotrophic osteoarthropathy. We performed combined (99mTc)MDP bone scans and indium-111 (111In) leukocyte studies on 35 patients who had radiographic evidence of neuropathic foot disease and clinically suspected osteomyelitis. The (111In)leukocyte study determined if there was an infection and the bone scan provided the anatomic landmarks so that the infection could be localized to the bone or the adjacent soft tissue. Seventeen patients had osteomyelitis and all showed increased (111In)leukocyte activity localized to the bone, giving a sensitivity of 100%. Among the 18 patients without osteomyelitis, eight had no accumulation of (111In)leukocytes, seven had the (111In)leukocyte activity correctly localized to the soft tissue, two had (111In)leukocyte activity mistakenly attributed to the bone, and one had (111In)leukocyte accumulation in a proven neuroma which was mistakenly attributed to bone. These three false-positive results for osteomyelitis reduced the specificity to 83%. Considering only the 27 patients with a positive (111In)leukocyte study, the combined bone scan and (111In)leukocyte study correctly localized the infection to the soft tissues or bone in 89%. Uninfected neurotrophic osteoarthropathy does not accumulate (111In)leukocytes. We found the combined bone scan and (111In) leukocyte study useful for the detection and localization of infection to soft tissue or bone in patients with neuropathic foot disease.

  17. Age-related changes in the hemodynamics of the femoral head as evaluated by early phase of bone scintigraphy

    The femoral head is reported to be in a markedly hypoemic state as compared with other tissues even under normal conditions, and it is therefore necessary to understand its hemodynamics to investigate the pathogenesis of hip disorders. It is known that aspects of intraosseous hemodynamics including blood flow and blood pool can be evaluated soon after radioisotope administration. In this study, hemodynamic changes in the femoral head according to gender and age were examined by investigating accumulation of radioisotope in the tissue during the early phase of bone scintigraphy. The subjects of this study consisted of 58 joints of 31 men and 75 joints of 41 women, whose ages ranged from 15 to 87 years (average age: 67.9 years). Images of bone scintigraphy were obtained for 15 to 20 minutes at 5 minutes and at 3 hours after radioisotope administration. The ratio of accumulation in the femoral head to that in the diaphysis (head-to-diaphysis ratio, HD ratio) was calculated. HD ratios obtained 15-20 minutes later ranged from 0.01 to 7.35 (1.88±0.91, mean±SD). HD ratios decreased with age, and a significant inverse correlation was observed between age and HD ratio, demonstrating a correlation coefficient of -0.27 (p=0.001). The HD ratio among men was 0.01-3.57 (1.66±0.71), while that among women was 0.53-7.35 (2.05±1.01), and a significant difference was observed in HD ratio between men and women (p=0.02). There was a significant difference in HD ratios between men and women in their teens to forties (p=0.03), while no significant differences was observed in the other age groups. HD ratios obtained 3 hours later ranged from 0.44 to 6.32 (1.95±0.79, mean±SD), and no significant correlation was observed between age and HD ratio, demonstrating a correlation coefficient of -0.14. The present study demonstrated that blood flow and blood pool of the femoral head decrease with aging particularly in women. This hemodynamic deterioration of the femoral head caused by aging

  18. Comparison of choline-PET/CT, MRI, SPECT, and bone scintigraphy in the diagnosis of bone metastases in patients with prostate cancer: a meta-analysis

    Published data on the diagnosis of bone metastases of prostate cancer are conflicting and heterogeneous. We performed a comprehensive meta-analysis to compare the diagnostic performance of choline-PET/CT, MRI, bone SPECT, and bone scintigraphy (BS) in detecting bone metastases in parents with prostate cancer. Pooled sensitivity, specificity, and diagnostic odds ratios (DOR) were calculated both on a per-patient basis and on a per-lesion basis. Summary receiver operating characteristic (SROC) curves were also drawn to obtain the area under curve (AUC) and Q* value. Sixteen articles consisting of 27 studies were included in the analysis. On a per-patient basis, the pooled sensitivities by using choline PET/CT, MRI, and BS were 0.91 [95 % confidence interval (CI): 0.83-0.96], 0.97 (95 % CI: 0.91-0.99), 0.79 (95 % CI: 0.73-0.83), respectively. The pooled specificities for detection of bone metastases using choline PET/CT, MRI, and BS, were 0.99 (95 % CI: 0.93-1.00), 0.95 (95 % CI: 0.90-0.97), and 0.82 (95 % CI: 0.78-0.85), respectively. On a per-lesion basis, the pooled sensitivities of choline PET/CT, bone SPECT, and BS were 0.84 (95 % CI: 0.81-0.87), 0.90 (95 % CI: 0.86-0.93), 0.59 (95 % CI: 0.55-0.63), respectively. The pooled specificities were 0.93 (95 % CI: 0.89-0.96) for choline PET/CT, 0.85 (95 % CI: 0.80-0.90) for bone SPECT, and 0.75 (95 % CI: 0.71-0.79) for BS. This meta-analysis indicated that MRI was better than choline PET/CT and BS on a per-patient basis. On a per-lesion analysis, choline PET/CT with the highest DOR and Q* was better than bone SPECT and BS for detecting bone metastases from prostate cancer. (orig.)

  19. Comparison of choline-PET/CT, MRI, SPECT, and bone scintigraphy in the diagnosis of bone metastases in patients with prostate cancer: a meta-analysis

    Shen, Guohua; Deng, Houfu; Hu, Shuang; Jia, Zhiyun [West China Hospital of Sichuan University, Department of Nuclear Medicine, Chengdu, Sichuan (China)

    2014-11-15

    Published data on the diagnosis of bone metastases of prostate cancer are conflicting and heterogeneous. We performed a comprehensive meta-analysis to compare the diagnostic performance of choline-PET/CT, MRI, bone SPECT, and bone scintigraphy (BS) in detecting bone metastases in parents with prostate cancer. Pooled sensitivity, specificity, and diagnostic odds ratios (DOR) were calculated both on a per-patient basis and on a per-lesion basis. Summary receiver operating characteristic (SROC) curves were also drawn to obtain the area under curve (AUC) and Q* value. Sixteen articles consisting of 27 studies were included in the analysis. On a per-patient basis, the pooled sensitivities by using choline PET/CT, MRI, and BS were 0.91 [95 % confidence interval (CI): 0.83-0.96], 0.97 (95 % CI: 0.91-0.99), 0.79 (95 % CI: 0.73-0.83), respectively. The pooled specificities for detection of bone metastases using choline PET/CT, MRI, and BS, were 0.99 (95 % CI: 0.93-1.00), 0.95 (95 % CI: 0.90-0.97), and 0.82 (95 % CI: 0.78-0.85), respectively. On a per-lesion basis, the pooled sensitivities of choline PET/CT, bone SPECT, and BS were 0.84 (95 % CI: 0.81-0.87), 0.90 (95 % CI: 0.86-0.93), 0.59 (95 % CI: 0.55-0.63), respectively. The pooled specificities were 0.93 (95 % CI: 0.89-0.96) for choline PET/CT, 0.85 (95 % CI: 0.80-0.90) for bone SPECT, and 0.75 (95 % CI: 0.71-0.79) for BS. This meta-analysis indicated that MRI was better than choline PET/CT and BS on a per-patient basis. On a per-lesion analysis, choline PET/CT with the highest DOR and Q* was better than bone SPECT and BS for detecting bone metastases from prostate cancer. (orig.)

  20. Incremental value of single photon emission tomography/computed tomography in 3-phase bone scintigraphy of an accessory navicular bone

    Jain, Sachin; Karunanithi, Sellam; Agarwal, Krishan Kant; Kumar, Ganesh; Roy, Shambo Guha; Tripathi, Madhavi

    2014-01-01

    Accessory navicular bone is one of the supernumerary ossicles in the foot. Radiography is non diagnostic in symptomatic cases. Accessory navicular has been reported as a cause of foot pain and is usually associated with flat foot. Increased radio tracer uptake on bone scan is found to be more sensitive. We report a case highlighting the significance of single photon emission tomography/computed tomography in methylene diphosphonate bone scan in the evaluation of symptomatic accessory navicula...

  1. The assessment of bee venom responses in an experimental model of mono-arthritis using Tc-99m DPD bone scintigraphy

    Several recent studies have shown that bee venom (BV) has an anti-nociceptive and anti-inflammatory effect on arthritis. However, objective methods for evaluation of the therapeutic effect of BV is insufficient in animal studies and clinical trials. Our purpose was to determine the usefulness of bone scintigraphy using Tc-99m DPD (3,3-diphosphono-1,2-propan-dicarbonacid) about effects of BV applied to carrageenan-induced mono-arthritis (CIA) model. Mono-arthritis was induced by an intra-articular injection of carrageenan in Sprague-Dawley rats. Administration of BV (0.8 mg/kg) was performed at 30 min before and at 4 h after the induction of mono-arthritis. We assigned rats to BV-before, BV-after, control-before and control-after groups and compared the results of each group by the weight-loading test and bone scintigraphy. The rats received an intravenous injection of 37 MBq of Tc-99m DPD by the tail vein and then scanning was performed at 4 and 24 h after the injection. Visual assessment and quantitative analysis were performed for both knees. The BV-before and BV-after groups were more improved than the control groups on the weight load test (p<0.05). Bone scintigraphy showed lower activity in the BV-before group than in the control-before group (p<0.05) on the 4 h imaging. However, a significant difference in the BV-before and BV-after groups was not observed on the 24 h imaging. BV had therapeutic effects by anti-nociceptive and anti-inflammatory activity in the CIA and bone scintigraphy performed on 4 h imaging provided visual and quantitative information for the assessment of the therapeutic response to BV as an objective method in mono arthritis model. (author)

  2. {sup 99m}Tc(V)-DMSA scintigraphy in monitoring the response of bone disease to vitamin D{sub 3} therapy in renal osteodystrophy

    Sarikaya, A.; Sen, S.; Hacimahmutoglu, S.; Pekindil, G. [Trakya Univ., Edirne (Turkey). Faculty of Medicine

    2002-02-01

    Renal osteodystrophy (ROD) is a common and serious complication for uremic patients and patients are treated with 1,25-dihydroxyvitamin D{sub 3}. The bone scanning agent {sup 99m}Tc-phosphate has also been used to evaluate in ROD but it is not clear that bone scintigraphy has a role in the follow-up of treatment. In this study {sup 99m}Tc(V)-DMSA scintigraphy was performed in eleven patients [age 40.7{+-}17.3 (mean {+-}SD) yr] with ROD before and after vitamin D{sub 3} therapy. Images were obtained after hemodialysis performed following tracer injection to maintain normal blood levels of the radiopharmaceutical and to reduce soft tissue activity. Lumbar vertebra-to-soft tissue uptake ratios (LUR) were quantified with the planar {sup 99m}Tc(V)-DMSA images. Alkaline phosphatase and parathyroid hormone levels after tretment had significantly decreased compared with pre-therapy. In all patients there was visually decreased uptake in bone structures after treatment. After treatment the mean LUR ratio was significantly lower than those of before treatment (3.59{+-}2.63 vs. 1.65{+-}0.62; p=0.01). LUR values were correlated with pre-therapy alkaline phosphatase and parathyroid hormone. These findings indicate that {sup 99m}Tc(V)-DMSA scintigraphy is sensitive in evaluating the response of ROD to vitamin D{sub 3} therapy. (author)

  3. Study on thd relationship between serum fibrosis markers levels, bone marrow scintigraphy patterns and clinical staging in patients with chronic ldiopathic myelofibrosis (CIMF)

    Objective: To study the changes of serum fibrosis markers levels and the pattern of bone marrow scintigraphy and their relationship with clinical stages in patients with chronic idiopathic myelofibrosis (CIMF). Methods: Transforming growth factor-β1 (TGF-β1) and platelet derived growth factor (PDGF) (with ELISA), serum typeIII procollagen (PCIII), type IV collagen (C-IV), and laminin (LN) (with RIA) were detected in 46 with patients with chronic idiopathic myelofibrosis and 34 controls. Bone marrow scintigraphy 99m Tc-sulfur colloid was performed in the 46 CIMF patients. Results: Five fibrosis markers in patients with CIMF were significantly higher than those in controls. There were significantly differences among the levels in different stages, especially with sclerotic stage in CIMF patients. The imaging patterns were classified into three types according to the radio-distribution and activity of bone marrow: 13 cases of increased imaging in 14 patients of cellular stage, 17 cases with creased expansion imaging in 19 patients of collagen fiber stage and 13 cases (100%) with totally depressed imaging in patients of sclerotic stage. Conclusion: As the disease progressed, the serum fibrosis markers levels gradually incroased and the scintigraphy patterns corresponded well to the clinical staging. (authors)

  4. 99mTc(V)-DMSA scintigraphy in monitoring the response of bone disease to vitamin D3 therapy in renal osteodystrophy

    Renal osteodystrophy (ROD) is a common and serious complication for uremic patients and patients are treated with 1,25-dihydroxyvitamin D3. The bone scanning agent 99mTc-phosphate has also been used to evaluate in ROD but it is not clear that bone scintigraphy has a role in the follow-up of treatment. In this study 99mTc(V)-DMSA scintigraphy was performed in eleven patients [age 40.7±17.3 (mean ±SD) yr] with ROD before and after vitamin D3 therapy. Images were obtained after hemodialysis performed following tracer injection to maintain normal blood levels of the radiopharmaceutical and to reduce soft tissue activity. Lumbar vertebra-to-soft tissue uptake ratios (LUR) were quantified with the planar 99mTc(V)-DMSA images. Alkaline phosphatase and parathyroid hormone levels after treatment had significantly decreased compared with pre-therapy. In all patients there was visually decreased uptake in bone structures after treatment. After treatment the mean LUR ratio was significantly lower than those of before treatment (3.59±2.63 vs. 1.65±0.62; p=0.01). LUR values were correlated with pre-therapy alkaline phosphatase and parathyroid hormone. These findings indicate that 99mTc(V)-DMSA scintigraphy is sensitive in evaluating the response of ROD to vitamin D3 therapy. (author)

  5. Research of bone metastases in prostate cancer: scintigraphy and radiological study

    This paper analyses the results of bone scan and radiologic study of the bones on the search of metastases of prostate cancer seen in the last two years. In 44 patients with prostatic cancer the diagnostic of metastatic disease was made by the 99m Tc scan in 52%, and by the metastatic radiologic survey in only 25%. (author)

  6. Usefulness of bone scintigraphy with HMDP {sup 99m}Tc in one case of atypical tuberculosis; Utilise de la scintigraphie osseuse a l'HMDP-{sup 99m}Tc dans un cas de tuberculose atypique

    Evangelista, E.; Itti, E.; Maaloul, M.; Azah, T.; Maignan, M. [Hopital Henri-Mondor, AP-HP, Universite Paris-12, Service de Medecine Nucleaire, 94 - Creteil (France); Bertocchi, M. [Hopital Henri-Mondor, AP-HP, Universite Paris-12, Service d' immunologie, 94 - Creteil (France); Oniankitan, O.; Chevalier, X. [Hopital Henri-Mondor, AP-HP, Universite Paris-12, Service de Rhumatologie, 94 - Creteil (France)

    2004-07-01

    We present a case of atypical osseous tuberculosis mimicking multiple secondary metastases on radiological and nuclear imaging. A multi-bacterial spondylitis of Ti was first diagnosed on a 56 year-old patient presenting with dorsal pain and neurological deficit of the left arm (fine needle aspiration was negative for Mycobacterium tuberculosis). Whole-body bone scintigraphy identified additional sites, including an asymptomatic sacroiliac lesion, which was accessible to biopsy that gave the final diagnosis of osseous tuberculosis. We propose, in the discussion, a practical review of imaging patterns in cases of typical or atypical osseous tuberculosis. (author)

  7. Diffuse pulmonary uptake of bone-seeking radiotracer in bone scintigraphy of a rare case of pulmonary alveolar microlithiasis

    Pulmonary alveolar microlithiasis (PAM) is a rare diffuse pulmonary disease representing microliths formed by deposition of calcium phosphonate in the alveolar airspaces. PAM is often diagnosed incidentally during chest X-ray imaging. Most of them are asymptomatic. We present a 39-year-old man referring for a bone scan due to a complaint of right leg pain. Bone scan showed diffuse uptake of bone-seeking radiotracer on both lung fields predominantly in basal regions. The bronchoalveolar lavage test confirmed the diagnosis of PAM

  8. Gangrenous Leg in a Patient With Diabetes on MDP Bone Scintigraphy.

    Evbuomwan, Osayande; Akinwale Ayeni, Olusegun; Dhoodhat, Shireen; Di Tamba Vangu, Mboyo

    2016-05-01

    Diabetic patients with peripheral arterial disease frequently experience gangrene of the lower limbs. It has been suggested that a bone scan is useful in differentiating viable from nonviable tissues in patients with extensive peripheral gangrene and thus can help determine the appropriate level of amputation in such patients. We present a 68-year-old diabetic woman with right breast cancer, who was referred to our facility for a bone scan as part of her metastatic workup. Bone scan findings revealed absolute photon deficiency in the distal half of her left lower limb. PMID:26828148

  9. Bone scintigraphic assessment of multifocal sequelae of staphylococcus aureus septicemia, a case report; Un cas de septicemie a staphylocoque dore: evaluation des sequelles multifocales en scintigraphie osseuse

    Andriamisandratsoa, N.; Yu, O.; Grucker, D. [Faculte de Medecine, Service de Medecine Nucleaire, Institut de Physique Biologique, 67 - Strasbourg (France); Bole, J.C.; Weber, J.C. [Hopital Universitaire de Strasbourg, Hopital Civil, Service de Medecine Interne A, 67 - Strasbourg (France)

    2003-10-01

    A 71-year old patient suffering from untreated non-insulin-dependent diabetes presented anti-inflammatory drug-resistant lumbalgia with referred inguinal pain either on the right or left side, corresponding to the first signs of septicemia due to staphylococcus aureus, with urinary onset. Despite specific antibiotic treatment, pulmonary, cardiac and neurological complications followed. Simultaneous investigations by MRI and bone scintigraphy performed in the remitting patient showed multiple septic metastatic localization in the soft tissues and bones. It was hence necessary to pursue the antibiotic therapy to avoid relapses. (author)

  10. New strategy in diagnostic, preventive and following way in osteonecrosis of sickle-cell disease in Cote d'Ivoire with bone scintigraphy

    Osteonecrosis is the most frequent complications of sickle-cell disease (S.C.D.) whose prevalence in Cote d'Ivoire is 21%. The main of this study was to compare scintigraphy, clinical and radiological observations to assess earlier diagnosis in S.C.D. osteonecrosis. It was a prospective study about 45 S.C.D. patients who presented coxopathy and had radio-labelled di phosphonates bone scintigraphy. The results revealed 49% of lesions whose 48% appeared with homogeneous hyper fixation, 11% homogeneous hypo fixation, 5% of hypo fixation got round by hyper fixation. Eighty-one percent of lesions concerned femoral head, 6% femoral condyle and 3% humoral head. Fifty percent of osteonecrosis was not visible in radiology and corresponded to the earlier stage. These invisible radiology aspects were observed in 100% hips without lameness, and in 43% permanent lameness. Scintigraphy (sensitive in 100%) isolated 38% more than conventional radiography. In main to improve S.C.D. osteonecrosis prognostic in Cote d'Ivoire, this preliminary study outline that scintigraphy is fundamental in management. (authors)

  11. Sacro-iliac joint disease in drug abusers: The role of bone scintigraphy

    Bone scintigrams demonstrated increased uptake in the sacroiliac joint in twenty drug addicts with low back pain and signs of localized sepsis. The localization of the disease was decisive for the orthopedist in the aspiration of the affected joint. (orig.)

  12. Preparation and evaluation of a radiogallium complex-conjugated bisphosphonate as a bone scintigraphy agent

    Ogawa, Kazuma, E-mail: kogawa@p.kanazawa-u.ac.jp [Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa 920-1192 (Japan); Takai, Kenichiro; Kanbara, Hiroya; Kiwada, Tatsuto [Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa 920-1192 (Japan); Kitamura, Yoji; Shiba, Kazuhiro [Advanced Science Research Center, Kanazawa University, Kanazawa 920-8640 (Japan); Odani, Akira [Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa 920-1192 (Japan)

    2011-07-15

    Introduction: {sup 68}Ga is a radionuclide of great interest as a positron emitter for positron emission tomography (PET). To develop a new bone-imaging agent with radiogallium, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) was chosen as a chelating site and Ga-DOTA complex-conjugated bisphosphonate, which has a high affinity for bone, was prepared and evaluated. Although we are interested in developing {sup 68}Ga-labeled bone imaging agents for PET, in these initial studies {sup 67}Ga was used because of its longer half-life. Methods: DOTA-conjugated bisphosphonate (DOTA-Bn-SCN-HBP) was synthesized by conjugation of 2-(4-isothiocyanatebenzyl)-1,4,7,10-tetraazacyclododecane-1,4,7, 10-tetraacetic acid to 4-amino-1-hydroxybutylidene-1,1-bisphosphonate (alendronate). {sup 67}Ga-DOTA-Bn-SCN-HBP was prepared by coordination with {sup 67}Ga, and its in vitro and in vivo evaluations were performed. Results: {sup 67}Ga-DOTA-Bn-SCN-HBP was prepared with a radiochemical purity of over 95% without purification. {sup 67}Ga-DOTA-Bn-SCN-HBP had great affinity for hydroxyapatite in binding assay. In biodistribution experiments, {sup 67}Ga-DOTA-Bn-SCN-HBP accumulated in bone rapidly but was hardly observed in tissues other than bone. Pretreatment of an excess amount of alendronate inhibited the bone accumulation of {sup 67}Ga-DOTA-Bn-SCN-HBP. Conclusions: {sup 67}Ga-DOTA-Bn-SCN-HBP showed ideal biodistribution characteristics as a bone-imaging agent. These findings should provide useful information on the drug design of bone imaging agents for PET with {sup 68}Ga.

  13. Pulmonary calcification in renal failure patient incidentally revealed by bone scintigraphy

    Pulmonary calcification is a subdiagnosed metabolic lung disease that is commonly asymptomatic and frequently associated with end-stage renal disease. We report a case of a 21-year-old man with a 4-year history of end-stage renal disease without respiratory symptoms. We discover incidentally on a bone scan a pulmonary calcification. Parathyroidectomy was refused by the patient. After 3 months of medical treatment, a second bone scan was done, and we found a partial response

  14. Baseline patterns of bone scintigraphy in patients with established post-poliomyelitis paralysis

    Marafi, Fahad A.; Esmail, Abdulredha A.; Elgazzar, Abdelhamid H. [Mubarak Alkabeer Hospital and Kuwait University, Departments of Nuclear Medicine, P.O. Box 24923, Safat (Kuwait); Al-Said Ali, Ali [Ministry of Health, Department of Surgery, Mubarak Alkabeer Hospital, Safat (Kuwait)

    2010-09-15

    Post-poliomyelitis syndrome causes variable musculoskeletal manifestations including pain, muscle weakness and fatigue. These manifestations are commonly secondary to overuse and misuse of muscles and joints and could follow a fall. Bone scan can be useful in determining the underlying cause and follow-up. The objective of this study was to describe the late scintigraphic patterns on bone scan following poliomyelitis. Bone scans of 8 adult patients (7 female and 1 male), aged 35 to 53 years, who were known to have paralytic poliomyelitis, were retrospectively studied. Six patients had unilateral while 1 had bilateral disease. All patients had three-phase bone scan and 5 had SPECT study as well. Studies were reviewed by two qualified nuclear medicine physicians and findings were recorded and analyzed. Several patterns were consistently identified: decreased blood pool activity in the affected lower limb of all patients; deformed ipsilateral hemi-pelvis with reduced uptake on the affected side in all patients with unilateral disease; stress changes with increased uptake in the bones of the contra-lateral lower extremity; and degenerative changes in multiple joints (shoulder, knee, hip, ankle and spine). Significant scoliosis was only noted in the patient with bilateral disease. Scintigraphic patterns on bone scan associated with the post-poliomyelitis syndrome and persistent weakness following a distant episode of poliomyelitis have been described. Awareness of these characteristic scintigraphic findings may facilitate an accurate diagnosis and lead to more appropriate patient management. (orig.)

  15. Baseline patterns of bone scintigraphy in patients with established post-poliomyelitis paralysis

    Post-poliomyelitis syndrome causes variable musculoskeletal manifestations including pain, muscle weakness and fatigue. These manifestations are commonly secondary to overuse and misuse of muscles and joints and could follow a fall. Bone scan can be useful in determining the underlying cause and follow-up. The objective of this study was to describe the late scintigraphic patterns on bone scan following poliomyelitis. Bone scans of 8 adult patients (7 female and 1 male), aged 35 to 53 years, who were known to have paralytic poliomyelitis, were retrospectively studied. Six patients had unilateral while 1 had bilateral disease. All patients had three-phase bone scan and 5 had SPECT study as well. Studies were reviewed by two qualified nuclear medicine physicians and findings were recorded and analyzed. Several patterns were consistently identified: decreased blood pool activity in the affected lower limb of all patients; deformed ipsilateral hemi-pelvis with reduced uptake on the affected side in all patients with unilateral disease; stress changes with increased uptake in the bones of the contra-lateral lower extremity; and degenerative changes in multiple joints (shoulder, knee, hip, ankle and spine). Significant scoliosis was only noted in the patient with bilateral disease. Scintigraphic patterns on bone scan associated with the post-poliomyelitis syndrome and persistent weakness following a distant episode of poliomyelitis have been described. Awareness of these characteristic scintigraphic findings may facilitate an accurate diagnosis and lead to more appropriate patient management. (orig.)

  16. FDG-PET, 99mTc-HMPAO white blood cell SPET and bone scintigraphy in the evaluation of painful total knee arthroplasties

    Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET), technetium-99m hexamethylpropylene amine oxime (HMPAO)-labelled white blood cell (WBC) scintigraphy and bone scintigraphy were used in the evaluation of total knee arthroplasties (TKAs). We prospectively included 21 patients who had a three-phase bone scan for exclusion of infection of TKAs. Four hours after injection of 185 MBq 99mTc-HMPAO-labelled WBCs, planar and single-photon emission tomographic (SPET) imaging was performed. Planar imaging was repeated at 24 h p.i. Consecutively images of the knees were obtained with a dedicated PET system 60 min following the injection of 370 MBq of FDG. Focal tracer uptake was scored on SPET and PET visually (0=no uptake, 4=intense uptake). In addition, SUV (standardised uptake value) per voxel was calculated from attenuation-corrected PET images using the MLAA algorithm. Focal uptake at the bone-prosthesis interface was used as the criterion for infection before and after correlation with the third phase of the bone scan. Final diagnosis was based on operative findings, culture and clinical outcome. In the infected TKAs, the WBC scan showed focal activity of grade 2 (n=2), 3 (n=1) or 4 (n=2). PET scan revealed focal activity of grade 4 (n=5) or 3 (n=1). WBC scan alone had a specificity for infection of 53% [positive predictive value (PPV) 42%, sensitivity 100%], compared with 73% for PET scan (PPV 60%, sensitivity 100%). Considering only lesions at the bone-prosthesis interface that were also present on the third phase of the bone scan, we found a specificity of 93% (PPV 83%) for WBC scan. Using these criteria, a specificity of 80% (PPV 67%) was obtained for PET scan. Two out of three false-positive PET scans were due to loosening of the TKA. It is concluded that WBC scintigraphy in combination with bone scintigraphy has a high specificity in the detection of infected TKAs. FDG-PET seems to offer no additional benefit. (orig.)

  17. Postoperative bone marrow alterations: Potential pitfalls in the diagnosis of osteomyelitis with In-111-labeled leukocyte scintigraphy

    Scintigraphy was used after injection of technetium-99m methylene diphosphonate (MDP) and indium-111-labeled white blood cells (WBCs) to assess for the presence of osteomyelitis in 97 patients who had undergone prior surgical procedures. Thirty-four patients with abnormal In-111-labeled WBC patterns underwent restudy with Tc-99m albumin colloid (AC). Scintigraphic findings were considered positive for osteomyelitis whenever localization of In-111-labeled WBCs exceeded Tc-99m AC activity in extent or focal intensity (discordant pattern). Ten of 12 patients with culture-proved osteomyelitis had discordant patterns; two had false-negative (concordant) patterns. The cases of 20 of 22 patients without infection who were considered to have osteomyelitis on the basis of patterns of In-111-labeled WBCs and Tc-99m MDP were reclassified correctly on the basis of concordant patterns of In-111-labeled WBCs and Tc-99m AC. Radiocolloid images improved the overall scintigraphic specificity for osteomyelitis from 59% without bone marrow imaging to 92%; sensitivity decreased from 94% to 88%

  18. A comparison of bone scintigraphy and MRI in the early diagnosis of the occult scaphoid waist fracture

    Objective. To determine the accuracy of MRI in the assessment of the radiographically occult scaphoid fracture. Design. This prospective study compared the sensitivity and specificity of MRI for detection of radiographically occult scaphoid fractures with bone scintigraphy (BS), the currently accepted imaging modality of choice. Consecutive patients with clinical signs of a scaphoid injury but no evidence of fracture on plain radiographs at presentation and after 7-10 days were evaluated by MRI and BS. All images were reported in masked fashion and the sensitivities and specificities of the imaging modalities determined. All patients with a scaphoid fracture demonstrated by MRI or BS were followed for at least a year after injury. Patients. Forty-three subjects (aged 12-74 years) had both MRI and BS carried out on average 19 days from the injury date. Results and conclusions. Six patients (14%) had scaphoid waist fractures. There were other bony injuries in a further six. In 40 patients there was agreement between the BS and MRI findings. In three cases there was discrepancy between the imaging modalities; in all three MRI was found to be the more sensitive and specific. MRI could become the investigation of choice for this injury. (orig.)

  19. MRI and bone scintigraphy in operated high risk femoral neck fractures

    Fifteen patients who had been operated on for high risk femoral neck fractures with titanium screws were examined with 1.0 Tesla MRI and scintimetry at 1 and 6 weeks after operation. Radiological and clinical follow-up was performed up to two years after surgery. Three patients underwent a third 1.5 Tesla MRI examination. Six patients had normal radiographic findings. Early redisplacement (R) was found in 5/15 patients and non-union (NU) in 2/15 patients. Two patients developed late segmental collapse (LSC). Scintigraphy correlated well with normal radiographic findings, but seemed less reliable in detecting R, NU and LSC. MRI seemed reliable but revealed pathological changes in 2/6 patients with an uneventful recovery. Three of 5 patients with R had moderate to severe pathological findings on MRI. In 2 cases with NU moderate or severe pathologic changes were seen, and 2 patients with LSC had clear pathological MRI findings. We conclude that MRI seem to be the method of choice to detect osteonecrotic areas early, even with T, weighted images only, if performed more than 6 weeks after the operation. (orig.)

  20. Ethylenediaminetetramethylene phosphate labelled with Indium-113 m (sup(113m)In-EDTMP) in bone scintigraphy

    Studies aimed at evaluating the utility of sup(113m)In-EDTMP as a bone imaging agent in regions of the world where supplies of sup(99m)Tc are difficult to ensure are reported. Preliminary studies were concerned with characterization of unlabelled EDTMP, its toxicity in rats, its labelling with sup(113m)In and the radiochemical purity of the labelled product. Dosimetric studies were carried out with the labelled product on 15 normal human volunteers after intravenous administration of the labelled material. Preliminary imaging studies were carried out on 5 normal human volunteers. Finally, clinical studies were carried out on 199 patients with various diseases involving bone. It is concluded that sup(113m)In-EDTMP is a appropriate agent to use for bone imaging where sup(99m)Tc is unavailable

  1. Juvenile Dermatomyositis Diagnosed by 99mTc-HDP Three-phase Bone Scintigraphy

    Juvenile dermatomyositis is a common inflammatory muscle disease of childhood, characterized by weakness in proximal muscles and specific skin rash. In case of juvenile dermatomyositis without characteristic clinical features, non-invasive imaging tools such as 99mTc-HDP three-phase bone scan are very helpful in diagnostic workup of myopathies. We report a case of 13-year old female with juvenile dermatomyositis, in which 99mTc-HDP three-phase bone scan was useful in diagnosis and assessing therapy response

  2. Three-phase bone scintigraphy for diagnosis of Charcot neuropathic osteoarthropathy in the diabetic foot - does quantitative data improve diagnostic value?

    Fosbøl, M; Reving, S; Petersen, E H;

    2016-01-01

    AIM: To investigate whether inclusion of quantitative data on blood flow distribution compared with visual qualitative evaluation improve the reliability and diagnostic performance of (99 m) Tc-hydroxymethylene diphosphate three-phase bone scintigraphy (TPBS) in patients suspected for charcot...... neuropathic osteoarthropathy (CNO) of the foot. METHOD: A retrospective cohort study of TPBS performed on 148 patients with suspected acute CNO referred from a single specialized diabetes care centre. The quantitative blood flow distribution was calculated based on the method described by Deutsch et al. All...... scintigraphies were re-evaluated by independent, blinded observers twice with and without quantitative data on blood flow distribution at ankle and focus level, respectively. The diagnostic validity of TPBS was determined by subsequent review of clinical data and radiological examinations. RESULTS: A total of 90...

  3. Tc-99m MDP bone scintigraphy in a case of Touraine-Solente-Gole syndrome

    Pachydermoperiostosis is a form of primary hypertrophic osteoarthropathy, also known as Touraine-Solente-Gole syndrome. It is a rare disease. In this report, we present the case of a 29-year-old man with this rare disorder, having significant findings on Tc-99m methylene diphosphonate bone scan

  4. Tc-99m MDP bone scintigraphy in a case of Touraine-Solente-Gole syndrome.

    Mudalsha, Ravina; Jacob, Mj; Jora, Charu; Pandit, Ag

    2011-01-01

    Pachydermoperiostosis is a form of primary hypertrophic osteoarthropathy, also known as Touraine-Solente-Gole syndrome. It is a rare disease. In this report, we present the case of a 29-year-old man with this rare disorder, having significant findings on Tc-99m methylene diphosphonate bone scan. PMID:21969783

  5. Bone scintigraphy in scurvy. [/sup 99m/Tc-diphosphonate and methylenediphosphonate

    Front, D.; Hardoff, R.; Levy, J.; Benderly, A.

    1978-08-01

    Scintigraphic bone changes in two cases of scurvy are described, the cause being subperiosteal hematoma. Generalized increased uptake was shown in the affected femur at an early stage of the disease. At a late stage, marked uptake both in the femoral shaft and surrounding tissue was seen causing scintigraphic appearance of widened (club-shaped) femur.

  6. Tc99m-MDP bone scintigraphy in Engelmann-Camurati disease

    Engelmann-Camurati disease (ECD) is a rare bone disorder characterized by autosomal dominant inheritance. It usually presents in early childhood and is associated with symmetrical diaphyseal sclerosis. We report a 20-year-old female with scintigraphic findings characteristic of ECD. She was treated with corticosteroids and showed marked clinical improvement

  7. Quantitative Assessment of Radioisotope Uptake in Condyles by SPECT Bone Scintigraphy

    Z. Dalili

    2006-03-01

    Full Text Available Statement of problem: Condylar hyperplasia of the mandible is a self limiting abnormality which can cause facial asymmetry, temporomandibular joint (TMJdysfunction and esthetic problems. Treatment planning is based on the results of isotope scanning, clinical findings and patient age. Single photon emission tomography(SPECT is considered to be a sensitive method in the calculation of condylar uptake differences.Purpose: The aim of this study was to determine the growth activity occurring in the mandibular condyles, and to devise an index of side-to-side differences in condylar activity in different individuals.Material and Methods: 38 patients, with an age range of 13 to 34 years, undergoing skeletal scintigraphy for a variety of conditions, were chosen for this study. 25 mci TC-99 was injected to all subjects in order to assess the difference between right (Rt andleft (Lt condylar uptake percentage and to calculate the Lt to Rt condylar uptake ratio.The normal index was determined.Results: The maximum amount of difference between the uptake of Rt and Lt condyles was 6.2 percent (Lt side and Rt side were 53.1 % and 46.9 %, respectively in the male patients and 5.7 percent in the female patients (Lt side and Rt side were 52.85 % and 47.15 %, respectively. The condylar activity difference and ratio of Lt to Rt condylar uptakes did not show a significant difference between the male and female groups.Conclusion: The difference between the growth activity of RT and LT normal TMJs was less than 6.2 percent.

  8. A meta-analysis of 18FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with breast cancer

    To perform a meta-analysis comparing the diagnostic value of 18FDG-PET, MRI, and bone scintigraphy (BS) in detecting bone metastases in patients with breast cancer. MEDLINE, EMBASE, Scopus, ScienceDirect, SpringerLink, Web of Knowledge, EBSCO, and the Cochrane Database of Systematic Review databases were searched for relevant original articles published from January 1995 to January 2010. Inclusion criteria was as follows: 18FDG-PET, MRI or 99mTc-MDP BS was performed to detect bone metastases (the number of published CT studies was inadequate for meta-analysis and therefore could not be included in this study); sufficient data were presented to construct a 2 x 2 contingency table; histopathological analysis and/or close clinical and imaging follow-up for at least 6 months were used as the reference standard. Two reviewers independently assessed potentially eligible studies and extracted relevant data. A software program called ''META-DiSc'' was used to obtain the pooled estimates for sensitivity, specificity, diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves, and the *Q index for each modality. Thirteen articles consisting of 23 studies fulfilled all inclusion criteria. On a per-patient basis, the pooled sensitivity estimates for MRI (97.1%) were significantly higher than those for PET (83.3%) and BS (87.0%; P 0.05). The pooled DOR estimates for MRI (298.5) were significantly higher than those for PET (82.1%) and BS (49.3%; P 0.05). The SROC curve for MRI showed better diagnostic accuracy than those for PET and BS. The SROC curve for PET was better than that for BS. The*Q index for MRI (0.935), PET (0.922), and BS (0.872) showed no significant difference (P ≥0.05). On a per-lesion basis, the pooled sensitivity estimates for BS (87.8%) were significantly higher than those for PET (52.7%; P 18FDG-PET and BS for diagnosis of bone metastases in patients with breast cancer on a per-patient basis. On a per-lesion basis, 18FDG-PET had

  9. The role of scintigraphy using 99mTc MDP, radiography an MRI in the evaluation of bone tumors and tumor like lesions

    Out of the modern tomographic methods even nuclear magnetic resonance allows only in certain cases a precise final diagnosis of the space occupying lesion. Based on the high contrasts of the various tissues and the multiplanar imaging MRI permits the definite judgement on the extention of the tumor within the bone as well as infiltration of the surrounding soft tissue. 3 phase bone scintigraphy, which is always performed, allows for the judgement of tumor activity before, during and after the various therapies as well the confirmation of the presence or absence of secondary foci or metastases. The scintigraphic determination of the type of osseous tumors however is only limited. The definite judgement of the osseous space occupying lesion being benign is only possible, if no or only a slide increase of bone metabolism can be observed. In cases with markedly increased tracer accumulation a sufficient assessment of dignity is not possible. (orig.)

  10. Diagnostic value of bone scintigraphy with sup(99m)Tc-pyrophosphate for evaluation of complications after hip joint replacement

    For 102 patients with complaints after total hip replacement, bone scintigraphies with sup(99m)Tc have been made in addition to the usual examinations. 95 of these patients had to be operated once more, whereas the infected endoprosteses detected in the remaining 7 patients have been treated for the time being by non-surgical measures. In 68 patients, the examination revealed an aseptic loosening of the total endoprosthesis, including fracture of the diaphysis in 19 cases. In one case, a replacement of the prosthesis had been necessary in spite of the alloarthroplasty being firmly fixed in the right place. The bacterioscopic and bacteriologic investigations clearly revealed an infection of the environment of the prosthesis, in 27 patients, whereas the findings obtained on 6 other patients have not been as unambiguons. 85% of the patients with septic complications showed an increased E.S.R., however only 26% of the patients with aseptic complications. In only 47% of the patients with infection of the hip joint, bacteria have been found in the hip joint puncture fluid, whereas the bacteriological examination of tissue taken from the environment of the artificial hip joint during the operation revealed no increase in bacteria in only one case (5%). In 4 patients (20%), the bacterioscopic findings showed no signs of an acute infection, although saprophytic germs had been isolated from the environment of the prosthesis. 78% of the cases with loosening of the prosthesis and 11% of the infections have been detected by X-ray examination. The nuclear medical examination showed normal radionuclide accumulation in 30% of the cases with loosened prosthesis and in 4% of the infections, for 6% each of the two complications the scintigrams yielded no unambiguous results. In 4 patients (40%) with total hip joint replacement on both sides, enhanced radionuclide accumulation has been abserved even on the symptom-free side. (orig./AJ)

  11. Ranking of three-phase bone scintigraphy for early diagnosis of Sudeck`s astrophy; Wertigkeit der Drei-Phasen-Skelettszintigraphie zur Fruehdiagnostik des Morbus Sudeck

    Steinert, H. [Klinik mit Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Mainz (Germany); Hahn, K. [Klinik mit Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Mainz (Germany)

    1996-04-01

    In a prospective study the value of the three-phase bone scintigraphy in the early diagnosis of Sudeck`s atrophy was analysed. 137 patients with the clinical suspicion on Sudeck`s atrophy in stage I were examined. By means of the clinical course and additional examinations (block response), pain experts confirmed the diagnosis separately. With the findings of hyperperfusion of all 5 phalanges, homogeneous hyperaemia of the affected hand or the foot and periarticular increased uptake of the whole extremity a reliable diagnosis of Sudeck`s atrophy was possible. The sensitivity was 95.9%, the specificity 100%. With bone scintigraphy Sudeck`s atrophy could be clearly differentiated from an inactivity atrophy. Three-phase bone scintigraphy is an excellent tool for the objective diagnosis of Sudeck`s atrophy in stage I. (orig.) [Deutsch] Analyse der Wertigkeit der Drei-Phasen-Skelettszintigraphie zur Fruehdiagnose des Morbus Sudeck in einer prospektiven Studie. 137 Patienten mit dem klinischen Verdacht auf einen Morbus Sudeck im Stadium I wurden untersucht. Die Diagnosesicherung wurde von Schmerzexperten separat anhand des klinischen Verlaufs und Zusatzuntersuchungen vorgenommen. Mit der Befundtrias Hyperperfusion aller 5 Phalangen, homogene Hyperaemie der betroffenen Hand bzw. des Fusses sowie periartikulaer vermehrter Knochenumbau der gesamten Extremitaet war szintigraphisch eine sichere Diagnose des akuten Morbus Sudeck moeglich. Die Sensitivitaet betrug 95,9%, die Spezifitaet 100%. Klinisch vom Morbus Sudeck schwer abgrenzbare Krankheitsbilder wie die Inaktivitaetsatrophie konnten szintigraphisch sicher abgegrenzt werden. Die Drei-Phasen-Skelettszintigraphie hat sich in der vorliegenden Studie somit zur Objektivierung des Morbus Sudeck im Stadium I als hervorragendes diagnostisches Instrument erwiesen. (orig.)

  12. Clinical approach to renal study incidental to 99mTc-MDP bone scintigraphy

    In order to investigate the feasibility of the assessment of renal function with 99mTc-MDP, we compared renographical images, renogram patterns and the glomerular filtration rate (GFR) obtained by means of a modified Gates' method and 200 MBq of 99mTc-MDP with those obtained by means of 99mTc-DTPA. Because 19 of 20 patients had malignant tumors in the genitourinary tract, there was no difference between the two tracers in identifying a parenchymal defect corresponding to renal cancer. Of eight patients with hydronephrosis, four had a defect or decreased uptake with a dilated pelvis, whereas the other four had marked radioisotope retention in the renal pelvis or the whole kidney on serial images. There was also no difference between the two tracers in identifying hydronephrosis. Of 38 paired renograms 35 showed the same renogram patterns with both tracers. Of three patients with different renogram patterns, two had hydronephrosis. In 20 patients including three patients with bone metastasis, total GFR and split GFR obtained with both tracers correlated with a correlation coefficient of r=0.920 (p99mTc-MDP can be used as a supplement to evaluate renal function incidental to the survey of bone metastases in patients with malignant tumor. (author)

  13. Correlation between extent of metastatic lesions in whole body bone scintigraphy of patients with prostatic cancer and prostatic acid phosphatase (PAP) in blood by PAP RIA kit 'Eiken'

    Whole body bone scintigraphy of thirteen patients who were pathohistologically confirmed prostatic cancer was processed by four colors, and then the extent of bone metastases was estimated quantitatively. On the basis of this estimation, the grade of the expansion of bone metastases was classified into 4 grades (0, 1, 2, and 3 grades). And then, correlations of the expantion of bone metastases with PAP, AcP and AlP levels in blood were investigated. The results are as follows: 1) Correlation between the extent of bone metastases and PAP levels was relatively high (r = 0.81). 2) As for the relation between the expansion grade of bone metastases and PAP levels, the levels did not increase in 0 and 1 grades, but markedly increased in 2 and 3 grades. AcP also showed a little similar tendency. 3) In the correlation of PAP with AcP and with AlP, AcP (r = 0.78) was higher than AlP (r = 0.42). 4) Therefore, PAP levels seem to be a good index of the extent of bone metastases in prostatic cancer. (author)

  14. Detection of occult infection following total joint arthroplasty using sequential technetium-99m HDP bone scintigraphy and indium-111 WBC imaging

    Preoperative exclusion or confirmation of periprosthetic infection is essential for correct surgical management of patients with suspected infected joint prostheses. The sensitivity and specificity of [111In]WBC imaging in the diagnosis of infected total joint prostheses was examined in 28 patients and compared with sequential [/sup 99m/Tc]HDP/[111In]WBC scintigraphy and aspiration arthrography. The sensitivity of preoperative aspiration cultures was 12%, with a specificity of 81% and an accuracy of 58%. The sensitivity of [111In]WBC imaging alone was 100%, with a specificity of 50% and an accuracy of 65%. When correlated with the bone scintigraphy and read as sequential [/sup 99m/Tc]HDP/[111In]WBC imaging, the sensitivity was 88%, specificity 95%, and accuracy 93%. This study demonstrates that [111In]WBC imaging is an extremely sensitive imaging modality for the detection of occult infection of joint prostheses. It also demonstrates the necessity of correlating [111In]WBC images with [/sup 99m/Tc]HDP skeletal scintigraphy in the detection of occult periprosthetic infection

  15. Predictive value of serum prostate specific antigen in detecting bone metastasis in prostate cancer patients using bone scintigraphy

    Radionuclide bone scan (BS) used to be the investigation of choice for detecting osseous metastases in prostate cancer. Now, with the availability serum prostate specific antigen (PSA) testing, clinicians do have a timely, cost-effective method to determine those patients who are highly unlikely to have osseous metastases. We determine the utility of PSA for predicting the presence of skeletal metastasis on BSs in prostate cancer patients. Retrospective analysis of medical records of 322 consecutive prostate cancers patients subjected to BS during the last 3 years was done. 52 cases were excluded due to following reasons: Serum PSA not available, hormonal or other therapy given prior to serum PSA measurement, and/or BS, and symptomatic for bone metastasis. In remaining 270 cases, PSA value and BS were evaluated. BS was performed with Tc99m methylene diphosphonate (MDP) as per the standard protocol. BS was found to be positive in 153/270 (56%) and negative in 117 (46%) patients. Of the 153 positive cases, 108 (70%) had serum PSA > 100 ng/ml, 42 (28%) had PSA of 20-100 ng/ml and only 3 (2%) had PSA < 20 ng/ml. All the patients with PSA > 100 ng/ml had multiple skeletal metastasis. Of the 117 negative cases, 110 (94%) had a PSA < 20 ng/ml, 5 had between 20 and 100 ng/ml and only 2 (1.8%) had PSA > 100 ng/ml. Of the 113 patients with serum PSA < 20 ng/ml, 110 (97.4%) did not show any bony metastasis. 150/157 (95.5%) patients with PSA > 20 ng/ml had bone metastasis. Using this criterion, 110 (40.7%) scans would have been omitted. Serum PSA < 20 ng/ml have high predictive value in ruling out skeletal metastasis. Our data are in corroboration with results from previous studies that BS should be performed only if PSA > 20 ng/ml. Using this cut-off, unnecessary investigation can be avoided. Avoiding BS in this group of patients would translate into a significant cost-saving and reduction in their psychological and physical burden

  16. A bone scintigraphy view of melorheostosis: about of a clinical report; Aspect scintigraphique de la melorheostose: a propos d'une observation clinique

    Oufroukhi, Y.; Ismaili, N.A.; Caoui, M.; Ben Rais, N. [Centre Hospitalier Universitaire Avicenne, Rabat (Morocco)

    2004-10-01

    Melorheostosis is an unusual osteopathy. It is featured by a hyperostosis, known as 'dripping candle wax'; over the entire length of a member, and being accompanied by a muscular atrophy and a deterioration of dermis and epidermis, often monomelic and of chronic evolution. It remains of unknown etiology. Through a general review of the literature, and a case of melorheostosis of the lower limbs, we propose to study the clinical and radiological views of this pathology as well as the role of the bone scintigraphy in the initial assessment and the monitoring. (author)

  17. Significance of bone-marrow scintigraphy in aplastic anemia: concise communication

    Tc-99m colloid and In-111 transferrin were used in a semiquantitative scintigraphic study of bone-marrow activity in 76 patients with aplastic anemia, the majority of which were severe cases. The results are compared with other known prognostic parameters and with a predictive index formulated from a prior multiparametric analysis performed in 352 cases. In 47 cases parallel abnormality of Tc and In uptakes was noted and was well correlated with other prognostic factors. Indium uptake is apparently a good indicator of the severity of aplasia; extension of active erythroid tissue, demonstrated with this method, is correlated with prognosis. In nine cases, excessive in uptake is explained by dyserythropoiesis associated with granulo- and thrombocytopenia (Fanconi's anemia in most cases). In 20 of our patients, TcSC uptake was excessive compared with that of In and with other prognostic factors. Statistically, this phenomenon carries an unfavorable prognosis but its physiological meaning remains to be defined

  18. Single lesion bone scintigraphy (LOUC) in patients with breast neoplasm, a dilemma

    Introduction: The staging of patients with advanced breast neoplasm includes evaluation with bone scan (CO). To confirm a malignant LOUC, is particularly interesting for its prognostic implications and therapeutic. The literature is reviewed and based on it raises a cost-effective methodology study. Discussion: The percentage of LOUC that are secondary is variable in the literature, between 10 and 50%. The most common sites are the pelvis (53.8%), skull (27.3%) and spine (25%). When reliability is correlated radiological findings (Rx) with CO, are not categorical in defining the neoplastic nature of the lesions increased uptake; and further studies are required. The Rx captante site will have a high reliability if it is compatible with pathology benign. If the Rx is normal malignancy is confirmed up to 12% of patients (false negative Rx). 13% of Rx LOUC correlate with malignancy and of these only 50% are secondary (false positive Rx). The lytic lesion with Rx periosteal reaction is the most predictive of malignancy. Computed tomography (CT) is useful in detecting lesions predominantly lytic and especially in defining pelvis, scapula and shoulder girdle. MRI has greater sensitivity than CO, is able to differentiate metastatic other degenerative and is useful in spine and pelvis injuries. Conclusions: LOUC with benign Rx is highly reliable. If the Rx is Normal is recommended that further studies. To pelvis and spine injuries a recommendation is cost-effective MRI of the region. In other topographies the TAC's recommendation. When Rx LOUC correlates with malignancy; before a therapeutic change, should be studied with MRI or CT depending on the topography and the criterion of cost-effectiveness prior. Justifies this behavior the high percentage of false positives. When you cannot determine with certainty the nature of the LOUC, biopsy is imposed. Tumor markers of bone metabolism and not to be used, diagnosed as an element of certainty to change a therapeutic strategy

  19. Skeleton scintigraphy in trauma

    Skeletal trauma is common and presents both an opportunity and a problem in skeletal scintigraphy. The opportunity arises in the ability of skeletal scintigraphy to demonstrate abnormalities early after direct trauma. It is well recognized that the early detection of fractures in some sites cannot be reliably achieved by standard radiography, especially in the femoral neck and scaphoid bone. The problem comes in recognizing the effects of skeletal trauma when using skeletal scintigraphy for another purpose, such as the detection of metastatic disease. iatrogenic trauma to either the skeleton or soft tissues may be manifest scintigraphic ally. For example Craniotomy typically leaves a rim pattern at the surgical margin. Rib Retraction during thoracotomy can elicit periosteal reaction. Areas of the skeletal receiving curative levels of ionizing radiation (typically 4000 rads or greater) characteristically demonstrate decreased uptake within 6 months to 1 year after therapy. The generally high sensitivity of the skeletal scintigraphy seems to make it an ideal survey test in cases of suspected child abuse especially in which radiographs are unrevealing. Because of difficulties in obtaining a history of trauma from a preschool child or even eliciting a satisfactory description of the location and nature of the pain, skeletal scintigraphy provides a simple and reliable investigation in these children. Subtle trauma, such as that from stress fractures is often difficult to visualize on a plain radiograph. Skeletal scintigraphy is frequently positive at the time of clinical presentation. Skeletal scintigraphy is exquisitely sensitive to the remodeling process and typically shows abnormalities 1 to 2 weeks or more before the appearance of radiographic changes in stress fractures. The periosteal reaction can be visualized within hours of the injury. Insufficiency and fatigue fractures such as vertebral compression fracture, which is probably the most common consequence of

  20. Urinary bladder carcinoma associated with Paget's disease of skull: Imaging findings on Tc99m-MDP bone scintigraphy, F18-Fluoride PET/CT and F18-FDG PET/CT

    Chakraborty, Dhritiman; Mittal, Bhagwant Rai; Kamaleshwaran, Koramadai Karuppuswamy; Kashyap, Raghava; Bhattacharya, Anish; Kumar, Santosh

    2011-01-01

    We report the imaging findings of a patient with Paget's disease in metastatic carcinoma bladder evaluated by Tc99m-Methylene diphosphonate (MDP) bone scintigraphy, F18-Fluoride positron emission tomography/computed tomography (PET/CT) and F18-fluorodeoxy glucose (FDG) PET/CT. Tc99m-MDP bone scan showed intense uptake in the skull bones without any other abnormal tracer distribution. F18-Fluoride PET/CT revealed intense uptake in the pelvic bones along with skull bones, but F18-FDG PET/CT sho...

  1. The Clinical usefulness of 99mTc HMPAO Leukocyte/99mTc phytate bone marrow scintigraphy for diagnosis of prosthetic knee infection: A preliminary study

    The preferred radionuclide imaging procedure for diagnosing prosthetic joint infection is combined radiolabeled leukocyte/99mTc sulfur colloid bone marrow scintigraphy, which has an accuracy of over 90%. Unfortunately, sulfur colloid is no longer available in South Korea. in this study, we evaluated the usefulness of 99mTc phytate, a substitute for 99mTc sulfur colloid, when combined with radiolabeled leukocyte scintigraphy in suspected prosthetic knee infections. Eleven patients (nine women, two men; mean age 72±6 years) with painful knee prostheses and a suspicion of infection underwent both 99mTc phytate bone marrow scintigraphy (BMS). The combined images were interpreted as positive for infection when radioactivity in the LS at the sits of clinical interest clearly exceeded that of the BMS (discordant); they were interpreted as negative when the increased activity in the LS was consistent with an increased activity in the BMS(concordant). The final diagnosis was made with microbiological or intraoperative findings and a clinical follow up of at least 12 months. Five of eleven patients were diagnosed as having an infected prosthesis. The overall sensitivity, specificity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the combined LS/BMS were 100%, 83%, 83%, 100% and 91%, respectively. We find that combined 99mTc HMPAO LS/99mTc phytate BMS shows comparable diagnostic performance to other studies utilizing sulfur colloid. Combined 99mTc HMPAO LS/99mTc phytate BMS is therefore expected to be an acceptable alternative to combined radiolabeled LS/99msulfur colloid BMS for diagnosing prosthetic knee infections

  2. A meta-analysis of {sup 18}FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with breast cancer

    Liu, Tao; Yang, Hui-Lin [The First Affiliated Hospital of Soochow University, Department of Orthopaedic Surgery, Suzhou (China); Cheng, Tao [Shanghai Jiaotong University School of Medicine, Department of Orthopaedic Surgery, Shanghai Sixth People' s Hospital, Shanghai (China); Xu, Wen [Public Health School of Soochow University, Department of Epidemiology and Biostatistics, Suzhou (China); Yan, Wei-Li [Shanghai Jiaotong University School of Medicine, Departments of Nuclear Medicine, Shanghai Renji Hospital, Shanghai (China); Liu, Jia [Shanghai Jiaotong University School of Medicine, Departments of Radiology, Shanghai Renji Hospital, Shanghai (China)

    2011-05-15

    To perform a meta-analysis comparing the diagnostic value of {sup 18}FDG-PET, MRI, and bone scintigraphy (BS) in detecting bone metastases in patients with breast cancer. MEDLINE, EMBASE, Scopus, ScienceDirect, SpringerLink, Web of Knowledge, EBSCO, and the Cochrane Database of Systematic Review databases were searched for relevant original articles published from January 1995 to January 2010. Inclusion criteria was as follows: {sup 18}FDG-PET, MRI or {sup 99m}Tc-MDP BS was performed to detect bone metastases (the number of published CT studies was inadequate for meta-analysis and therefore could not be included in this study); sufficient data were presented to construct a 2 x 2 contingency table; histopathological analysis and/or close clinical and imaging follow-up for at least 6 months were used as the reference standard. Two reviewers independently assessed potentially eligible studies and extracted relevant data. A software program called ''META-DiSc'' was used to obtain the pooled estimates for sensitivity, specificity, diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves, and the *Q index for each modality. Thirteen articles consisting of 23 studies fulfilled all inclusion criteria. On a per-patient basis, the pooled sensitivity estimates for MRI (97.1%) were significantly higher than those for PET (83.3%) and BS (87.0%; P <0.05). There was no significant difference between PET and BS (P <0.05). The pooled specificity estimates for PET (94.5%) and MRI (97.0%) were both significantly higher than those for BS (88.1%; P <0.05). There was no significant difference between PET and MRI (P >0.05). The pooled DOR estimates for MRI (298.5) were significantly higher than those for PET (82.1%) and BS (49.3%; P <0.05). There was no significant difference between PET and BS (P >0.05). The SROC curve for MRI showed better diagnostic accuracy than those for PET and BS. The SROC curve for PET was better than that for BS

  3. Scintigraphy of spinal disorders in adolescents

    Bone scintigraphy in adolescents is useful in helping to differentiate between developmental (atypical lumbar Scheuermann disease), infectious (discitis, osteomyelitis), neoplastic (osteoid osteoma, osteoblastoma), and traumatic (occult fractures, spondylolysis, pseudoarthrosis) disease of the spine. Double-phase (blood pool, delayed images) scintigraphy can characterize the pattern (i.e., linear in fracture, ovoid in nidus of osteoid osteoma). Single-photon emission computed tomography (SPECT) can be helpful in detecting the subtle presence of stress reaction (spondylolyses) not noted on routine planar scintigraphy and radiography. Bone scintigraphy is most beneficial when correlated with other imaging modalities in refining the diagnosis of spinal diseases. (orig.)

  4. Adrenal scintigraphy

    The exact localization of adrenal lesions can be achieved by noninvasive procedures. Whereas radiological methods reflect morphological changes, scintigraphy of adrenal cortex and medulla depends on function. - Radiolabeled 6β-methyl-19-norcholesterol is used for adrenocortical scintigraphy in primary aldosteronism, Cushing's syndrome and hyperandrogenism. By dexamethasone suppression a correct classification of adrenocortical lesions by scintigraphy can be observed in about 89% with a specificity of 86%. 123-I- and 131-I-metaiodobenzylguanidine is used for specific scintigraphy of the adrenal medulla. This method is a safe and reliable method for localization of adrenal and extraadrenal pheochromocytomas. (orig.)

  5. Adrenal scintigraphy

    Fischer, M.; Vetter, H.

    1986-04-01

    The exact localization of adrenal lesions can be achieved by noninvasive procedures. Whereas radiological methods reflect morphological changes, scintigraphy of adrenal cortex and medulla depends on function. - Radiolabeled 6..beta..-methyl-19-norcholesterol is used for adrenocortical scintigraphy in primary aldosteronism, Cushing's syndrome and hyperandrogenism. By dexamethasone suppression a correct classification of adrenocortical lesions by scintigraphy can be observed in about 89% with a specificity of 86%. 123-I- and 131-I-metaiodobenzylguanidine is used for specific scintigraphy of the adrenal medulla. This method is a safe and reliable method for localization of adrenal and extraadrenal pheochromocytomas.

  6. Detection of metastases in breast cancer patients. Comparison of FDG PET with chest X-ray, bone scintigraphy and ultrasound of the abdomen

    Distant metastases at primary diagnosis are a prognostic key factor in breast cancer patients and play a central role in therapeutic decisions. To detect them, chest X-ray, abdominal ultrasound, and bone scintigraphy are performed as standard of care in Germany and many centers worldwide. Although FDG PET detects metastatic disease with high accuracy, its diagnostic value in breast cancer still needs to be defined. The aim of this study was to compare the diagnostic performance of FDG PET with conventional imaging. Patients, methods: a retrospective analysis of 119 breast cancer patients who presented for staging was performed. Whole-body FDG-PET (n = 119) was compared with chest X-ray (n = 106) and bone scintigraphy (n = 95). Each imaging modality was independently assessed and classified for metastasis (negative, equivocal and positive). The results of abdominal ultrasound (n = 100) were classified as negative and positive according to written reports. Imaging results were compared with clinical follow-up including follow-up imaging procedures and histopathology. Results: FDG-PET detected distant metastases with a sensitivity of 87.3% and a specificity of 83.3%. In contrast, the sensitivity and specificity of combined conventional imaging procedures was 43.1% and 98.5%, respectively. Regarding so-called equivocal and positive results as positive, the sensitivity and specificity of FDG-PET was 93.1% and 76.6%, respectively, compared to 61.2% and 86.6% for conventional imaging. Regarding different locations of metastases the sensitivity of FDG PET was superior in the detection of pulmonary metastases and lymph node metastases of the mediastinum in comparison to chest X-ray, whereas the sensitivity of FDG PET in the detection of bone and liver metastases was comparable with bone scintigraphy and ultrasound of the abdomen. Conclusions: FDG-PET is more sensitive than conventional imaging procedures for detection of distant breast cancer metastases and should be

  7. An osteomalacia related to phosphate diabetes - bone scintigraphy with SPECT/CT contribution; Une osteomalacie liee a un diabete phosphore - role de la scintigraphie osseuse couplee a la TEMP-TDM

    Ruyer, A.; Granier, P.; Mourad, M. [Centre Hospitalier Antoine-Gayraud, Service de Medecine Nucleaire, 11 - Carcassonne (France)

    2009-12-15

    We report the case of a 59-year-old woman, investigated for disabling pain of the left thigh, unrelated to any traumatic event. Interrogation had found diffuse pain of myalgia-type and arthralgia-type for approximately a year without local inflammatory signs and insufficiency fractures of both calcaneus two years before. The Technetium {sup 99m}-labeled hydroxy-methylene diphosphonate ({sup 99m}Tc-H.D.P.) whole-body bone scintigraphy evidenced multiple hot spots on the higher third of left femur, rib cage, sternum, scapula, pelvis, right hip and both calcaneus. Moreover, a more diffuse and heterogeneous prominent uptake appeared on rib cage, spine and pelvis. These images suggested a diffuse metastatic disease of the skeleton. The single photon emission computerized tomography guided by computerized tomography (SPECT/CT), centered on lumbar spine, pelvis and the upper end of femurs showed that the multiple hot spots were in fact bone fractures. These findings pointed diagnosis to a metabolic disease. The clinical context was in favour of an osteomalacia. Further explorations showed an osteomalacia related to phosphate diabetes. A thorough work-up did not reveal any known aetiology. To date, idiopathic phosphate diabetes seems the most likely diagnosis. Nuclear medicine input in osteomalacia is discussed. (authors)

  8. Complementary roles of bone scintigraphy and MR imaging in the detection and long-term follow-up of primary non-Hodgkin's bone lymphoma in a child-case report

    Marina, Vlajkovic; Milena, Rajic [Center of Nucler Medicine, Clinical Center Nis, Nis (Serbia); Vesna, Petronijevic [Clinic of Physical Medicine, Rehabilitation and Prosthetics, Clinical Center Nis, Nis (Serbia); Sladana, Petrovic [Center of Radiology, Clinical Center Nis, Nis (Serbia); Vera, Artiko [Center of Nuclear Medicine, Clinical Center of Serbia, Belgrade (Serbia)

    2015-06-01

    The aim of our report is to demonstrate the complementary roles of bone scintigraphy (BS), magnetic resonance imaging (MR), and positron emission tomography using 2-deoxy-2-[18F]fluoro-D-glucose (F-18-FDG PET/CT) in the diagnosis and treatment monitoring of a child with primary non-Hodgkin's lymphoma of bone (PLB). Increased blood flow, high tissue accumulation, and markedly increased uptake on the late BS pointed toward an active bone process in the left femoral region. Bone marrow infiltration of the left femur and cortical sclerosis, which were both demonstrated by MR imaging, were later confirmed as PLB by bone marrow biopsy. The normalizations of the flow and tissue phases of BS a year after treatment and during the entire follow-up were in keeping with inactive disease and clinical remission. However, even 8 years after treatment and complete remission, MR imaging demonstrated persistent unmodified bone marrow alteration and appreciable cortical involvement. A slightly increased metabolic activity of the left femoral epiphysis demonstrated by F-18-FDG PET/CT and mild activity in the same region on delayed BS were demonstrated in the late follow-up. Our results strongly suggest that BS and MR imaging should be included in the diagnostic algorithm of children with undefined bone symptoms. However, mild metabolic activity on the F-18-FDG PET/CT scan could not reliably differentiate between the presence or absence of disease in a patient with PLB in clinical remission. (orig.)

  9. Complementary roles of bone scintigraphy and MR imaging in the detection and long-term follow-up of primary non-Hodgkin's bone lymphoma in a child-case report

    The aim of our report is to demonstrate the complementary roles of bone scintigraphy (BS), magnetic resonance imaging (MR), and positron emission tomography using 2-deoxy-2-[18F]fluoro-D-glucose (F-18-FDG PET/CT) in the diagnosis and treatment monitoring of a child with primary non-Hodgkin's lymphoma of bone (PLB). Increased blood flow, high tissue accumulation, and markedly increased uptake on the late BS pointed toward an active bone process in the left femoral region. Bone marrow infiltration of the left femur and cortical sclerosis, which were both demonstrated by MR imaging, were later confirmed as PLB by bone marrow biopsy. The normalizations of the flow and tissue phases of BS a year after treatment and during the entire follow-up were in keeping with inactive disease and clinical remission. However, even 8 years after treatment and complete remission, MR imaging demonstrated persistent unmodified bone marrow alteration and appreciable cortical involvement. A slightly increased metabolic activity of the left femoral epiphysis demonstrated by F-18-FDG PET/CT and mild activity in the same region on delayed BS were demonstrated in the late follow-up. Our results strongly suggest that BS and MR imaging should be included in the diagnostic algorithm of children with undefined bone symptoms. However, mild metabolic activity on the F-18-FDG PET/CT scan could not reliably differentiate between the presence or absence of disease in a patient with PLB in clinical remission. (orig.)

  10. Adrenal scintigraphy

    The following items are discussed:anatomy and physiology of adrenal glands, clinical indications of scintigraphy, radiobiology and radiochemistry, scintigraphic imaging, adrenocortical hyperfunction, aldosteronism and hypertension associated with low renin level, excess of androgen, adrenocortical hyperfunction and future perspectives of adrenal scintigraphy. (M.A.)

  11. Lung scintigraphy

    A review of lung scintigraphy, perfusion scintigraphy with SPECT, lung ventilation SPECT, blood pool SPECT. The procedure of lung perfusion studies, radiopharmaceutical, administration and clinical applications, imaging processing .Results encountered and evaluation criteria after Biello and Pioped. Recommendations and general considerations have been studied about relation of this radiopharmaceutical with other pathologies

  12. The role of 18FDG, 18FDOPA PET/CT and 99mTc bone scintigraphy imaging in Erdheim–Chester disease

    García-Gómez, F.J., E-mail: javier191185@gmail.com [Department of Nuclear Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain); Acevedo-Báñez, I.; Martínez-Castillo, R.; Tirado-Hospital, J.L.; Cuenca-Cuenca, J.I.; Pachón-Garrudo, V.M.; Álvarez-Pérez, R.M.; García-Jiménez, R. [Department of Nuclear Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain); Rivas-Infante, E. [Department of Pathology, Virgen del Rocío Universitary Hospital, Seville (Spain); García-Morillo, J.S. [Department of Internal Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain); Borrego-Dorado, I. [Department of Nuclear Medicine, Virgen del Rocío Universitary Hospital, Seville (Spain)

    2015-08-15

    Highlights: • Erdheim–Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. • Multifocal nature of involvement in ECD can produce a wide variety of clinical signs. In our experience, neurological involvement is associated with mortality in all cases. Characteristic long bone osteosclerosis was a quasi-pathognomonic finding in bone scintigraphy. • To the best of our knowledge, the 18FDOPA-PET/CT not seem useful in the initial staging of ECD based on a single case report. • Bone scintigraphy and the 18FDG-PET/CT that were particularly useful in despite systemic involvement, locate the optimum site for biopsy and treatment response evaluation. In this context, a baseline 18FDG-PET/CT with an optional bone scintigraphy may help in monitoring the disease and could be considered when patients were incidentally diagnosed and periodically follow-up 18FDG-PET/CT must be performed in the follow up to evaluate the treatment response. - Abstract: Erdheim–Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes that stain positively for CD68 marker but not express CD1a and S100 proteins. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. Multisystemic involvement leads to a wide variety of clinical manifestations that results in a poor prognosis although recent advances in treatment. We present the clinical, nuclear medicine findings and therapeutic aspects of a serie of 6 patients with histopathological diagnosis of ECD, who have undergone both bone scintigraphy (BS) and 18F-fluorodeoxyglucose (18FDG)-PET/CT scans in our institution. A complementary 18F-fluorodopa (18FDOPA)-PET/CT was performed in one case. Three different

  13. The role of 18FDG, 18FDOPA PET/CT and 99mTc bone scintigraphy imaging in Erdheim–Chester disease

    Highlights: • Erdheim–Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. • Multifocal nature of involvement in ECD can produce a wide variety of clinical signs. In our experience, neurological involvement is associated with mortality in all cases. Characteristic long bone osteosclerosis was a quasi-pathognomonic finding in bone scintigraphy. • To the best of our knowledge, the 18FDOPA-PET/CT not seem useful in the initial staging of ECD based on a single case report. • Bone scintigraphy and the 18FDG-PET/CT that were particularly useful in despite systemic involvement, locate the optimum site for biopsy and treatment response evaluation. In this context, a baseline 18FDG-PET/CT with an optional bone scintigraphy may help in monitoring the disease and could be considered when patients were incidentally diagnosed and periodically follow-up 18FDG-PET/CT must be performed in the follow up to evaluate the treatment response. - Abstract: Erdheim–Chester disease (ECD) is a rare non-Langerhans cell histiocitosis, characterized by multisystemic xanthogranulomatous infiltration by foamy histiocytes that stain positively for CD68 marker but not express CD1a and S100 proteins. Etiology and pathogenesis are still unknown and only about 500 cases are related in the literature. Multisystemic involvement leads to a wide variety of clinical manifestations that results in a poor prognosis although recent advances in treatment. We present the clinical, nuclear medicine findings and therapeutic aspects of a serie of 6 patients with histopathological diagnosis of ECD, who have undergone both bone scintigraphy (BS) and 18F-fluorodeoxyglucose (18FDG)-PET/CT scans in our institution. A complementary 18F-fluorodopa (18FDOPA)-PET/CT was performed in one case. Three different

  14. Skeletal Scintigraphy (Bone Scan)

    ... placed over the patient's body. SPECT involves the rotation of the gamma camera heads around the patient's ... prescribed procedure with your doctor, the medical facility staff and/or your insurance provider to get a ...

  15. Role of {sup 11}C-choline PET/CT in the re-staging of prostate cancer patients with biochemical relapse and negative results at bone scintigraphy

    Fuccio, Chiara; Castellucci, Paolo [Nuclear Medicine Unit, Department of Hematology Oncology and Laboratory Medicine, Azienda Ospedaliero - Universitaria di Bologna Policlinico Sant' Orsola - Malpighi, University of Bologna, Bologna (Italy); Schiavina, Riccardo [Urology Unit, Department of Specialist Surgery and Anaesthesiology, Azienda Ospedaliero - Universitaria di Bologna Policlinico Sant' Orsola - Malpighi, University of Bologna, Bologna (Italy); Guidalotti, Pier Luigi; Gavaruzzi, Gilberto; Montini, Gian Carlo; Nanni, Cristina [Nuclear Medicine Unit, Department of Hematology Oncology and Laboratory Medicine, Azienda Ospedaliero - Universitaria di Bologna Policlinico Sant' Orsola - Malpighi, University of Bologna, Bologna (Italy); Marzola, Maria Cristina [Department of Nuclear Medicine and PET/CT Centre, ' Santa Maria della Misericordia' Hospital, Via Tre Martiri 140, 45100 Rovigo (Italy); Rubello, Domenico, E-mail: domenico.rubello@libero.it [Department of Nuclear Medicine and PET/CT Centre, ' Santa Maria della Misericordia' Hospital, Via Tre Martiri 140, 45100 Rovigo (Italy); Fanti, Stefano [Nuclear Medicine Unit, Department of Hematology Oncology and Laboratory Medicine, Azienda Ospedaliero - Universitaria di Bologna Policlinico Sant' Orsola - Malpighi, University of Bologna, Bologna (Italy)

    2012-08-15

    Aim: to evaluate the utility of {sup 11}C-choline PET/CT in prostate cancer (PC) patients who have demonstrated a biochemical recurrence and a negative bone scintigraphy (BS). Materials and methods: 123 consecutive PC patients (mean age 67.6 years; range 54-83) with a biochemical relapse (mean PSA value 3.3 ng/mL; range 0.2-25.5) after radical prostatectomy (RP) were included in our retrospective study. Patients underwent a BS that resulted negative and a {sup 11}C-choline PET/CT within 4 months from BS (range: 1 day to 4 months; mean: 2.5 months). Validation of results was established by: (1) a positive biopsy, (2) a positive subsequent BS, CT or MR and (3) a normalization of {sup 11}C-choline uptake after systemic therapy or a progression of the disease. Results: {sup 11}C-choline PET/CT was positive in 42/123 patients (34.1%). {sup 11}C-choline PET/CT detected lesions in: bone (10 patients), lymph-nodes (20 patients), bone and lymph nodes (7 patients), bone and lung (1 patient), lymph-nodes and lung (1 patient), local relapse (3 patients). Overall, {sup 11}C-choline PET/CT showed a total of 30 unknown bone lesions in 18/123 (14.6%) patients. Conclusion: {sup 11}C-choline PET/CT showed a better sensitivity than BS in patients with biochemical relapse after RP: {sup 11}C-choline PET/CT detected unknown bone lesions in 18/123 (14.6%) patients.

  16. Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: Head-to-head comparison with CT and bone scintigraphy

    Baun, Christina; Falch Braas, Kirsten; Gerke, Oke;

    Departments of Nuclear Medicine, *Radiology, **Oncolocy, and ***Surgery, Odense University Hospital, Odense, Denmark Purpose: Breast cancer (BC) is the most common type of cancer among women in Denmark and about 1/3 of the affected women experience recurrence. The prognosis is good if loco regional recurrence......Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: Head-to-head comparison with CT and bone scintigraphy  Kirsten Falch, Christina Baun, Oke Gerke, , Ziba A. Farahani, Poul F. Høilund-Carlsen, Lisbet B. Larsen*, Marianne Ewertz**, Katrine Søe*** and Malene G. Hildebrandt...... had sensitivities of 67% and 81% and specificities of 100% and 48%, respectively. Conclusion: These interim results suggest that FDG PET/CT may have a role in the diagnostic work-up of patients with suspected recurrent breast cancer. The 3-hour FDG-PET scan may be diagnostically superior to the other...

  17. Asymmetrically increased rib cage uptake on bone scintigraphy: Incidental detection of pleural mesothelioma on single photon emission computed tomography/computed tomography

    Follow-up bone scintigraphy (BS) in a patient of carcinoma left breast, who was treated with surgery followed by radiotherapy 12 years back, revealed asymmetrically increased radiotracer uptake in left-sided ribs. Since, this pattern was atypical for metastatic rib involvement, single photon emission computed tomography/computed tomography (SPECT/CT) of thorax was done in the same setting which revealed circumferential nodular left-sided pleural thickening. Biopsy confirmed it to be pleural mesothelioma. Left-sided ribs showed no abnormality on CT, thus suggesting the rib uptake as reactive in nature. This pattern of asymmetric rib uptake on BS should be kept in mind and warrants further investigation for determining underlying pathology

  18. Abnormal gastrointestinal accumulation of radiotracer by gastric bleeding during {sup 99m}Tc-MDP bone scintigraphy

    Chun, Kyung A.; Lee, Sang Woo; Lee, Jae Tae; Lee, Kyu Bo [College of Medicine, Kyungpook National Univ., Taegu (Korea, Republic of)

    1998-06-01

    We present a case in which a patient with acute hemorrhagic gastritis demonstrated abnormal gastrointestinal accumulation of radiotracer during {sup 99m}Tc-methylene diphosphonate (MDP) skeletal scintigraphy. A hemorrhagic gastritis was subsequently demonstrated by endoscopy. The mechanism for the intestinal localization of {sup 99m}Tc-MDP in this patients 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.

  19. Quantitative three-phase bone scintigraphy in the evaluation of intravenous regional blockade treatment in patients with stage-I reflex sympathetic dystrophy of upper extremity

    The objective this study was to investigate the role of quantitative three phase bone scintigraphy (QTPBS) in the evaluation of efficacy of intravenous regional blockade treatment in patients having reflex sympathetic dystrophy (RSD) of the upper extremity. Twenty-six patients with stage-I RSD were focused on in this study. Patients were treated with physical therapy and intravenous (I.V.) regional blockade therapy consisting of dexamethasone and lidocaine. All patients were clinically evaluated before and 1 month after the completion of the therapy protocol. QTPBS was applied to patients before therapy and 1 month after the therapy. As a control group, 11 healthy subjects also underwent QTPBS. Perfusion, hyperemic and fixation indices were calculated from three-phase bone scintigraphy. All patients showed statistically significant clinical improvement after the therapy (p<0.01). Pre-treatment, perfusion (1.67±0.63), hyperemic (1.44±0.48) and fixation (1.69±0.48) indices of patients were higher than those of healthy subjects (perfusion index (PI): 0.95±0.05, hyperemic index (HI): 0.94±0.06, fixation (FI): 1.01±0.2) (p<0.01) and all indices significantly decreased after the treatment (PI: 1.33±0.46, HI: 1.18±0.23, FI: 1.42±0.26) (p<0.01). I.V. regional blockade therapy combined with corticosteroids is a simple, safe and effective method for the treatment of patients with stage-I RSD in the upper extremity. QTPBS is a valuable and objective method to evaluate the response to therapy and may be useful for staging of patients and predicting the response to therapy. (authors)

  20. Follow-up bone scintigraphy and rhenium application during therapy of a prostate cancer; Skelettszintigraphie und Radio-Rhenium-Behandlung im Verlauf eines metastasierenden Prostatakarzinoms

    Ostwald, E.; Sabri, O.; Cremerius, U.; Jakse, G.; Buell, U. [Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin

    1999-07-01

    A 78-year-old patient with prostate cancer and osseous metastases had a pain symptomatic. In the Urology he was treated with antiandrogenes. The outcome of the bone scintigraphy showed a super bone scan with normalization after antiandrogene-therapy which seemed to be a sign of remission, before he showed a progressive form with multiple osseous metastases. Pain could not be treated with non steroidal antiphlogistics and opiates, so the indication for treatment with Rhenium-186-HEDP was given in this case. (orig.) [German] Ein 78 Jahre alter Patient mit einem ossaer metastasierenden Prostatakarzinom wurde uns zur Schmerztherapie vorgestellt. In der urologischen Klinik war eine Behandlung mit Antiandrogenen durchgefuehrt worden, in deren Verlauf der skelettszintigraphische Befund, welcher vor Therapiebeginn als super bone scan imponierte, zunaechst wieder einen Normalbefund als Zeichen der Remission anzeigte, bevor es dann zu einer multifokalen Skelettmetastasierung kam. Die dadurch verursachte Schmerzsymtomatik liess sich wegen Unvertraeglichkeit von nichtsteroidalen Antiphlogistika (NSAR) und Opiaten nicht medikamentoes beherrschen, so dass hier als Alternative eine Behandlung mit Rhenium-186-HEDP eingesetzt wurde. (orig.)

  1. Adrenal scintigraphy

    The visualization of functioning adrenocortical tissue by scintigraphy became possible with the introduction of radioiodinated cholesterol derivatives. According to the literature, there is evidence that one of these iodinated cholesterols, 6-β-iodomethyl-nor-cholesterol, concentrates in the adrenal cortex to a much greater extent than 131I-19-odocholesterol. Results comparing both radiopharmaceuticals are described. The authors investigated the possibility of increasing the uptake of iodinated cholesterol using simultaneous ACTH and the 'cholesterol side-chain cleavage enzymeblocker': aminoglutethimide. The results of adrenal scintigraphy performed in 37 patients are described. Finally, the literature on adrenal scintigraphy is reviewed, and results reported in various studies are compared. (Auth.)

  2. Skeletal scintigraphy in benign and malignant disease

    This paper begins with a discussion of the technical factors in skeletal scintigraphy, including collimation, the use of three-phase bone scan, and single-photon emission computed tomography. Skeletal scintigraphy for benign conditions is commonly indicated for the patient presenting with pain (trauma, sports-related injury, posttraumatic pain syndrome, painful orthopedic prosthesis) and for the patient with abnormal laboratory test results (metabolic bone disease, Paget disease). For malignant conditions, the bone scan is useful in the evaluation of metastases in patients with extraosseous malignancies and primary bone tumors. The discussion addresses the various scan patterns seen in the more common tumors, such as prostate carcinoma, breast carcinoma, and lung carcinoma. Bone scintigraphy is an exquisitely sensitive modality. With some understanding of the techniques necessary for obtaining the optimal bone scan, and of the patterns that can be seen in various clinical conditions, the radiologist will find the bone scan a very specific tool for evaluating both benign and malignant diseases

  3. A diagnostic trap potentially lethal: chordomas uncovered by C3 large osseous destruction inconspicuous on bis-phosphonates-({sup 99}Tc) bone scintigraphy; Un piege diagnostique potentiellement letal: chordome revele par une vaste lesion lytique de C3 normofixante a la scintigraphie osseuse aux bisphosphonates-({sup 99}Tc)

    Paycha, F.; Ramadan, A.; Akrout, L. [Hopital Louis Mourier, Unite de Medecine Nucleaire, 92 - Colombes (France); Dion, E. [Hopital Louis Mourier, Service de Radiologie, 92 - Colombes (France); Grossin, M. [Hopital Louis Mourier, Service d' Anatomie Pathologique, 92 - Colombes (France); Gazals-Hatem, D. [Hopital Beaujon, Service d' Anatomie Pathologique, 92 - Clichy (France)

    2006-07-15

    The authors describe a case report of a brachialgy uncovering a solitary bone destruction of C3 associated with epidural involvement. CT and MRI properly depicted the lesion and the loco-regional extension but failed to entertain the diagnosis of the causative tumor, a chordoma. Bis-phosphonates-({sup 99m}Tc) bone scintigraphy proved unconspicuous. Diagnosis was eventually established from the resection specimen, after decision of C3 spondyl-ectomy, C4 hemi-superior spondyl-ectomy and epidural extension excision. Immunohistochemistry study of the material was decisive in identifying the tumor. Cervical chordoma is a tricky diagnosis. Discussion underscores that the crux of diagnostic process is the double discrepancy firstly between extra-osseous and intra-osseous tumoral expansion, secondly between large tumoral mass obvious on multi-slice morphological imaging and negativity of bone scintigraphy, SPECT study included. Among the armamentarium of conventional scintigraphies and PET studies, methionine-({sup 11}C) PET emerges as the most promising anatomo-metabolic procedure to assess loco-regional tumoral expansion, tumoral viability, therapy efficiency, and, potentially, to search for metastases in chordoma. (author)

  4. Evaluation of patients with metastatic bone lesions from breast carcinoma using whole body scintigraphy with pentavalent technetium-99m dimercaptosuccinic acid: preliminary results

    Pentavalent technetium-99m dimercaptosuccinic acid (DMSA(V)-99mTc) was designed as a tumor-seeking agent, chemically different from its analog trivalent used in renal tubular studies. This radiopharmaceutical was introduced in 1984 and has been used in oncologic application. It was proposed as a new agent for detecting metastases from breast carcinoma in 1992. Aim: To evaluate the sensibility and specificity of the scintigraphic study with DMSA(V)-99mTc in bone metastatic disease from breast carcinoma. Materials and Methods: Prospective study was done in 10 female patients, with average age of 49.8 years (42 to 73) with breast carcinoma and metastatic bone disease. All patients were submitted to whole body scanning with methylene diphosphonate-99mTc (MDP-99mTc) and DMSA(V)-99mTc. The sensibility and the specificity were calculated. Results: A total of one hundred eighty-nine bone lesions were diagnosed clinically and by follow-up, radiographic exams, scintigraphy or biopsy. The presence of 178 metastatic lesions and 11 benign lesions was detected. DMSA(V)-99mTc concentrated in 165 lesions that matched with the MDP-99mTc concentration. Only one benign lesion concentrated the DMSA(V)-99mTc and was established as a false-positive by biopsy. No concentration of DMSA(V)-99mTc was found in other 10 benign lesions that had increased uptake of MDP-99mTc. High accumulation of DMSA(V)-99mTc was observed in liver metastases on one patient with no corresponding concentration of MDP-99mTc. In this study, the use of DMSA(V)-99mTc to detect bone metastases showed 92.1% of sensibility and 90.9% of specificity. Conclusion: High sensibility and specificity to metastatic bone disease from breast carcinoma were found on scintigraphic study with DMSA(V)-99mTc. It suggests that it could be used as an adjuvant technique in scintigraphic bone evaluation in patients with breast carcinoma, improving the specificity of MDP-99mTc bone scans

  5. Skull base osteomyelitis in otitis externa: The utility of triphasic and single photon emission computed tomography/computed tomography bone scintigraphy

    Skull base osteomyelitis (SBO) refers to infection that has spread beyond the external auditory canal to the base of the skull in advanced stages of otitis externa. Clinically, it may be difficult to differentiate SBO from severe otitis externa without bony involvement. This study was performed to determine the role of three phase bone scintigraphy (TPBS) and single photon emission tomography/computed tomography (SPECT/CT) in detecting SBO. We retrospectively analyzed records of 20 patients (14 M, 6 F) with otitis externa and suspected SBO. TPBS and SPECT/CT of the skull were performed. Findings were correlated with clinical, laboratory and diagnostic CT scan findings. All patients were diabetic with elevated erythrocyte sedimentation rate. A total of 18 patients had bilateral and two unilateral symptoms. Cranial nerves were involved in eight patients and microbiological culture of ear discharge fluid positive in seven. Early images showed increased temporal vascularity in nine patients and increased soft-tissue uptake in 10, while delayed images showed increased bone uptake in 19/20 patients. Localized abnormal tracer uptake was shown by SPECT/CT in the mastoid temporal (15), petrous (11), sphenoid (3) and zygomatic (1) and showed destructive changes in five. Thus, TPBS was found positive for SBO in 10/20 patients and changed the management in four. Our study suggests that TPBS with SPECT/CT is a useful non-invasive investigation for detection of SBO in otitis externa

  6. New strategy in diagnostic, preventive and following way in osteonecrosis of sickle-cell disease in Cote d'Ivoire with bone scintigraphy; Nouvelle strategie dans le diagnostic, la prevention et le suivi de l'osteonecrose drepanocytaire en Cote d'Ivoire a partir de la scintigraphie osseuse

    Kouame-Koutouan, A.; Aboukoua-Kouassi, N.; Koffi, D.; Sery, J.M. [Cocody Univ., UFR sciences Medicales (SMA), Service de Biophysique et Medecine Nucleaire, Abidjan (Cote d' Ivoire); Meite, M.; Sanogo, I. [Clinique du CHU de Yopougon, Service d' Hematologie (Cote d' Ivoire)

    2009-10-15

    Osteonecrosis is the most frequent complications of sickle-cell disease (S.C.D.) whose prevalence in Cote d'Ivoire is 21%. The main of this study was to compare scintigraphy, clinical and radiological observations to assess earlier diagnosis in S.C.D. osteonecrosis. It was a prospective study about 45 S.C.D. patients who presented coxopathy and had radio-labelled di phosphonates bone scintigraphy. The results revealed 49% of lesions whose 48% appeared with homogeneous hyper fixation, 11% homogeneous hypo fixation, 5% of hypo fixation got round by hyper fixation. Eighty-one percent of lesions concerned femoral head, 6% femoral condyle and 3% humoral head. Fifty percent of osteonecrosis was not visible in radiology and corresponded to the earlier stage. These invisible radiology aspects were observed in 100% hips without lameness, and in 43% permanent lameness. Scintigraphy (sensitive in 100%) isolated 38% more than conventional radiography. In main to improve S.C.D. osteonecrosis prognostic in Cote d'Ivoire, this preliminary study outline that scintigraphy is fundamental in management. (authors)

  7. Whole body bone scintigraphy and single photon emission computed tomography/computed tomography (SPECT/CT) as combined nuclear medicine protocol for the initial staging of prostate cancer

    Full text: The aim of the study was to apply a combined nuclear medicine protocol, including Whole Body Bone Scintigraphy (WBS) and Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) of the pelvis for the initial staging of patients with prostate cancer. We have examined 23 patients with newly diagnosed prostate cancer. the patients were divided in to three risk groups, respectively low risk group (5 patients, 22%), intermediate risk group (6 patients, 26%) and high risk group (12 patients, 52%). Pathological findings detected by WBS were reported in 16 (67%) of the patients. In 7 (30%) of them they were suspicious for metastases.After the SPECT/CT of the pelvis all suspicious foci from the WBS were confirmed to be osteosclerotic metastatic leasons. In addition, the CT scan visualized enlarged regional lymph nodes in 7 patients (30%) and seminal vesicles with altered morphology suspected for infiltration in 5 patients (22%). In four out of 7 patients with enlarged lymph nodes we found simultaneous bone metastases, while in the rest of them the lymphadenopathy was an isolated finding. As a result from the application of the combined nuclear medicine protocol in one of the patients from the low risk group and in one of those with intermediate risk, as well as in six high-risk patients the opportunity for surgery was rejected because of bone metastases and/or regional lymphadenopathy. In the remaining 15 patients, including also those with high risk, decision for radical prostatectomy was made. Our first experience with the application of the combined nuclear medicine protocol, including WBS and SPECT/CT of the pelvis demonstrated that the procedure allows for right initial staging of patients with prostate cancer as well as for choosing an appropriate treatment by performing a one-stop complex imaging examination

  8. Role of 11C-choline PET/CT in the restaging of prostate cancer patients showing a single lesion on bone scintigraphy

    The purpose of this study is to assess the utility of 11C-choline positron emission tomography (PET)/CT in the restaging of prostate cancer (PC) patients who showed a single finding on bone scintigraphy (BS) that was classified as equivocal or suspected for metastatic lesion. A total of 25 PC patients with biochemical failure (mean prostatic specific antigen (PSA) value 11.1 ng/mL; median value 6.3 ng/mL; range 0.2-37.7 ng/mL) after primary treatment were included in this retrospective study. All of them showed a single lesion on BS reported as suspected for metastatic lesion or as equivocal finding. Patients underwent 11C-choline PET/CT within 1-4 months from BS. Validation was established by follow-up for at least 6 months. On the basis of biopsy confirmation and/or 6-month follow-up, 22 of 25 patients were classified as positive for the presence of metastatic bone lesions: 13 with a single lesion and 9 with multiple lesions. 11C-choline PET/CT was positive in 19/25 patients and, on a lesion basis, it showed 50 positive findings. BS results were confirmed in 8/25 (32%) patients. 11C-choline PET/CT detected multiple sites of relapse in 11/25 (44%) patients: in 2/11, a single bone lesion associated with other extraosseous sites of relapse; in 6/11, multiple bone lesions; in 3/11, multiple bone lesions and other extraosseous localizations. Finally, 6/25 patients were negative on 11C-choline PET/CT. In 3/6 patients, an osteoblastic lesion was seen on CT attenuation correction images (PET false negative; BS true positive), while in 3/6 patients only findings suggestive of the presence of degenerative disease were found (PET true negative; BS false positive). On a patient basis, 11C-choline PET/CT showed a diagnostic sensitivity of 86% (19/22) and a specificity of 100% (19/19). In our study, 11C-choline PET/CT detected unknown lesions in 11/25 patients. Patients with a single equivocal finding on BS could have important additional information from 11C-choline PET

  9. Study on the preparation of methylene diphosphonate (MDP) labeling with 99mTc for bone scintigraphy

    The 99mTc-MDP kit was prepared by using aseptic technique. The composition of MDP invivo kit including 5 mg MDP, 0.5 mg stannous chloride, 0.5 mg ascorbic acid and 5 mg sodium chloride. The kit produces 99mTc-MDP with more than 95% labelling efficiency at pH 6-7 when mixed with requisite amount of 99mTc-pertechnetate. The preparation has been found sterity, pyrogen free, to be sufficiency stable invitro as well as invivo, blood clearance. After intravenous administrations abound 50% of the dose is accumulated and retained by the skeleton. The kit provides quality product in high yield, more stable than other phosphonate kit, high bone uptake. High avidity of 99mTc-MDP for bone imaging makes it a promising agent for the detection of bone diseases. (author)

  10. Characteristic Uptake Pattern of Bone Scintigraphy in Patients with Hepatocellular Carcinoma Following Treatment with High-Intensity Focused Ultrasound

    Ma, Waihan; Ho, Waiyin; Lai, Andrew S. H.; Wong, Kwongkuen; Law, Martin [Queen Mary Hospital, Pokfulam (Hong Kong)

    2013-12-15

    This study retrospectively reviews the characteristic bone scintigraphic findings in 18 patients with hepatocellular carcinoma (HCC) following treatment with high-intensity focused ultrasound (HIFU). A potential complication of HIFU is damage to the tissues along the path of the ultrasound beam and structures superficial to the lesion of interest. Patients with hepatocellular carcinoma who underwent a bone scan between 1st December 2005 and 31st December 2011 were considered for this study. Among these patients, only those who had bone scans after the HIFU treatment were included. The time between HIFU treatment and bone scans, HIFU energy, HCC sites, tumour sizes and related radiological findings were evaluated. In total, 20 bone scans of 18 patients were reviewed. Of these scans, two patients were normal; three patients showed decreased uptake, four patients showed increased uptake and nine patients showed mixed uptakes of the bony tracer in their rib cages. The defects were located in the anterior, lateral, anterolateral or posterolateral aspects of the rib cage. The majority of those cold defects were in the right anterior rib cages. SPECT/CT was used to localise the decreased uptake in ribs. The magnetic resonance imaging in individual patients invariably showed ill-defined rim enhancement along the right chest wall, signifying chest wall injury. The results showed that tissue ablation using HIFU caused tissue injury along the pathway of high-intensity ultrasound beams. The harm to tissues is presented as photopenic area on the rib cages due to necrosis or hot spots due to rib fractures in the bone scan. Since these cold defects are subtle, they are easily overlooked or mistaken as aggressive bony metastasis.

  11. Characteristic Uptake Pattern of Bone Scintigraphy in Patients with Hepatocellular Carcinoma Following Treatment with High-Intensity Focused Ultrasound

    This study retrospectively reviews the characteristic bone scintigraphic findings in 18 patients with hepatocellular carcinoma (HCC) following treatment with high-intensity focused ultrasound (HIFU). A potential complication of HIFU is damage to the tissues along the path of the ultrasound beam and structures superficial to the lesion of interest. Patients with hepatocellular carcinoma who underwent a bone scan between 1st December 2005 and 31st December 2011 were considered for this study. Among these patients, only those who had bone scans after the HIFU treatment were included. The time between HIFU treatment and bone scans, HIFU energy, HCC sites, tumour sizes and related radiological findings were evaluated. In total, 20 bone scans of 18 patients were reviewed. Of these scans, two patients were normal; three patients showed decreased uptake, four patients showed increased uptake and nine patients showed mixed uptakes of the bony tracer in their rib cages. The defects were located in the anterior, lateral, anterolateral or posterolateral aspects of the rib cage. The majority of those cold defects were in the right anterior rib cages. SPECT/CT was used to localise the decreased uptake in ribs. The magnetic resonance imaging in individual patients invariably showed ill-defined rim enhancement along the right chest wall, signifying chest wall injury. The results showed that tissue ablation using HIFU caused tissue injury along the pathway of high-intensity ultrasound beams. The harm to tissues is presented as photopenic area on the rib cages due to necrosis or hot spots due to rib fractures in the bone scan. Since these cold defects are subtle, they are easily overlooked or mistaken as aggressive bony metastasis

  12. Incidental Detection of Subcutaneous Myopericytoma of Trunk on FDG PET/CT and Bone Scintigraphy for Imaging of Colon Cancer.

    Demir, Selin Soyluoglu; Sarikaya, Ali; Aktas, Gul Ege; Oz Puyan, Fulya

    2016-08-01

    Myopericytoma is a rare type of unusual soft tissue tumor with perivascular myoid differentiation. A 53-year-old man with the diagnosis of colon cancer was referred to Tc-MDP bone scan and F-FDG PET/CT for staging. A subcutaneous mass located in right lower back with heterogeneous FDG uptake was detected on PET/CT. There was increased osteoblastic activity on MDP bone scan in the same region. Mass was resected and subsequently confirmed as myopericytoma by histopathology. PMID:27124684

  13. Biological properties of 99Tcm-HMIBP and its usefulness for bone scintigraphy by comparing with 99Tcm-MDP

    Objective: Zoledronate has been extensively used for the treatment of tumor-induced hypercalcaemia and osteolytic bone metastases. 1-hydroxy-2-(1-methylimidazol-2-yl) ethylidene-1,1-bisphos- phonic acid (HMIBP) with similar chemical structure as Zoledronate, was therefore considered to be useful as bone imaging agent. In this study the usefulness of 99Tcm labeled HMIBP for bone imaging was evaluated and the results with the well-established 99Tcm-methylene diphosphonic acid (MDP) imaging was compared. Methods: Labeled with 99Tcm, the SnCl2·2H2O quantity, radiochemical purity, pH value and stability at 4 degree C of 99Tcm-HMIBP were measured. Besides, the partition coefficient, plasma protein binding rate, hemodynamic parameters of 99Tcm-HMIBP and median lethal dose (LD50) of HMIBP were determined. 99Tcm-HMIBP bone imaging was performed in normal New Zealand rabbits and compared with 99Tcm-MDP bone imaging. Results: The kit composed of 5 mg HMIBP and 0.05 mg SnCl2·2H2O. The labeling rate was 96% after 180 d storage at 4 degree C. The radiochemical purity of 99Tcm-HMIBP was 98% at pH 5 and the partition coefficients were 0.0125 and 0.0054 at pH 7.0 and 7.4 respectively. The plasma protein binding rate of 99Tcm-HMIBP was 44.77%. The hemodynamic parameter C valued 3.0979 e-0.0721t+0.1250 e-0.0076t and LD50 was 8.2 mg/kg. The bone images of 99Tcm-HMIBP were fairly well 3 h after the injection, which was comparable to 99Tcm-MDP bone imaging. Conclusions: 99Tcm-HMIBP had good biological properties and comparable bone imaging quality with 99Tcm-MDP. It might be a potential agent for both treatment and imaging. (authors)

  14. SPECT-CT evaluation of lesions classified as indeterminate on bone scintigraphy in cancer patients; Evaluation par la TEMP-TDM des lesions classees indeterminees en scintigraphie osseuse chez les patients de cancerologie

    Granier, P.; Mourad, M. [Center Hospitalier Antoine-Gayraud, Service de Medecine Nucleaire, 11 - Carcassonne (France)

    2008-05-15

    The aim of the present study was to investigate the contribution of the single photon emission computed tomography/computed tomography (SPECT/CT) in cancer patients and to evaluate its ability to correctly classify indeterminate lesions on planar bone scintigraphy (P.B.S.). Methods From November 2006 to August 2007, all patients with confirmed malignancy, whose P.B.S. showed indeterminate lesions, underwent without delay a SPECT/CT. The study included 120 patients (67 men, 53 women), with a mean age of 69 {+-}12 years (range 42-96 years). The patients with obvious metastases, important pains or who did not accept the examination were excluded from the study. The location of the lesions was described either as precise, probable or indeterminate. The lesions were classified either as definitely malignant, definitely benign or indeterminate. Results Breast, prostate, lung and kidney neoplasms represented approximately 80% of all cancers. The P.B.S. highlighted 267 lesions of location either as precise (n = 29), probable (n 129) or indeterminate (n = 109), classified either as definitely malignant (n = 28), definitely benign (n = 27) or indeterminate (n = 212). The SPECT/CT revealed 440 lesions, of location either as precise (n 353), likely (n = 39) or indeterminate (n = 48), classified either as definitely malignant (n 84), definitely benign (n = 305) or indeterminate (n = 51). Thoracic and lumbar spine and pelvis were the locations of 79% of the scintigraphic lesions and of 88% of the osseous metastases. SPECT/CT modified the final report of 80 patients, by excluding from metastases (n 2), by showing metastases (n = 23) and by showing the benign character of indeterminate lesions (n = 55). Moreover, 69 patients out of 120 (> 57%) had an evolution confirmed with 35 true positives, 31 true negatives, one false negative and two patients with indeterminate lesions on SPECT/CT, without osseous metastasis. Conclusion The assessment of the indeterminate scintigraphic

  15. Bone dosimetry and scintigraphy in post-traumatic reflex sympathetic dystrophy syndrome (RSDS) with upper limb involvement

    In 24 patients affected with post-traumatic reflex sympathetic dystrophy syndrome (RSDS) with upper limb involvement following humeral fractures, bone mineral density (BMD, mg/cm2) was measured by means of dual-photon absorptiometry in the distal radius of both the affected and the normal contralateral limbs. Subsequently, all patients underwent dynamic and static scintigraphic exams after i.v. injection of 99mTc-MDP (20 mCi), with gamma camera collimator centered in both limbs. BMD values were significantly lower in the affected sides than in the normal contralateral ones. Time-activity curves with MDP showed increased flow in the involved limbs. Significant increase in blood pool and in bone uptake was also oserved. After carbocalcin treatment (80 U/q.d.i.m. in 12 cases and 40 U/q.d.i.m. in the other 12 cases for month) all the patients presented improved clinical symptoms and significant increase in BMD, that was restored to normal values in 7 of the patients who had a longer treatment (40 U/q.d.i.m. for 2 months). Both local blood flow and bone up-take in the affected side significantly decreased after carbocalcitonin therapy while bone avidity index increased in those patients in whom this parameter had been measured. Results confirmed the usefulness of radioisotopic procedures in post-traumatic RSDS for both diagnosis (by demonstrating increased local blood flow and early bone demineralization) and monitoring response to treatment with carbocalcitonin, which seems to play an important role in this condition

  16. Comparison of Tc-99m Ciprofloxacin (Infecton) and Tc-99m Methylene diphosphonate (MDP) three-phase bone scintigraphy in the diagnosis of osteomyelitis in patients with Sickle Cell Disease

    The high incidence of Sickle Cell Disease (SCD) is a major health problem in Oman. These patients are more prone to infections than the general population, and in particular, they are highly susceptible to osteomyelitis. Because bone infarction is more common than osteomyelitis in SCD, an accurate and rapid differential diagnosis is essential before initiating appropriate treatment. The present prospective study evaluates the usefulness of the new radiopharmaceutical, Tc- 99m Ciprofloxacin (Infecton) for the differential diagnosis of infection and infarction in patients with SCD. Majority of subjects studied were children. The results of Tc-99m Infecton imaging were compared with those of the 3-phase bone scintigraphy using Tc- 99m Methylene diphosphonate (Tc-99m MDP). Twenty-five patients referred for ruling out infection were imaged after intravenous injection of 5.5 MBq/kg body weight of Tc-99m Infecton. First pass, blood pool and late images (at one, four and 24 hours post injection) were performed. Subsequently all patients were also studied by three-phase bone scintigraphy using Tc-99m MDP. No adverse effects were observed. The sensitivity, specificity, accuracy and positive likelihood ratio of Tc-99m Infecton imaging for osteomyelitis were 100%, 92%, 94% and 12.5 respectively. Although bone scintigraphy would rarely be used by itself as a stand-alone test in the diagnosis of osteomyelitis in patients with SCD, its corresponding values were: 88%, 64%, 71% and 2.4. The results of this study suggest that the use of Tc-99m Infecton imaging is extremely beneficial in the management of patients of Sickle Cell Disease with suspected osteomyelitis. (author)

  17. Parathyroid scintigraphy

    Geatti, O. [Azienda Ospedali Riuniti di Trieste, Trieste (Italy). Div. of Nulcear Medicine

    1999-09-01

    The paper discusses the role of parathyroid scintigraphy in the preoperative location of enlarged parathyroid tissues. Various modified acquisition and processing protocols have been reported and {sup 201}Thallium still continues to be used, but other radiopharmaceuticals, such as {sup 99m}Tc-methoxy isobutyl isonitrile and {sup 99m}Tc-tetrofosmin are now often preferred, especially because of the more favourable physical properties of the Technetium labelling.

  18. MRI versus scintigraphy with {sup 99m}Tc-HMPAO-labelled granulocytes in the diagnosis of bone infection; Confronto RM e scintigrafia con granulociti tecneziati nella diagnosi di infezione ossea

    Vittolini, Enrico; Del Giudice, Eleonora; Caudana, Roberto [Azienda Ospedaliera Carlo Poma, Mantova (Italy). Dipartimento di diagnostica per immagini; Pizzoli, Andrea [Azienda Ospedaliera Carlo Poma, Mantova (Italy). Divisione di ortopedia e traumatologia

    2005-04-01

    Purpose: To assess the reliability of MRI and scintigraphy with {sup 99m}Tc-HMPAO-labelled granulocytes in the diagnosis of bone infection. Materials and methods: Between November 2001 and November 2003, 25 patients (16 men and 9 women; age range 22-72 years; mean age 48 years) with suspected bone infection were evaluated. The lower limbs were more frequently involved (20/25 cases). MRI (TI and T2-w sequences, both with and without fat suppression; TI-w fat-suppressed sequence after Gadolinium administration) and scintigraphy with {sup 99m}Tc-HMPAO-labelled granulocytes were performed in all patients; the study was performed 30 min, 150 min and 24 h after the injection of {sup 99m}Tc labelled autologous granulocytes. The maximum interval between MRI and scintigraphy was 15 days. The diagnosis was confirmed surgically (18/25 cases) or by clinical follow-up (7/25 cases). Results: In 10/25 cases the clinical suspicion of bone infection was confirmed by MRI, scintigraphy and surgery. In 12/25 cases the clinical suspicion of bone infection was not confirmed either by imaging, surgery (5/12 cases) or follow-up (7/12 cases). In 3/25 cases the results were discordant: in 1/3 cases with conic osteomyelitis confirmed by MRI and surgery, a false-negative diagnosis was made by scintigraphy. In 2/3 cases with negative diagnoses confirmed by surgery, a false-positive diagnosis was made by scintigraphy owing to the infection of adjacent soft tissues. Conclusions: MRI is more reliable for the detection and evaluation of the local spread of bone infection. Conversely, when metallic devices causing artefacts on MR images are present, scintigraphy is the preferred alternative modality. [Italian] Scopo: Valutare l'affidabilita della Risonanza Magnetica (RM) e della Scintigrafia (Scgrm) con granulociti autologhi marcati con 99mTc, nella diagnosi di infezione ossea (IO). Materiale e metodi: Nel periodo compreso tra nov. '01 e nov. '03, sono stati valutati 25 pazienti (16

  19. Liver scintigraphy

    Liver scintigraphy can be classified into 3 major categories according to the properties of the radiopharmaceuticals used, i.e., methods using radiopharmaceuticals which are (1) incorporated by hepatocytes, (2) taken up by reticulo endothelial cells, and (3) distributed in the blood pool of the liver. Of these three categories, the liver scintigraphy of the present research falls into category 2. Radiopharmaceuticals which are taken up by endothelial cells include 198Au colloids and 99mTc-labelled colloids. Liver scintigraphy takes advantage of the property by which colloidal microparticles are phagocytosed by Kupffer cells, and reflect the distribution of endothelial cells and the intensity of their phagocytic capacity. This examination is indicated in the following situations: (i) when you suspect a localized intrahepatic lesion (tumour, abscess, cyst, etc.), (ii) when you want to follow the course of therapy of a localized lesion, (iii) when you suspect liver cirrhosis, (iv) when you want to know the severity of liver cirrhosis or hepatitis, (v) when there is hepatomegaly and you want to determine the morphology of the liver, (vi) differential diagnosis of upper abdominal masses, and (vii) when there are abnormalities of the right diaphragm and you want to know their relation to the liver

  20. The value of Tc-99m-tetrofosmin scintigraphy in the assessment of P-glycoprotein in patients with malignant bone and soft-tissue tumors

    P-glycoprotein (Pgp) overexpression has been shown to be correlated with resistance to chemotherapy in patients with malignant bone and soft-tissue tumors. The aim of our study was to investigate the role of 99mTc-tetrofosmin as a functional imaging agent reflecting Pgp expression in these tumors. Twenty eight patients with various malignant bone and soft-tissue tumors were studied. Radionuclide angiography with 99mTc-tetrofosmin was done first and planar images were acquired at 15 min and 90 min postinjection. Vascular phase was evaluated visually on dynamic images, metabolic state was evaluated both visually and quantitatively on planar images. Quantitative analysis was performed by the calculation of tetrofosmin uptake in the lesion against background and percent washout rate (WR%) of the tracer. Immunohistochemical analysis of Pgp was performed on biopsy specimens and the degree of expression was graded from 0 to 3. There was a positive correlation between the Pgp score and the washout rate of tetrofosmin (r=0.73, p=0.000). The mean washout rate of tetrofosmin from the lesions with Pgp expression (31.81±6.72) was found to be significantly higher than those of without Pgp expression (21±3.49) (p=0.000). No statistically significant correlation was found between 15 min and 90 min uptake ratios (UR) of tetrofosmin and Pgp score (r=-0.10, p=0.6 and r=-0.21, p=0.2, respectively). When the cut-off value of 24.5 (according to receiver operating characteristic (ROC)-analysis) for the washout rate was used to discriminate the lesions with and without Pgp expression, the test yielded a sensitivity value of 87.5% with a specificity of 100%. In malignant bone and soft-tissue tumors, 99mTc-tetrofosmin uptake were not related to Pgp overexpression. Pgp overexpression was found to be correlated with the washout rate of the tracer. 99mTc-tetrofosmin scintigraphy with washout analysis may not only be a useful method for evaluating Pgp overexpression but also its function

  1. 18F-FDG PET/CT for Diagnosis of Osteosclerotic and Osteolytic Vertebral Metastatic Lesions: Comparison with Bone Scintigraphy

    Uchida, Kenzo; Nakajima, Hideaki; Miyazaki, Tsuyoshi; Tsuchida, Tatsuro; Hirai, Takayuki; Sugita, Daisuke; Watanabe, Shuji; Takeura, Naoto; Yoshida, Ai; Okazawa, Hidehiko; Baba, Hisatoshi

    2013-01-01

    Study Design A retrospective study. Purpose The aims of this study were to investigate the diagnostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in PET/computed tomography (CT) in the evaluation of spinal metastatic lesions. Overview of Literature Recent studies described limitations regarding how many lesions with abnormal 18F-FDG PET findings in the bone show corresponding morphologic abnormalities. Methods The subjects for this retrospective study were 227 pat...

  2. Bayesian meta-analysis of test accuracy in the absence of a perfect reference test applied to bone scintigraphy for the diagnosis of complex regional pain syndrome.

    Held, Ulrike; Brunner, Florian; Steurer, Johann; Wertli, Maria M

    2015-11-01

    There is conflicting evidence about the accuracy of bone scintigraphy (BS) for the diagnosis of complex regional pain syndrome 1 (CRPS 1). In a meta-analysis of diagnostic studies, the evaluation of test accuracy is impeded by the use of different imperfect reference tests. The aim of our study is to summarize sensitivity and specificity of BS for CRPS 1 and to identify factors to explain heterogeneity. We use a hierarchical Bayesian approach to model test accuracy and threshold, and we present different models accounting for the imperfect nature of the reference tests, and assuming conditional dependence between BS and the reference test results. Further, we include disease duration as explanatory variable in the model. The models are compared using summary ROC curves and the deviance information criterion (DIC). Our results show that those models which account for different imperfect reference tests with conditional dependence and inclusion of the covariate are the ones with the smallest DIC. The sensitivity of BS was 0.87 (95% credible interval 0.73-0.97) and the overall specificity was 0.87 (0.73-0.95) in the model with the smallest DIC, in which missing values of the covariate are imputed within the Bayesian framework. The estimated effect of duration of symptoms on the threshold parameter was 0.17 (-0.25 to 0.57). We demonstrate that the Bayesian models presented in this paper are useful to address typical problems occurring in meta-analysis of diagnostic studies, including conditional dependence between index test and reference test, as well as missing values in the study-specific covariates. PMID:26479506

  3. Diagnosis of initial changes in patients suffering from rheumatoid arthritis. A comparison between low-field magnetic resonance imaging, 3-phase bone scintigraphy and conventional X-ray

    Besides conventional X-rays, in the diagnostic work up of initial changes in patients suffering from rheumatoid arthritis (RA), 3-phase bone scintigraphy (3P-Sz) is as well established as magnetic resonance imaging (MRI). The aim of this study was to compare the diagnostic value of the newly developed low field MRI with the proven methods X-rays and 3P-Sz. Methods: 65 patients (47f, 18m; 20-86 yrs) were studied on a one day protocol with 3P-Sz (550 MBq Tc-99m DPD), MRI and X-rays of the hands. Images were visually analysed by two blinded nuclear medicine physicians and radiologists and classified as a) RA-typical, b) inflammatory, non-RA-typical and c) non inflammatory changes. All methods were compared to 3P-Sz as golden standard. Results: In comparison to 3P-Sz, low field MRI presents with almost equal sensitivity and specificity in rheumatoid-typical and inflammatory changes. Conventional X-rays revealed in arthritis-typical changes as well as in inflammatory changes a significantly lower sensitivity and also a lower negative predictive value while specificity equals the one of MRI. Quantitative analysis of 3P-Sz using ROI-technique unveiled significantly higher values in patients with rheumatoid arthritis than in those with no inflammatory changes. Conclusion: MRI represents an equally sensitive method in the initial diagnosis of rheumatoid-typical and inflammatory changes in the region of the hands as compared to the 3P-Sz. Besides the basic diagnosis with conventional X-rays, 3P-Sz is still the recommended method of choice to evaluate the whole body when RA is suspected. Additionally, quantitative analysis of the 3P-Sz using the ROI technique in the region of the hands reveals statistically significant results and should therefore be taken into account in the assessment of inflammatory changes. (orig.)

  4. Should bone scintigraphy be used as a routine adjunct to skeletal survey in the imaging of non-accidental injury? A 10 year review of reports in a single centre

    Aim: To retrospectively analyse the bone scintigraphy (BS) and skeletal survey (SS) data to evaluate the role and limitations of BS in the diagnosis of non-accidental injury (NAI). Materials and methods: All SS and BS performed over a 10 year period, for possible NAI, in children under 2 years old were retrospectively reviewed. Reports were compared in cases where both studies were performed and findings classified into one of three groups: (1) congruent: both reports agreed; (2) BS added confidence to the SS findings; (3) BS demonstrated a new finding. False-positive and false-negative rates for BS were calculated. Results: One hundred and sixty-six patients had both SS and BS. The findings were congruent in 74% of cases. BS added confidence to the SS findings in 8% and revealed a new abnormality in 4% of patients. BS demonstrated false-positive and -negative rates of 2% and 13%, respectively. Occult bony injury was detected in 12% of the 237 patients imaged. Discussion: When used as an adjunct to SS in the investigation of NAI, BS can aid the confidence of diagnosis or identify new findings in 12% of cases. In centres where nuclear medicine is readily available and there is appropriate expertise in paediatric BS, this modality provides a time-effective alternative to follow-up SS at 10–14 days. -- Highlights: •Retrospective evaluation of bone scintigraphy (BS) in the diagnosis of NAI. •Compares fracture detection using bone scintigraphy and skeletal survey (SS). •BS can aid confidence of diagnosis or identify new findings in 12% of cases. •BS provides a time effective alternative to follow up SS at 10–14 days

  5. ~(99)Tc~m标记双膦酸盐骨显像剂的研究进展%The new advanced of ~(99)Tc~m-labeled bisphosphonates as bone scintigraphy agent

    刘键; 张现忠; 张仕坚; 王学斌

    2009-01-01

    双膦酸盐是一类具有很强亲骨性的药物,99Tcm标记的双膦酸盐如~(99)Tc~m-亚甲基二膦酸盐(~(99)Tc~m-MDP)等被广泛应用于骨显像.近些年来,为了克服~(99)Tc~m-MDP的缺点,许多新型的双膦酸配体被设计与合成,以期望获得性能更加优异的骨显像剂.该文对近10年来发展的99Tcm标记双膦酸盐类骨显像剂的结构与性能进行了综述.%Bisphosphonates have a strong affinity for bone tissue and hydroxyapatite.Some of them have been labelled with ~(99)Tc~m for bone scintigraphy agent.This article is intended to summarize research and development in some new ~(99)Tc~m labeled bisphosphonates as bone scintigraphy agent in recent years.

  6. Detection of bone metastases in patients with lung cancer: 99mTc-MDP planar bone scintigraphy, 18F-fluoride PET or 18F-FDG PET/CT

    The aim of the study was to compare the diagnostic accuracy of 18F-fluorodeoxyglucose (FDG) PET/CT versus standard planar bone scintigraphy (BS) and 18F-labelled NaF (18F) PET for the detection of bone metastases (BM) in non-small cell lung cancer (NSCLC). 18F-FDG PET/CT was performed in 126 patients with NSCLC. Within 7 days BS (n = 58) or 18F PET (n = 68) was performed. 18F-FDG PET/CT, BS and 18F PET were evaluated by two experienced readers. Lesions were graded on a scale from 1 (definite BM) to 5 (degenerative lesion), and equivocal lesions were determined as indifferent (grade 3). A total of 92 patients showed degenerative lesions (grade 4/5) on PET/CT, BS or 18F PET. In 34 patients (27%) BM lesions were diagnosed (grades 1 and 2). In 13 of 18 patients BM were concordantly diagnosed with PET/CT and 18F PET. PET/CT showed more BM compared to 18F PET (53 vs 40). In one patient one osteolytic BM was false-negative on 18F PET. However, 18F PET identified four patients with BM compared to negative findings on PET/CT. Of 16 patients, 11 had concordant findings of BM on PET/CT and BS. In three patients BS was false-negative and in two patients BM were diagnosed as indifferent. Integrated 18F-FDG PET/CT is superior to BS in the detection of osteolytic BM in NSCLC. Thus, PET/CT may obviate the need to perform additional BS or 18F PET in the staging of NSCLC, which significantly reduces costs. (orig.)

  7. Clinical Value of 99Tcm-MDP SPECT Bone Scintigraphy in the Diagnosis of Unilateral Condylar Hyperplasia

    Bing Wen

    2014-01-01

    Full Text Available Purpose. To investigate the clinical value of 99Tcm-MDP SPECT for the diagnosis of unilateral condylar hyperplasia (UCH. Methods. One hundred forty-nine patients who underwent mandibular 99Tcm-MDP SPECT between January 2009 and December 2012 were studied, including 105 cases that were clinically suspected of UCH and 44 comparable cases without UCH as a control group. Results. Increased bone activity was observed in the affected condyles for all UCH patients. In the UCH group, the relative percentage uptake on the affected side was 59% (SD±4.3%, significantly higher than the 41% (SD±4.1% uptake on the contralateral side (P<0.001. Similarly, the condyle/skull ratio was significantly higher for the affected side (1.66±0.63 than for the contralateral side (1.34±0.34, P<0.01. No significant difference was found in the control group between the left and right condyles. Values for the sensitivity (95%, specificity (61%, positive (84.4% and negative (84.6% predictive values, and accuracy (84.5% for 99Tcm-MDP SPECT in the diagnosis of UCH were calculated. However, for the hyperplastic condyle, no correlation was observed between the thickness of each cartilage layer and the relative uptake in the SPECT image. Conclusion. 99Tcm-MDP SPECT is accurate for diagnosing UCH and can provide a reference for treatment options.

  8. The Clinical usefulness of {sup 99mT}c HMPAO Leukocyte/{sup 99mT}c phytate bone marrow scintigraphy for diagnosis of prosthetic knee infection: A preliminary study

    Jung, Kyung Pyo; Park, Ji Sun; Lee, Ah Young; Choi, Su Jung; Lee, Seok Mo; Bae, Sang Kyun [Inje Univ., Pusan Paik Hospital, Pusan (Korea, Republic of)

    2012-12-15

    The preferred radionuclide imaging procedure for diagnosing prosthetic joint infection is combined radiolabeled leukocyte/{sup 99mT}c sulfur colloid bone marrow scintigraphy, which has an accuracy of over 90%. Unfortunately, sulfur colloid is no longer available in South Korea. in this study, we evaluated the usefulness of {sup 99mT}c phytate, a substitute for {sup 99mT}c sulfur colloid, when combined with radiolabeled leukocyte scintigraphy in suspected prosthetic knee infections. Eleven patients (nine women, two men; mean age 72{+-}6 years) with painful knee prostheses and a suspicion of infection underwent both {sup 99mT}c phytate bone marrow scintigraphy (BMS). The combined images were interpreted as positive for infection when radioactivity in the LS at the sits of clinical interest clearly exceeded that of the BMS (discordant); they were interpreted as negative when the increased activity in the LS was consistent with an increased activity in the BMS(concordant). The final diagnosis was made with microbiological or intraoperative findings and a clinical follow up of at least 12 months. Five of eleven patients were diagnosed as having an infected prosthesis. The overall sensitivity, specificity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the combined LS/BMS were 100%, 83%, 83%, 100% and 91%, respectively. We find that combined {sup 99mT}c HMPAO LS/{sup 99mT}c phytate BMS shows comparable diagnostic performance to other studies utilizing sulfur colloid. Combined {sup 99mT}c HMPAO LS/{sup 99mT}c phytate BMS is therefore expected to be an acceptable alternative to combined radiolabeled LS/{sup 99ms}ulfur colloid BMS for diagnosing prosthetic knee infections.

  9. The herniation pit, a common cause of focal uptake in the femoral neck bone scan. Positive and differential diagnosis in osseous SPECT/CT; L'herniation pit, une cause frequente d'hyperfixation focale du col femoral en scintigraphie osseuse. Diagnostic positif et differentiel en TEMP/TDM osseuse

    Girma, A. [Centre Antoine-Lacassagne, Service de medecine nucleaire, 06 - Nice (France); Ramadan, A.; Paycha, F. [Hopital Louis-Mourier, service de medecine nucleaire, 92 - Colombes (France); Baccarc, S. [Hopital Louis-Mourier, service de radiologie, 92 - Colombes (France)

    2010-07-01

    The distinction of the various possible diagnoses in front of a focal uptake in the femoral neck in bone SPECT / CT is based on a triad of criteria that are symptomatic or not of the injury, its precise scintigraphy location at the femoral neck and CT appearance. (N.C.)

  10. Osseous scintigraphy in exploration of fever osteo-articular pain in sickle cell disease

    Osteo articular complications of sickle cell disease are multiple and can occur in the acute mode, (Bone infarction, acute osteomyelitis) or chronic (osteonecrosis, osteomyelitis).Through 6 cases we present the interest, lack and limitations of planar scintigraphy with bis phosphonates. Two patients underwent an early bone scan supplemented by medullary scintigraphy with nano colloids, the diagnosis was a bone infarction. In two children, the bone scan was performed between 5 and 7 days after the beginning of symptoms and did not objectify image of acute osteo articular complication. In the last patient, abnormal scintigraphy does not allow to differentiate osteomyelitis and bone infarction. The bone scan remains an essential consideration in the exploration of bone manifestations in sickle cell disease. Its association with bone marrow scintigraphy provides better diagnostic accuracy in differentiating osteomyelitis and bone infarction and adjusting the therapeutic management. (N.C.)

  11. A control study between DWIBS and bone scintigraphy mapping in the diagnosis of bone metastatic diseases%背景抑制扩散加权成像与核素骨扫描在恶性肿瘤骨转移病变诊断中的对照研究

    沈茜刚; 岳磊; 周良平; 彭卫军; 毛健; 张灵; 姚之丰; 程竞仪; 刘晓航; 丁建辉

    2014-01-01

    Background and purpose:Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for MR imaging systemic examination, especially the lymph node and bone diseases can be clear, and the imaging result is similar with PET. The aim of this study was to compare the value of clinical application in the diagnosis of malignant metastatic osteopathic between DWIBS and bone scintigraphy mapping. Methods:Thirty-six specimens conifrmed with malignant tumors by the pathology of operation or biopsy underwent both DWIBS imaging and bone scintigraphy mapping, chi-square test was used for comparing the detection results of bone metastasis by this two imaging methods. Results:Thirty (165 positions in all) of 36 malignant tumor patients were conifrmed as having bone metastasis, compared that 26 patients (143 positions) with DWIBS method and 23 patients (132 positions) with bone scintigraphy mapping were detected, but there was no statistical signiifcance between this two imaging methods (χ2=1.002, P=0.506). The sensitivity, positive predictive value (PPV) and accuracy of the detection rate of bone metastasis were similar in DWIBS and bone scintigraphy, with 86.7%, 96.3%, 86.1%and 76.7%, 88.5%, 72.2%, respectively;but the speciifcity and negative predictive value (NPV) in DWIBS (83.3%and 55.6%) was higher than that of in bone scintigraphy (50.0%and 30.0%). The detection rates of different bone metastasis with DWIBS and bone scintigraphy were 86.7%(143/165) and 80.0%(132/165), and it was no signiifcant difference (χ2=2.640, P=0.104);DWIBS method was better than bone scintigraphy in the detection of osseous metastasis on pelvis and limbs long bone, and there was different signiifcant (χ2=6.783 and 7.636, P=0.023 and 0.016). Conclusion:DWIBS could detect bone metastatic lesions effectively, and there is ifne consistency with bone scintigraphy. Therefore, DWIBS is to hope to be extended and applicated clinically.%背景与目的:背景

  12. Metastatic calcifications of hyperparathyroidism detected by M.D.P.- Tc 99 m bone scintigraphy in patients with parathyroid carcinoma: A case report; Les calcifications metastatiques de l'hyperparathyroidie identifiees par scintigraphie osseuse au M.D.P.-Tc 99 m dans le cadre du carcinome parathyroidien: a propos d'un cas

    Doudouh, A.; Biyi, A.; Oufroukhi, Y.; Zekri, A. [Hopital Militaire Mohammed-5, Service de Medecine Nucleaire, Rabat (Morocco); Sekkach, Y. [Hopital Militaire Mohammed-5, Service de Medecine B, Rabat (Morocco)

    2008-02-15

    The authors report a case of gastric, renal, pulmonary, and myocardial uptake of M.D.P.-Tc 99 m in a patient with parathyroid carcinoma. Parathyroid carcinoma is a rare cause of primary hyperparathyroidism which becomes complicated during its evolution by metastatic calcifications. Metastatic calcifications are frequently located in lungs and heart. If an adequate treatment is not undertaken, these calcifications progress and evolve into severe respiratory and cardiac complications. In our patient, quasi-complete disappearance of metastatic calcifications on the follow-up bone scintigraphy, performed four weeks after surgical cure of parathyroid tumour, indicates the great interest of this examination in early identification of metastatic calcifications and monitoring of their disappearance after treatment. (authors)

  13. Musculoskeletal scintigraphy of the equine athlete.

    Dyson, Sue

    2014-01-01

    Nuclear scintigraphic examination of equine athletes has a potentially important role in the diagnosis of lameness or poor performance, but increased radiopharmaceutical uptake (IRU) is not necessarily synonymous with pain causing lameness. Nuclear scintigraphy is highly sensitive to changes in bone turnover that may be induced by loading and knowledge of normal patterns of RU is crucial for accurate diagnosis. Blood pool images can be useful for identification of some soft tissue injuries, although acute bone injuries may also have intense IRU in blood pool images. Some muscle injuries may be associated with IRU in bone phase images. The use of scintigraphy together with other diagnostic imaging modalities has helped us to better understand the mechanisms of some musculoskeletal injuries. In immature racehorses, stress-related bone injury is a common finding and may be multifocal, whereas in mature sport horses, a very different spectrum of injuries may be identified. False-negative results are common with some injuries. PMID:24314041

  14. Bone changes in tuberous sclerosis mimicking metastases

    Pui, M.H.; Kong Hwai Loong; Choo Hui Fen [National University Hospital (Singapore). Depts. of Diagnostic Radiology and Oncology

    1996-02-01

    Sclerotic and lytic bone changes of tuberous sclerosis (TS) can mimic bone metastases. A case is reported of a patient with concomitant sclerotic bone metastases from bronchogenic carcinoma and TS bone changes, diagnosed by bone scintigraphy and magnetic resonance imaging. The increased bone uptake and abnormal magnetic resonance signal allowed distinction of TS bone lesions from bone metastases. 6 refs., 4 figs.

  15. Bone changes in tuberous sclerosis mimicking metastases

    Sclerotic and lytic bone changes of tuberous sclerosis (TS) can mimic bone metastases. A case is reported of a patient with concomitant sclerotic bone metastases from bronchogenic carcinoma and TS bone changes, diagnosed by bone scintigraphy and magnetic resonance imaging. The increased bone uptake and abnormal magnetic resonance signal allowed distinction of TS bone lesions from bone metastases. 6 refs., 4 figs

  16. Skeletal scintigraphy following incidental trauma

    The significance of antecedent trauma in skeletal scintigraphy was assessed in 503 patients, of whom 241 (46%) had prior fracture or tooth extraction. In patients with sufficiently accurate histories for site-by-site analysis, 33 of 131 fracture sites and 16 of 83 dental-procedure sites were positive scintigraphically. In general, the frequency of scan positivity diminished as the interval between trauma and scanning increased, but a significant number of patients showed prolonged uptake at fracture sites. Several patterns of uptake suggested trauma rather than metastatic disease. Knowledge of a history of trauma is often critical in bone scan interpretation

  17. Osseous scintigraphy in exploration of fever osteo-articular pain in sickle cell disease; La scintigraphie osseuse dans l'exploration des douleurs osteoarticulaires febriles chez les drepanocytaires

    El Ajmi, W.; Slim, I.; Zaabar, L.; Ben Sellem, D.; Letaief, B.; Mhiri, A.; Ben Slimene, M.F. [Institut Salah Azaiez, Service de medecine nucleaire, Tunis (Tunisia)

    2010-07-01

    Osteo articular complications of sickle cell disease are multiple and can occur in the acute mode, (Bone infarction, acute osteomyelitis) or chronic (osteonecrosis, osteomyelitis).Through 6 cases we present the interest, lack and limitations of planar scintigraphy with bis phosphonates. Two patients underwent an early bone scan supplemented by medullary scintigraphy with nano colloids, the diagnosis was a bone infarction. In two children, the bone scan was performed between 5 and 7 days after the beginning of symptoms and did not objectify image of acute osteo articular complication. In the last patient, abnormal scintigraphy does not allow to differentiate osteomyelitis and bone infarction. The bone scan remains an essential consideration in the exploration of bone manifestations in sickle cell disease. Its association with bone marrow scintigraphy provides better diagnostic accuracy in differentiating osteomyelitis and bone infarction and adjusting the therapeutic management. (N.C.)

  18. Application of whole-body bone scintigraphy in diagnosis and staging of Langerhans cell histiocytosis in infants%全身骨显像在婴幼儿朗格汉斯组织细胞增多症诊断和分期中的应用

    丁献敏; 刘保平; 韩星敏; 程兵; 阮翘

    2011-01-01

    目的 探讨全身骨显像在婴幼儿朗格汉斯组织细胞增多症(LCH)诊断和分期中的应用价值.方法 对20例经手术病理或骨髓穿刺、皮疹压片细胞学确诊为LCH的婴幼儿行全身骨显像检查,对骨显像阳性者加行局部X线或CT检查.利用ROI技术计算全身骨显像阳性病灶的F/N比值并求出位于相同部位病灶的F/N比值均值.结果 20例患儿全身骨显像10例阳性,4例为多发病灶,6例为单发病灶.单纯颅骨放射分布异常3例,颅骨合并其他部位骨3例,肩胛骨2例,肋骨1例,下肢骨1例;单发颅骨病灶的F/N比值均值为0.36,长骨病灶的F/N比值均值为3.52.结论 全身骨显像有助于婴幼儿LCH的诊断及分期.%Objective To assess the application value of whole-body bone scintigraphy in diagnosis and staging of Langerhans cell histiocytosis (LCH) in infants. Methods Whole-body bone scintigraphy was performed in 20 infants of LCH confirmed with surgical pathology or bone marrow aspiration and laboratory data. The infants with positive bone scintigraphy underwent X-ray or CT, and the F/N value of positive lesions and lesions located in the same area were calculated by ROI technology. Results Ten of 20 patients showed positive in bone scans, including 4 with multi-focal lesions and 6 with single lesion. Among 10 patients with positive scintigrams, there were 3 patients with abnormal bone uptakes limited to cranial, 3 with cranial and other parts of abnormal bone uptakes, 2 with scapula abnormal uptakes, as well as rib and lower limb bone involvement (each n= 1). The average ratios of F/N on cranial alone was 0. 36, while focused on long bones was 3. 52. Conclusion Whole-body bone scintigraphy is useful in the diagnosis and staging of LCH in infants.

  19. Hepatic scintigraphy for leptospirosis

    Six patients with leptospirosis were investigated. Hepatic scintigraphy showed abnormal radiocolloidal distribution, with non-homogeneous concentration in all of them, and minimum to moderate splenic uptake. Hepatic scintigraphy is proved to be a good function test of the hepatic defeat system

  20. In-111 WBC scintigraphy in adult osteomyelitis

    Unlike pediatric bone infections, adult osteomyelitis is commonly related to trauma, surgery, or direct extension from an overlying soft tissue infection. Because of this, the findings on Tc-99m MDP bone scintigraphy tend to be nonspecific. Therefore the value of In-111 WBC scintigraphy in the diagnosis of adult osteomyelitis was evaluated. 52 scans were obtained on 51 adult patients who were consecutively referred to the authors' department with this provisional diagnosis. The diagnosis was confirmed by at least two of the following: positive culture, surgery, x-rays, laboratory results, and clinical response to antibiotics. Of the 52 scans studied the sensitivity was 84%, specificity was 82%, and the accuracy was 83%. False positive results occurred most frequently in patients with inflammatory arthritis. False negative examinations occurred in patients who had In-111 WBC concentration in overlying soft tissue obscuring the bony abnormality. Neither the chronicity of the infection, nor prior treatment with antibiotics created difficulty in scan interpretation. It was concluded that although somewhat less sensitive than TcMDP bone scanning, In-111 WBC scintigraphy is more specific than previously studied radiopharmaceuticals in the assessment of bone infections in the adult population

  1. In-111 WBC scintigraphy in adult osteomyelitis

    Ehrlich, L.; Martin, R.H.; Saliken, J.

    1984-01-01

    Unlike pediatric bone infections, adult osteomyelitis is commonly related to trauma, surgery, or direct extension from an overlying soft tissue infection. Because of this, the findings on Tc-99m MDP bone scintigraphy tend to be nonspecific. Therefore the value of In-111 WBC scintigraphy in the diagnosis of adult osteomyelitis was evaluated. 52 scans were obtained on 51 adult patients who were consecutively referred to the authors' department with this provisional diagnosis. The diagnosis was confirmed by at least two of the following: positive culture, surgery, x-rays, laboratory results, and clinical response to antibiotics. Of the 52 scans studied the sensitivity was 84%, specificity was 82%, and the accuracy was 83%. False positive results occurred most frequently in patients with inflammatory arthritis. False negative examinations occurred in patients who had In-111 WBC concentration in overlying soft tissue obscuring the bony abnormality. Neither the chronicity of the infection, nor prior treatment with antibiotics created difficulty in scan interpretation. It was concluded that although somewhat less sensitive than TcMDP bone scanning, In-111 WBC scintigraphy is more specific than previously studied radiopharmaceuticals in the assessment of bone infections in the adult population.

  2. Skeletal scintigraphy for followup of fracture healing during electrical stimulation

    The influence of slowly pulsating bipolar sequences of rectangular pulses upon bone growth was investigated in animals. Control was achieved by analysis of bone mineral content, analysis of stability by use of the 3-point-bending-assay and by skeletal scintigraphy using sup(99m)Tc-diphosphonate. The results show up, that changes of mineralization are controlled by scintigraphy at an early time delivering reliable information concerning the efficiency of electrical stimulation. A case report demonstrates successful clinical use of the implantable electrical stimulator JES 2. (orig.)

  3. Evaluation of renal uptake on 111InCl3 bone marrow scintigraphy in patients with aplastic anemia and myelodysplastic syndrome

    High renal uptake on bone marrow scan with indium-111 chloride is often shown in patients with bone marrow abnormality. We evaluated the renal uptake on bone marrow scan in 27 cases of aplastic anemia, 20 cases of myelodysplastic syndrome (MDS) and 10 cases of other diseases. The high renal uptake was observed in patients not only with aplastic anemia but also with MDS. The renal uptake correlated with blood transfusion units, unsaturated iron binding capacity (UIBC), blood pool imaging and bone marrow uptake. The renal uptake correlated with UIBC better than with the blood transfusion units. Following mechanism of the renal uptake is proposed that frequent blood transfusion makes low UIBC, and the low UIBC causes the failure to chelate indium with transferrin. The fast blood clearance of un-chelated indium via kidneys is followed. Hypoplastic bone marrow may also play an important role for the high renal uptake because all patients with the high renal uptake could not be explained by above mentioned mechanism. Caution should be paid to the scans with the high renal uptake because both aplastic anemia and MDS patients show the high renal uptake. (author)

  4. Significance of thymic scintigraphy

    Thymic scintigraphy by 67Ga-citrate and 75Se-methionine was done on 6 cases of thymoma, and 5 cases of myasthenia gravis. Scan was positive on 5 of 6 cases of thymoma. All patients with malignant thymoma were positive. Among the 7 cases of myasthenia gravis, scintigrams revealed 2 thymomas and 1 hyperplasia on whom no thymic mass suspected. Thymic scintigraphy is useful examination when dealing with myasthenia gravis. (auth.)

  5. Usefulness of Bone Metabolic Markers in the Diagnosis of Bone Metastasis from Lung Cancer

    Chung, Jae Ho; Park, Moo Suk; Kim, Young Sam; Chang, Joon; Kim, Joo Hang; Kim, Sung Kyu; Kim, Se Kyu

    2005-01-01

    Bone metastasis is common in lung cancer patient and the diagnosis of bone metastasis is usually made by using imaging techniques, especially bone scintigraphy. However, the diagnostic yield from bone scintigraphy is limited. The aim of this study is to assess the clinical usefulness of urinary pyridinoline cross-linked N-telopeptides of Type I collagen (NTx), urinary deoxypyridinoline (DPD), and serum alkaline phosphatase (ALP) in the assessment of bone metastasis in patients with lung cance...

  6. Value of 99Tcm-MDP SPECT bone scintigraphy in diagnosis of unilateral condylar hyperplasia of the mandible%99Tcm-MDP SPECT颞颌关节显像对髁突肥大的诊断价值

    文兵; 沈影; 汪长银

    2012-01-01

    目的 探讨99Tcm-MDP SPECT颞颌关节显像对髁突肥大的诊断价值.方法 回顾性分析2009年至2010年行99Tcm-MDP SPECT颞颌关节显像的髁突肥大(临床确诊)患者56例(男22例,女34例,平均年龄21.5岁),其中31例接受了髁突高位切除术并有组织病理学结果.另收集10例因恶性肿瘤等其他疾病行骨显像的对照者,男女各5例,平均年龄22.6岁,加做颞颌关节显像.对所有研究对象进行SPECT图像分析及半定量分析,采用独立样本t检验比较髁突肥大组与对照组间患侧髁突/顶骨及患侧髁突/双侧髁突的摄取比差异,髁突肥大组患侧与健侧的摄取差异行配对t检验.对手术治疗患者的SPECT结果与其病理结果进行Pearson相关分析.结果 髁突肥大组患侧髁突/顶骨摄取比(1.66 ±0.63)及患侧髁突/双侧髁突摄取比(0.59±0.44)均明显高于对侧(1.34±0.34、0.41±0.04,t=3.687和6.590,均P<0.01),并且明显高于对照组左侧髁突相应数据(1.12 ±0.07和0.50±0.01,t =6.459和4.750,均P<0.001).SPECT检查诊断髁突生长活跃的灵敏度为95.2%(20/21),特异性为60.0%(6/10),阳性预测值为83.3% (20/24),阴性预测值为6/7.患侧髁突/双侧髁突摄取比与软骨组织增生的厚度无明显相关[软骨膜、增殖层、肥大层的平均厚度分别为(150.5±94.9)、(185.2±113.6)、(167.7 ±76.9)μm,r=0.46、0.47、-0.12,均P>0.05].结论 99Tcm-MDP SPECT颞颌关节显像能够有效评估髁突肥大患者的骨质生长活性,为手术方式的选择提供重要依据.%Objective To investigate the clinical value of 99Tcm-MDP SPECT bone scintigraphy in diagnosis of unilateral condylar hyperplasia (UCH) of the mandible.Methods Temporomandibular joint tomography using 99Tcm-MDP SPECT was performed in 56 UCH patients (22 males,34 females,mean age 21.5 y) preoperatively and 10 controls with other diseases (5 males,5 females,mean age 22.6 y).Thirtyone UCH patients received high condylar resection

  7. Bone scan and joint scan of hands and feet in rheumatoid arthritis; Scintigraphie osseuse et articulaire des mains et des pieds dans la polyarthrite rhumatoide

    Carpentier, N.; Verbeke, S.; Perdrisot, R.; Grilo, R.M.; Quenesson, E.; Bonnet, C.; Vergne, P.; Treves, R.; Bertin, P.; Boutros-Toni, F. [Centre Hospitalier Universitaire Dupuytren, Faculte de Medecine, 87 - Limoges (France)

    2000-09-01

    The aim of this study was to determine the ability of joint scan and bone scan of hands and feet, in patients with rheumatoid arthritis, to localize the altered joints. The sensitivity, the specificity, the positive predictive value (PPV) and the negative predictive value (NPV) of joint scan were determined in comparison with clinical joint assessment. Fifteen patients (780 joints) were clinically examined (pain and synovitis); during the same day, a bone scan and a joint scan were realized by oxidronate {sup 99m}Tc intravenous injection. Patients were scanned 5 minutes (tissual time, T{sub t}) and 3 hours 1/4 (bone time, T{sub 0}) after the administration. The uptake of the bi-phosphonate was evaluated with a qualitative method using a grey scale. The uptake of {sup 99m}Tc oxidronate was quantitated using an extra-articular region of interest. The sensitivity, specificity, PPV and NPV of the scan at Tt were 46%, 96%, 85% et 78%. The same parameters were 75%, 66%, 53% and 84% for the scan realized at T{sub 0}. The joint scan has showed 22% of false positive. These false positives could be a consequence of an earlier detection of joint alterations by scan. The joint scan should forecast the evolution of joints in patients with rheumatoid arthritis. (author)

  8. Assessment of mandibular growth by skeletal scintigraphy

    Accurate assessment of facial skeletal growth remains a major problem in craniomaxillofacial surgery. Current methods include: (1) comparisons of chronologic age with growth histories of the patient and the family, (2) hand-wrist radiographs compared with a standard, and (3) serial cephalometric radiographs. Uptake of technetium-99m methylene diphosphonate into bone is a reflection of current metabolic activity and blood flow. Therefore, scintigraphy with this radiopharmaceutical might serve as a good method of assessing skeletal growth. Thirty-four patients, ranging in age from 15 months to 22 years, who were undergoing skeletal scintigrams for acute pathologic conditions of the extremities, were used to develop standards of uptake based on age and skeletal maturation. The results indicate that skeletal scintigraphy may be useful in evaluation of mandibular growth

  9. Increased technetium-99 m hydroxy diphosphonate soft tissue uptake on bone scintigraphy in chronic kidney disease patients with secondary hyperparathyroidism

    Enevoldsen, Lotte Hahn; Heaf, James Goya; Højgaard, Liselotte;

    2015-01-01

    In bone scan patients with dialysis-treated chronic kidney disease (CKD) and hyperparathyroidism, soft tissue accumulation of technetium-99 m hydroxy/methylene diphosphonate (Tc-99 m-HDP/MDP) has been reported primarily in case reports and usually explained by hypercalcaemia and...... only differed from patients without in terms of plasma phosphate levels (1·95 ± 0·15 (n = 37) versus 1·27 ± 0·08 (n = 26), P = 0·0012). All patients with myocardial uptake (n = 27) had a coronary arteriography-verified history of coronary artery disease (CAD), whereas CAD was only present in six of the...

  10. RES scintigraphy in polycythemia vera and secondary or relative polycythemia

    Rudberg, U. (Depts. of Diagnostic Radiology and Internal Medicine, St. Goeran' s Hospital, Stockholm (Sweden)); Skaarberg, K.O. (Depts. of Diagnostic Radiology and Internal Medicine, St. Goeran' s Hospital, Stockholm (Sweden))

    1993-03-01

    Scintigraphy of the reticuloendothelial system (RES) was performed in 19 patients with polycythemia vera (PCV) and in 18 with secondary or relative polycythemia (PS). Bone marrow extension was found in all patients with PCV and in 11 of 18 patients with PS. The patients with PCV had a higher degree of extension than those with PS. Increased pelvic bone marrow activity was found in 16 of 19 PCV patients, but in none with PS. Splenomegaly was found in 9 patients with PCV, and in none with PS. It is concluded that RES scintigraphy in the majority of patients may differentiate between PCV and PS using the parameters pelvic bone marrow activity, bone marrow extension and splenic size. (orig.).

  11. Ventilation-perfusion scintigraphy

    A historical review of different investigation methods measuring lung function (perfusion and gas exchange) is given. The principles and handling of some ventilation methods using radioxenon, radiokrypton or radiolabelled aerosols, and the injection method of xenon are explained. The clinical applicability of these studies is evaluated considering ventilation and perfusion lung defects and congestive heart failure. The combination of the three principal techniques (perfusion scintigraphy using MAA, ventilation scintigraphy using radioxenon or radiokrypton, perfusion and ventilation scientigraphy after injection of radioxenon) lead to typical patterns of differential diagnosis of perfusion defects. (TRV)

  12. Scintigraphy and thyroid nodules

    The scintigraphy indications are: definition of the functional character in the multi nodules impairments, exploration of low T.S.H. (131I irradiation-therapy, cytological selection of hypo contrasted nodules. The comparison of the 123I fixation and the T.S.H. rate allows to identify the autonomous nodules and the autoimmune nodules hyperplasia. The longitudinal surveillance of nodules (97% of benign pathology) is simplified by scintigraphy: in lack of empowerment, the T.S.H surveillance is useless, in presence of hyper functional areas, the cytology is little useful but a surveillance or an etiologic treatment are required. (IT4, 131I, or surgery). (N.C.)

  13. Bone

    Bone scanning provides information on the extent of primary bone tumors, on possible metastatic disease, on the presence of osteomyelitis prior to observation of roentgenographic changes so that earlier therapy is possible, on the presence of collagen diseases, on the presence of fractures not disclosed by x-ray films, and on the evaluation of aseptic necrosis. However, the total effect and contribution of bone scanning to the diagnosis, treatment, and ultimate prognosis of pediatric skeletal diseases is, as yet, unknown. (auth)

  14. Three-phase bone scintigraphy with Tc-99m MDP in the diagnosis and management of acute osteoarticular infections in children

    One of the most important causes of residual damage in skeleton is incompletely treated osteoarticular infections (OAI). Goal: to assess the value of emergency three-phase bone scan (3FBS) in the evaluation of OAI. Methods: Thirty-eight children were studied with 54 3FBS. Results: Global analysis: 76% of the cases were principally articular; staphylococcus germs and hip's affection were the common. Nine patients with preoperative scan were positive with 16 foci, 86% confirmed by surgery cultivate. Seven children had negative 3FBS without posterior clinical symptomatology; in 5 of them it was demonstrated soft tissue involvement with normal osteoblastic phase. In 14/17 cases evaluated after surgical intervention, there was a relation between the scan and the clinical course. In two of those cases, in the 3FBS a new location was found. Conclusion: 3FBS is a helpful tool in the diagnosis and assessment of acute OAI in pediatric population. A positive 3FBS is highly accurate for OAI and a negative one rules it out securely (au)

  15. Gated equilibrium bloodpool scintigraphy

    This thesis deals with the clinical applications of gated equilibrium bloodpool scintigraphy, performed with either a gamma camera or a portable detector system, the nuclear stethoscope. The main goal has been to define the value and limitations of noninvasive measurements of left ventricular ejection fraction as a parameter of cardiac performance in various disease states, both for diagnostic purposes as well as during follow-up after medical or surgical intervention. Secondly, it was attempted to extend the use of the equilibrium bloodpool techniques beyond the calculation of ejection fraction alone by considering the feasibility to determine ventricular volumes and by including the possibility of quantifying valvular regurgitation. In both cases, it has been tried to broaden the perspective of the observations by comparing them with results of other, invasive and non-invasive, procedures, in particular cardiac catheterization, M-mode echocardiography and myocardial perfusion scintigraphy. (Auth.)

  16. Contemporary adrenal scintigraphy

    High-resolution computed tomography (CT) and magnetic resonance (MR) imaging have replaced scintigraphy as primary imaging modalities for the evaluation of adrenal diseases. Thin-slice CT, CT contrast washout studies and MR pulse sequences specifically designed to identify adrenal lipid content have radically changed the approach to anatomic imaging and provide unique insight into the physical characteristics of the adrenals. With a confirmed biochemical diagnosis, further evaluation is often unnecessary, especially in diagnostic localization of diseases of the adrenal cortex. However, despite the exquisite detail afforded by anatomy-based imaging, there are not infrequently clinical situations in which the functional insight provided by scintigraphy is crucial to identify adrenal dysfunction and to assist in localization of adrenocortical and adrenomedullary disease. The introduction of hybrid PET/CT and SPECT/CT, modalities that directly integrate anatomic and functional information, redefine the radiotracer principle in the larger context of high-resolution anatomic imaging. Instead of becoming obsolete, scintigraphy is an element of a device that combines it with CT or MR to allow a direct correlation between function and anatomy, whereby the combination creates a more powerful diagnostic tool than the separate component modalities. (orig.)

  17. Selective coronary scintigraphy

    Isotopic techniques occupy a leading place amongst examinations practicable on coronary patients because of their reliability and the safety and simplicity of their use. The present work reviews the possible applications of selective coronary scintigraphy in pathology. After a brief discussion on scintigraphy, isotopic techniques for myocardium research, coronarography and other methods to study local myocardium perfusion the theoretical bases for the use of the exploration are studied, the techniques and methods employed are reported and the results discussed. Coronary scintigraphy consists of selective injection in the two coronary arteries previously catheterized during a coronarography, of two different populations of microspheres labelled with two physically short-lived indicators: 15μ 99m Tc-labelled serumalbumin microspheres, 10 to 15μ In-labelled siderophiline microspheres. Various studies have shown the complete harmlessness of the exploration when certain precautions are taken regarding the size and number of the spheres. The microspheres disperse into the downstream arterial territory proportionally to the number of capillaries present in the different parts of the irrigated region, and are temporarily stopped in the precapillaries. The preparation of the different images needed to interpret the Face and OAG examination for the left coronary, then for the right coronary, is carried out at the end of the coronarography and lasts about 45 minutes. It is also possible by selective injection in the aorta-coronary bridges to judge their functional condition by observation of the regions they irrigate. 56 patients of the Necker hospital cardiological clinic have been examined

  18. 99Tcm-MDP骨三相显像在慢性骨髓炎外科手术治疗中的应用%Application of 99Tcm-MDP Three-Phase Bone Scintigraphy in the Surgery of Chronic Osteomyelitis

    吉蘅山; 薛杨波; 朱虹; 胡裕效; 张垒

    2014-01-01

    Objective To investigate the effect of 99Tcm-MDP three-phase bone scintigraphy in the surgery of chronic osteomyelitis. Methods Combined with surgical operation methods, the 99Tcm-MDP three-phase bone scintigraphy data of 34 patients with chronic osteomyelitis who were recruited from 2002 to 2008 in our hospital was analyzed to explore the diagnostic and therapeutic value of 99Tcm-MDP three-phase bone scintigraphy in chronic osteomyelitis. Results The A/N ratio was increased in 28 patients in blood lfow phase, which indicated that the positive rate of chronic osteomyelitis in blood lfow phase was 82.4%. The abnormal gather of tracer agent was occurred in soft tissues of 10 patients in blood pool phase and bones of 34 patients in delayed phase, which indicated that the positive rates of chronic osteomyelitis in blood pool phase and delayed phase were 29.4% and 100%, respectively. Conclusion The scope, position and size of bone lesions can be evaluated with 99Tcm-MDP three-phase bone scintigraphy, which can provide a correct guidance for the surgeon to thoroughly remove necrotic tissue of bone lesions.%目的:探讨99Tcm-MDP骨三相显像在慢性骨髓炎外科手术治疗中的作用。方法回顾性分析我科2002~2008年34例慢性骨髓炎患者99Tcm-MDP骨三相显像的资料,结合临床骨科手术方法,探讨99Tcm-MDP骨三相显像对慢性骨髓炎的诊断及治疗价值。结果34例患者中,28例患者血流相患/健侧摄取比值(A/N比值)明显增加,阳性率为82.4%;血池相10例患者软组织内可见示踪剂异常浓聚,阳性率为29.4%;延迟相34例患者骨骼均可见示踪剂异常浓聚,阳性率为100%。结论核素骨三相显像可以评估病灶的范围、死骨的大小及位置,为术中彻底清除骨性病灶的坏死组织提供正确的指导作用。

  19. Bone metastases in breast cancer and its risk factor

    Breast cancer is considered to often involve bone metastasis. Early detection and treatment of bone metastasis are essential in improving the prognosis of this disease. In 47 patients with bone metastasis confirmed with bone scintigraphy, we examined the appearance time of bone metastasis; bone metastasis was frequently observed with the progress of stage, but no association with the appearance time was found. Age was not associated with the incidence of bone metastasis but was found to be closely related to its appearance time. That is to say, patients with breast cancer below 40 years of age showed relatively early bone metastasis. Bone scintigraphy is required every 6 months at least for 3 years after the operation. In patients over 40 years of age, on the other hand, bone scintigraphy is required only once a year but has to be continued for 5 years or more, because they often show relatively late bone metastasis. (author)

  20. Contribution of osseous scintigraphy in the fractures of constraint- about five cases; Apport de la scintigraphie osseuse dans les fractures de contrainte- a propos de 5 cas

    Berehou, F.; Haddam, A.; Ben Rais, N. [Service de medecine nucleaire, CHU Ibn Sina, Rabat, (Morocco)

    2009-05-15

    The fracture of constraint lies on an unbalance between the bone resistance and the constraints at which it is submitted. The early diagnosis lies always on four principal elements: anamnesis, the poorness of the clinical examination, an early positive dual phase skeleton scintigraphy, and the delayed emergence of radiological signs. The highlighting of a hyper fixation at the skeleton scintigraphy on a bone prone to a constraint fracture in a context of intense physical activity or osseous insufficiency is highly evocative of the diagnosis. (N.C.)

  1. Hepatobiliary scintigraphy in children.

    Nadel, H R

    1996-01-01

    Hepatobiliary scintigraphy using iminodiacetic (IDA) radiopharmaceuticals provides clinically useful information on the function of the biliary tract in a variety of pathological processes in children, including neonatal jaundice, gallbladder dysfunction, trauma, and liver transplantation. Phenobarbital premedication (5 mg/kg per day for a minimum of 5 days in divided doses) is used in infants who are being examined for neonatal jaundice to increase the accuracy of 99mTc-IDA scintigraphy in differentiating extrahepatic biliary atresia from neonatal hepatitis. Biliary atresia can be ruled out in an infant if a patent biliary tree is shown with passage of activity into the bowel. If no radiopharmaceutical is noted in the bowel on imaging up to 24 hours, distinction between severe hepatocellular disease and biliary atresia cannot be made. The literature reports 91% accuracy, 97% sensitivity, and 82% specificity for hepatobiliary imaging in the diagnosis of biliary atresia. The impairment of both intrahepatic and extrahepatic biliary drainage is an important cause of liver disease in cystic fibrosis. Hepatobiliary scintigraphy in cystic fibrosis has shown characteristic patterns of dilatation of mainly the left hepatic duct, narrowing of the distal common bile duct, gallbladder dysfunction, and delayed bowel transit. Cholecystitis in children may be acalculous. Sensitivity and specificity for the scintigraphic diagnosis of acute acalculous cholecystitis is reported to range from 68% to 93% and 38% to 93%, respectively. Cholescintigraphy in a suspected bile leak provides information generally not available with other techniques, except for direct cholangiography. If the amount of intraperitoneal accumulation of the tracer is greater than that entering the gastrointestinal tract, surgery is usually indicated. Hepatobiliary imaging in children who have undergone liver transplantation will assess graft vascularity, parenchymal function, biliary drainage, presence of a leak

  2. Gamma-scintigraphy

    Gamma-scintigraphy is a medical technique making it possible to fix the image of certain organs after the concentration in these of emitting radioactive products. It is already widely used in the case of the thyroid gland with iodine-132 by applying the isotope iodine 131. The study of the liver and gall bladder is carried out using colloidal gold 198 and Bengal pink marked with iodine 131. Serum albumin marked with iodine 131 makes it possible to study rachidian blockages. Other applications can already be foreseen in this direction. (author)

  3. Tc-99m HIG Scintigraphy in Detection of Active Inflammation in Ankylosing Spondylitis

    Özhan Özdoğan

    2011-08-01

    Full Text Available Objective: The diagnosis of active inflammation in ankylosing spondylitis (AS is crucial for treatment to delay possible persistent deformities. There are no specific laboratory tests and imaging methods to clarify the active disease. We evaluated the value of Tc-99m human immunoglobulin (HIG scintigraphy in detection of active inflammation. Material and Methods: Twenty-nine patients were included. Tc-99m methylenediphosphonate bone (MDP and HIG scintigraphies were performed within 2-5 day intervals. Two control groups were constituted both for MDP and HIG scintigraphies. Active inflammation was determined clinically and by serologic tests. Both scintigraphies were evaluated visually. Sacroiliac joint index values (SII were calculated. Results: Active inflammation was considered in five (sacroiliitis in 2, sacroiliitis-spinal inflammation in 1, achilles tendinitis in 1, arthritis of coxafemoral joints in 1 patients. HIG scintigraphy demonstrated active disease in all 3 patients with active sacroiliitis. But, it was negative in the rest. The other 2 active cases were HIG negative. Right and left SII obtained from HIG scintigraphy was higher (p<0.05 in clinically active patients than inactive patients. There was not any significant difference between patients with inactive sacroiliitis and normal controls. Right and left SII obtained from bone scintigraphy was higher (p<0.05 in patient group than in control group. Conclusion: Clinically inactive AS patients, behave no differently than normal controls with quantitative sacroiliac joint evaluation on HIG scintigraphy. HIG scintigraphy may be valuable for evaluation of sacroiliac joints in patients with uncertain laboratory and clinical findings. (MIRT 2011;20:52-58

  4. Tc-99m Labeled HMPAO white Blood Cell Scintigraphy in Pediatric Patients

    Funda Aydın

    2012-04-01

    Full Text Available Objective: 99mTc labeled hexamethylpropylene amine oxime (HMPAO white blood cell (WBC scintigraphy is a frequently used option for acute infection, particularly in pediatric patients. This scintigraphy is applied to detect sites of infection/inflammation in patients with fever of unknown origin, to find and follow up osteomyelitis, and to detect suspicion of acute appendicitis. The aim of this retrospective study was to evaluate the value of 99mTc-HMPAO labeled WBC scintigraphy in pediatric patients. Material and Methods: The study was conducted between January 2006 and December 2008 and included 13 patients (5 boys, 8 girls; mean age 6.9±6.2 years. Those patients who had suspicion of bone infection (n=7, fever of unknown origin (n=3, and suspicion of acute appendicitis (n=3 were evaluated retrospectively. 99mTc-HMPAO labeled WBC scintigraphy imaging was performed to all patients. Diagnosis was done according to operation and pathological results or clinical follow-up. Results: 99mTc-HMPAO labeled WBC scintigraphy has been found to be true positive in 6 cases, true negative in 6 cases, and false negative in one patient who had fewer unknown origin. The false negative case has been found to have encephalitis with MRI. Conclusion: Leukocyte scintigraphy has been described as a useful diagnostic tool in the diagnosis of suspicion of bone infection, fever of unknown origin and suspicion of acute appendicitis. 99mTc-HMPAO labeled WBC scintigraphy is a rapid and very accurate method for detecting those pathologies. Our results showed that WBC scintigraphy might be reliably used for diagnosis of suspected bone infection and acute appendicitis, fever of unknown origin, and acute appendicitis, in pediatric patient population. (MIRT 2012;21:13-18

  5. RI scintigraphy in myasthenia gravis

    35 cases of myasthenia gravis were studied with RI scintigraphy. 67Ga-citrate was used in 34 patients and 76Se-selenomethionine in 5 patients for thymus scintigraphy. RI scintigram was negative in non-tumorous thymus, regardless of the severity of illness and it was positive in seven of nine patients with thymomas. RI accumulation in thymus was found both in benign and malignant thymomas. RI seems to accumulated in lymphocytic and mixed thymus more than epithelial type. (author)

  6. RI scintigraphy in myasthenia gravis

    Kuroda, Yoshikazu; Miyamoto, Mariko (Tokyo Metropolitan Fuchu Hospital (Japan)); Maki, Masako; Yamazaki, Toshiro

    1982-10-01

    35 cases of myasthenia gravis were studied with RI scintigraphy. /sup 67/Ga-citrate was used in 34 patients and /sup 76/Se-selenomethionine in 5 patients for thymus scintigraphy. RI scintigram was negative in non-tumorous thymus, regardless of the severity of illness and it was positive in seven of nine patients with thymomas. RI accumulation in thymus was found both in benign and malignant thymomas. RI seems to accumulated in lymphocytic and mixed thymus more than epithelial type.

  7. Liver scintigraphy in ponies

    Six derivatives of ethylenediamine-N,N'-bis (alpha-2-hydroxy phenyl) acetic acid labeled with /sup 99m/Tc were prepared and their imaging qualities evaluated in ponies. The 6 agents produced good scintigraphic images of certain structures of the liver in the pony. For each agent, 13 different scans were taken. Dorsal views of the left lateral, right lateral, and quadrate lobe were obtained with dorsal scans. Left lateral and left lateral oblique (45 degrees) scans provided a left lateral view of the left lobe and a medial view of the right lateral lobe. Right lateral scans revealed the right lateral and quadrate lobes. Administration of /sup 99m/Tc-labeled colloids which are commonly used in other species for liver scintigraphy resulted in extensive lung uptake in the pony

  8. Estrogen receptor scintigraphy.

    Scheidhauer, K; Scharl, A; Schicha, H

    1998-03-01

    Radio-labeled estrogen receptor ligands are tracers that can be used for functional receptor diagnosis. Their specificity towards receptors, together with the fact that only 50-70% of mammary carcinomas are receptor positive, renders them unsuitable for detection of primary tumors or metastases, and this means that estrogen receptor scintigraphy can be used neither for tumor screening nor for staging. However, both 18F-labeled and 123I-labeled estradiol derivatives are suitable for in vivo imaging of estrogen receptors. Their high specificity, established in animal experiments and in vitro studies has been reproduced in in vivo applications in humans. Tracers with positron radiation emitters are, however, hardly suitable for broad application owing to the short half-life of 18F, which would mean that users would need to be situated close to a cyclotron and a correspondingly equipped radiochemical laboratory. The number of available PET scanners, on the other hand, has increased over the last few years, especially in Germany, so that this, at least, does not present a limiting factor. All the same, 123I-labeled estradiol derivatives will find more widespread application, since the number of gamma-cameras incorporating modern multi-head systems is several times greater. The results of studies with 123I-E2-scintigraphy published to date are very promising, even given the initial technical problems mentioned above. As a method of examination, it could be optimised by using improved tracers with a higher tumor contrast and less disturbance from overlapping in diagnostically relevant locations, for instance, by selecting tracers with higher activities whose excretion is more renal than hepatobiliary. The use of modern multi-head camera systems can also be expected to improve the photon yield. PMID:9646642

  9. New trends in parathyroid scintigraphy

    Giordano, A. [Univ. Cattolica del Sacro Cuore, Ist. di Medicina Nucleare, Roma (Italy); Rubello, D.; Casara, D. [Azienda Ospedaliera di Padova, Servizio di Medicina Nucleare II, Padova (Italy)

    2001-09-01

    The paper focusses on the recent advances in parathyroid imaging in both diagnostic and surgical fields which justify the present favourable trend towards a considerable expansion of nuclear medicine applications in this area. The main methodological advances in parathyroid scintigraphy are the rebirth of the dual-tracer (subtraction) technique with technetium-99m sestamibi, the possibility of also using {sup 99m}Tc-tetrofosmin within a dual-tracer (subtraction) methodology and the more extensive use of single-photon emission tomography, which the authors believe will become the standard methodology. The indications for parathyroid scintigraphy have been affected by advances in hyperparathyroidism surgery, including wider use of unilateral neck exploration and of minimally invasive radioguided surgery. As these techniques can only be performed in hyperparathyroid patients with a single adenoma, careful pre-operative assessment is required, and parathyroid scintigraphy undoubtedly is the most accurate localisation method. To date, the majority of papers have also demonstrated the cost-effectiveness of scintigraphically guided limited neck surgery. The authors conclude that: (1) parathyroid scintigraphy can be recommended not only in persistent or recurrent hyperparathyroidism but also in hyperparathyroid patients prior to first surgery; (2) scintigraphy should always be performed by applying the most accurate technique available because reliable scintigraphy gains or reinforces the surgeon's trust, reliably guides cost-effective operative strategies and justifies the recognition of new potential diagnostic indications. (orig.)

  10. Value of In-111 white blood cell scintigraphy in evaluation of osteitis pubis and osteomyelitis of the symphysis pubis

    The authors tested the hypothesis that white blood cell In-111 (WBC) scintigraphy but not bone scanning can differentiate osteitis pubis (OP) from osteomyelitis of the symphysis pubis (OSP). Six patients underwent three-phase Tc-99m MDP bone scintigraphy, followed by In-11 WBC scintigraphy 48 hours later OP and OSP were suspected in four and two patients, respectively, with radiographic changes present in two of the former and both of the latter patients. The first, second, and third phases of bone scintigraphy were abnormal in three of five, three of five, and six of six patients, respectively, while In-111 WBC scintigraphy was positive in only one of six patients. All five patients with negative In-111 WBC studies were diagnosed and having OP, while OSP was confirmed surgically in the patient in whom In-111 WBC scintigraphy was positive. In three of five patients with OP and normal In-111 WBC scintigraphs, there was less uptake in the symphysis than in the adjacent pubic bone

  11. Evaluation of the inflammatory activity in chronic osteomyelitis. Contribution of the scintigraphy with polyclonal antibodies

    Active chronic osteomyelitis or complicating osteomyelitis (superimposed on diseases that changes the normal bone structure fractures, post-surgery, prosthesis) can be difficult to diagnose by anatomic radiological imaging modalities, like plain radiograph and CT. These diseases frequently cause also increased bone remodeling, leading to nonspecific uptake of Tc-99m-bone scan agents and gallium-67. New radiopharmaceuticals with greater inflammation/infection avidity and specificity are being developed, including the nonspecific polyclonal immunoglobulin (IgG) labeled with technetium-99. Tc-99m-IgG may be available as a ready to use kit, with no reported side effects, low patient absorbed radiation dose and low cost. The mechanism of IgG uptake at the inflammation site has not been fully elucidated yet. Specific (receptor linking, physico-chemical immunoglobulin properties) and nonspecific mechanisms (enhanced vascular permeability and macromolecular exudate) has been suggested. IgG scintigraphy results are affected by the isotope, labeling procedure adopted and characteristics of the inflammatory focus. Nineteen patients with suspected osteomyelitis (active chronic osteomyelitis or violated bone osteomyelitis) were studied by Tc-99m-IgG scintigraphy (directly labeled polyclonal immunoglobulin, Sandoglobuilina - Sandoz). All patients also underwent standard three-phase bone scintigraphy using methylene diphosphonate (Tc-99m-MDP), gallium-67 scintigraphy and plain radiographs. Infection was found in 8 sites. Sensitivity and specificity for Tc-99m-MDP, gallium-67 and Tc 99m-IgG scintigraphy were, respectively, 88 and 36%, 75 and 73%,88 and 82%. All patients with false positive IgG scintigraphies had previous surgery. Other current scintigraphic procedures used in the diagnosis of osteomyelitis are also reviewed. (author)

  12. Evaluation of diagnostic procedures such as plain-film scintigraphy and MR imaging for spinal metastases in relation to biological characteristics in breast cancer

    The relationship between spinal metastases diagnosed by plain-film, bone scintigraphy, and MR imaging and biological characteristics in 26 patients with breast cancer was investigated retrospectively. It was found that bone scintigraphy is useful for detecting metastases in case with slow-growing tumors determined by DNA polymerase α or with estrogen-receptor (ER) positivity. In contrast, cases with rapidly growing tumors showed false-negative plain-film or bone scintigraphy results, including cases with ER-negative tumors or DNA polymerase α of more than 20%. MR imaging was found to be highly sensitive in detecting spinal metastases even in aggressive cases. MR imaging was found to have greater reliability in detecting spinal metastases of breast cancer compared to bone scintigraphy. In conclusion, it may be important to consider the degree of malignancy of each case with spinal metastases of breast cancer in evaluating imaging diagnosis. (author)

  13. Gallium scintigraphy in patients with adult T-cell leukemia lymphoma

    Gallium scintigraphy was evaluated in 25 patients with adult T-cell leukemia lymphoma (ATLL). Anterior and posterior images were obtained at 72 h after administration of 3 mCi67Ga-citrate using a gamma camera (Maxi-Camera 400 T, General Electric Co.) with a medium energy standard parallel hole collimator. Abnormally high accumulations were observed in 17 out of 25 cases (superficial lymph node, 8; hilar and mediastinal lymph node, 7; paraaortic lymph node, 2; lung, 9; liver, 1; bone, 1). There were 10 malignant lesions detected by 67Ga scintigraphy in 9 out of 17 cases (superficial lymph node, 1; hilar and mediastinal lymph node, 6; paraaortic lymph node, 1; liver, 1; bone, 1). White blood cell count and serum LDH levels were significantly raised in patients with abnormally high accumulations of 67Ga. In conclusion, 67Ga scintigraphy seemed to be a useful examination to detect malignant lesions in patients with ATLL. (orig.)

  14. 全身MR扩散加权成像与骨扫描探测骨转移灶的初步对比研究%Comparison of whole body MR diffusion weighted imaging and skeletal scintigraphy In detecting bone metastasis

    徐贤; 马林; 张金山; 蔡幼铨; 徐白萱; 程流泉; 郭行高

    2008-01-01

    目的 通过与单光子发射计算机体层摄影术(SPECT)骨扫描对比,初步探讨全身MR扩散加权成像(DWI)技术探测骨转移灶的可行性.方法 对42名正常志愿者及38例可疑合并骨转移的恶性肿瘤患者行全身MR DWI及SPECT骨扫描,并将骨骼系统分为8个区域,分别记录每例患者各区域全身MR DWI和SPECT骨扫描分别显示的病灶数目及各区域阳性病例数,进行每一患者及每一区域的全身MR DWI及骨扫描的对照分析.结果 全身MR DWI阳性病例30例,受累区域69处,共探测出病灶数169处;骨扫描阳性病例29例,受累区域68处,共探测出病灶数156处;全身MR DWI阳性而SPECT骨扫描阴性者2例,SPECT骨扫描阳性而全身MR DWI阴性者1例;SPECT骨扫描阴性而全身MR DWI阳性区域8例,其中,脊柱3例、骨盆2例、股骨3例;骨扫描阳性而全身MRDWI阴性区域7例,其中颅骨4例、肩胛骨2例、胸锁骨1例.结论 全身MR DWI与SPECT骨扫描对检测骨转移病灶有很好的一致性,且两者可互相补充;全身MR DWI还可检测各脏器及淋巴结病灶,适用于肿瘤患者随访.%0bjective To evaluate the application of whole body MR diffusion weighted imaging (DWI)in the detection of bone metastasis using skeletal scintigraphy as the referenee.Methods Fonv.two healthy volunteers and 38 patients with malignant tumors were enrolled in our studv.A11 the patients received MR examination and skeletal scintigraphy within one week.MR examination was performed on GE signa 3.0T MR scanner using a build.in body coil.The skeletal system Was divided into eight regons and the images of the whole body MR DWI and skeletal seintigraphy were reviewed to compare the two modalities patient by patient and region by region.The images were reviewed separately by two radiologists and two nuclear medicine physicians,who were blinded to the results of another imaging modality.Results A total of 169 metastatic lesions in 69 regions of 30 patients were

  15. Neuroblastoma presenting clincally as hip osteomyelitis: a ''signature'' diagnosis on skeletal scintigraphy

    At their initial emergency room presentation, four children were thought to have hip osteomyelitis. Skeletal scintigraphy, however, demonstrated multiple areas of abnormal tracer uptake in the bones in all four, and in three there was abnormal uptake in a soft tissue abdominal mass. The skeletal scintigraphic findings promptly led to the correct diagnosis of neuroblastoma. (orig.)

  16. Neuroblastoma presenting clincally as hip osteomyelitis: a ``signature`` diagnosis on skeletal scintigraphy

    Applegate, K. [Div. of Nuclear Medicine, Dept. of Radiology, Children`s Hospital, Boston, MA (United States); Connolly, L.P. [Div. of Nuclear Medicine, Dept. of Radiology, Children`s Hospital, Boston, MA (United States); Treves, S.T. [Div. of Nuclear Medicine, Dept. of Radiology, Children`s Hospital, Boston, MA (United States)

    1995-11-01

    At their initial emergency room presentation, four children were thought to have hip osteomyelitis. Skeletal scintigraphy, however, demonstrated multiple areas of abnormal tracer uptake in the bones in all four, and in three there was abnormal uptake in a soft tissue abdominal mass. The skeletal scintigraphic findings promptly led to the correct diagnosis of neuroblastoma. (orig.)

  17. The application of Tc-99m-Nanocoll scintigraphy in orthopaedics

    Indium-111 labeled leucocyte imaging has many disadvantages, so the application of Tc-99m labeled albumin parts was investigated. A comparison is made between Tc-99m Nanocoll and Tc-99m MDP scintigraphy in inflammation processes in bone and joints in 74 patients. The results of this research are provisional. 3 refs.; 6 figs.; 1 table

  18. Thyroid scintigraphy in veterinary medicine.

    Daniel, Gregory B; Neelis, Dana A

    2014-01-01

    Thyroid scintigraphy is performed in cats and dogs and has been used to a limited degree in other species such as the horse. Thyroid scintigraphy is most commonly used to aid in the diagnosis and treatment management of feline hyperthyroidism but is also used in the evaluation of canine hypothyroidism and canine thyroid carcinoma. This article reviews the normal scintigraphic appearance of the thyroid in the cat, the dog, and the horse and the principles of interpretation of abnormal scan results in the cat and the dog. Radioiodine is the treatment of choice for feline hyperthyroidism, and the principles of its use in the cat are reviewed. PMID:24314043

  19. Calcification-related absorption in thyroid scintigraphy

    The enhanced absorption of X-rays in calcified structures is a basic prerequisite for performing conventional bone radiography. On the other hand, nothing has been reported on possible absorption effects of 'calcifications' as frequent findings in thyroid nodules or in the sternal bone / sternoclavicular joints. This may be caused by the general opinion, that the high energy of 99mTc-photons (140 keV) do not make visible absorptions effects very likely. Patients, methods: To prove possible absorption effects of calcifications on thyroid scintigraphy experimentally, effects of calcium absorbers were tested on a technetium flood phantom. Furthermore, absorption effects of various calcifications (discs of calcium sulphate and calcium carbonate with varying thickness) on normal thyroid tissue and autonomous nodules were simulated in a thyroid phantom. CT 130 kV-images of 46 consecutive patients were checked for presence of retrosternal or retroclavicular growth of the thyroid gland and to measure the extent and density of the sternal bone and calcified intrathyroidal nodules. In addition, clinical cases are presented in which a possible absorption by calcifications seems to be likely. Results: Bony structures in front of the thyroid gland or calcified intrathyroidal nodules could be seen on CT in 24/46 patients. The mean averaged density was 219 Houndsfield units (SD: 89 HU). The quantitative measurements using a 99mTc-flood source showed a mean absorption of 4.9%. In a thyroid phantom, absorption effects were visible only in 3/20 positions of the calcium discs over the thyroid phantom. Focal effects could be better detected in situations of only moderate uptake of the surrounding tissue. A dependence of absorption and chemistry (sulphate, carbonate) could not be found. Conclusion: Visible absorption effects caused by sternal bone or thyroid calcifications are seldom but potentially able to diminish the visible uptake and should be taken into account when interpreting

  20. Comparison of radionuclide scintigraphy and radiography for the evaluation of diabetic osteomyelitis

    Radionuclide scintigraphy using Tc-99m and radiography were compared in the evaluation of diabetic osteomyelitis in 11 patients. Of the eleven patients, nine showed findings highly suggestive of osteomyelitis by bone scan. Of these nine patients, however, six were considered negative for osteomyelitis based on radiography. Bone imaging appears to be more sensitive diagnostic procedure in determining osteomyelitis than X-rays. (Auth.). 9 refs., 5 tabs

  1. 18F-FDG符合线路显像与99mTc-MDP骨显像及二者联合对乳腺癌骨转移的检出效能%18F-FDG SPECT coincidence, 99mTc-MDP bone scintigraphy and combination of the two techniques for detecting malignant bone metastasis from breast cancer

    陆涤宇; 夏亮; 王志; 乔雪玲

    2012-01-01

    目的 采用ROC曲线比较18F-FDG符合线路显像、99mTc-MDP骨显像及二者联合对乳腺癌骨转移的检出效能.方法 收集手术病理诊断为乳腺癌的女性患者113例,均于4周内先后接受18F-FDG符合线路显像及99mTc-MDP骨显像;对两种显像结果按5分法评分,以二者评分之和为联合评分值,以病理诊断或临床随访为确诊“金标准”,比较ROC曲线下面积(AUC),评价99mTc-MDP骨显像、18F-FDG符合线路显像及联合评分法对乳腺癌骨转移患者的检出效能,比较不同方法在各自最佳诊断阈值下的灵敏度、特异度、准确率、阳性预测值(PPV)和阴性预测值(NPV).结果 113例中,12例(10.62%)最终确诊为骨转移,101例(89.38%)无骨转移.99mTc-MDP骨显像、18 F-FDG符合线路显像以及二者联合诊断评分的ROC曲线分析显示三者AUC分别为0.991、0.874和0.993,三种方法对乳腺癌骨转移的诊断效能均佳,尤以99mTc-MDP骨显像与联合诊断为最佳(P均<0.01).最佳阈值点下,单独18F-FDG符合线路显像、99mTc-MDP骨显像及联合检出骨转移患者的灵敏度分别为75.00%(9/12)、75.00%(9/12)、83.33%(10/12),特异度为100%(101/101)、98.02%(99/101)、98.02%(99/101),准确率为97.35%(110/113)、95.58%(108/113)、96.46%(109/113),PPV为100%(9/9)、81.82%(9/11)、83.33%(10/12),NPV为97.12%(101/104)、97.06%(99/102)、98.02%(99/101).结论 99mTc-MDP骨显像对乳腺癌骨转移患者的检出效能优于18F-FDG符合线路显像,二者联合可提高对骨转移患者的检出率.%Objective To observe the efficacy of 18F-FDG SPECT coincidence (18F-FDG SPECT) , 99mTc-MDP bone scintigraphy (BS) and combination of the two techniques (18F-FDG SPECT+99mTc-MDP BS) for detecting bone metastasis from breast cancer by ROC curve analysis. Methods Totally 113 patients with breast cancer underwent both 99mTc-MDP BS and 18F-FDG SPECT within 4 weeks. The images were interpreted according to 5

  2. Significance of cold defects in central skeleton on 99mTc-HMPAO labelled granulocyte scintigraphy

    Couret et al address osteoarticular infections of the central skeleton which is a difficult condition to diagnose clinically. 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) labelled granulocytes scintigraphy is of value for the detection of peripheral bone sepsis, but a cold defect is often encountered in central skeleton scans. The significance of a cold defect in 18 scintigraphic studies from patients referred with suspected infections of central skeleton is discussed. Of these 18 studies, only 4 cold defect corresponded to an acute or chronic sepsis and 6 to a healed sepsis. Of the remaining 8 studies, 4 corresponded to osteoarthritis, 1 to aggressive granulomatous lesions, 1 to chemical discitis, 1 to Paget's disease, and 1 to bone metastase. All the cold defects on the labelled granulocytes scans corresponded to an increased uptake on the 99mTc-diphosphonate (99mTc-MDP) scans. Among the cases studied, no increased uptake was found on the labelled granulocytes images; increased uptake of activity being required to classify the scintigraphy as positive in the appendicular skeleton. In fact, in central bone sepsis, the mechanism(s) inducing the destruction of the granulopoietic bone marrow or an obstacle to the granulocyte migration is not yet well established. We concluded that increased uptake of activity being very rare and cold defect having no specificity, labelled granulocytes scintigraphy is of lower interest in central skeleton bone sepsis detection than in peripheral bone sepsis detection. (authors). 51 refs., 4 figs., 1 tab

  3. Gallium scintigraphy in acute panniculitis

    Gallium scintigraphy was performed in a 27-yr-old female in search of a possible occult focus of infection; it showed an unusual diffuse superficial accumulation in the thighs and buttocks. Biopsy of an area of abnormal uptake showed lobular panniculitis which, in the clinical context, led to the diagnosis of Weber-Christian syndrome

  4. A parathyroid scintigraphy case study

    O' Leary, Desiree [UCD School of Diagnostic Imaging, St Anthony' s Campus, Herbert Avenue, Dublin 4 (Ireland)]. E-mail: desiree.oleary@ucd.ie

    2005-05-01

    Background: There has been much debate concerning the most suitable protocol for parathyroid scintigraphy; the merits of various radiopharmaceuticals versus the correct imaging protocol to visualise both ectopic and anatomically placed adenomas against the various equipment choices have been debated. Aim: To demonstrate, through the use of a case study, the necessity of changing imaging protocols for parathyroid scintigraphy where a definitive imaging diagnosis is absent in the face of strong clinical suspicion. Method: Use is made of Tc99mMIBI, full field chest scintigraphy, a clearly defined imaging protocol and SPECT imaging to locate ectopic parathyroid tissue in a female patient with significant symptoms of parathyroid hyperfunction. Results: A single hyperfunctioning adenoma is located in the pre-carinal area of the mediastinum. Using a radioguided surgical technique the hyperfunctioning tissue is excised and confirmed by histopathology. Conclusion: Whilst a dramatic reduction in patient symptoms was not seen immediately in this patient, the symptoms of the illness have been subsiding since January 2003. This case study demonstrates the necessity of changing imaging protocols for parathyroid scintigraphy where a definitive imaging diagnosis is absent in the face of strong clinical suspicion.

  5. Dynamic oesophageal scintigraphy in achalasia

    The dynamic oesophageal scintigraphy and the 'condensed image' of the dynamic study was performed in 15 patients (5 women and 10 men) with mean age 53 ± 6 years. In all patients it was found a retention of the radioactive water bolus in the proximal and middle third of the oesophagus. The radionuclide oesophageal transit was impaired in achalasia. (author)

  6. Insufficiency fracture of the sacrum after hormonal therapy and radiotherapy for prostate cancer. A case in which 99mTc-MDP bone scintigraphy was useful for differential diagnosis

    A case in which radiotherapy was requested for bone metastases from prostate carcinoma after hormonal and radiation therapy and diagnosed as insufficiency fracture of the sacrum on bone scan was reported. A 78-year-old man underwent endocrine therapy with luteinizing hormone releasing hormone agonists and radical radiotherapy toward pelvis for prostate cancer. The onset of buttock pain started from the nine-month after the beginning of radiotherapy, and was diagnosed as sacrum metastasis by MRI, and radiotherapy was requested again for pain control. However, on bone scan, butterfly-like changed accumulation was noted, therefore sacrum insufficiency fracture was suspected. Addition of CT inspection and reconfirmation of MRI were performed, and bone metastases became negative, and serial observation was performed of the painkilling effect after that. No tumor marker rise was seen after five months without sigh of new bone metastases and the final diagnosis became insufficient fracture. In order to avoid unnecessary treatment, we think that the view of bone scintigram for diagnosis of sacrum insufficient fracture should be known. (author)

  7. Contribution of osseous scintigraphy in the mandibular eosinophilic granuloma in child. About one case; Apport de la scintigraphie osseuse dans le granulome eosinophile mandibulaire chez l'enfant. A propos d'un cas

    Berehou, F.; Haddam, A.; Benrais, N. [CHU Ibn Sina, Service de medecine nucleaire, Rabat (Morocco)

    2010-07-01

    Langerhans cell histiocytosis is a rare disease in children. It has a very wide clinical spectrum, ranging from the simple eosinophilic granuloma to the severe form of multiple organs. This case illustrates the value of bone scintigraphy in early diagnosis of this disease. Bone scintigraphy provides analytical elements essential to an orthopedic surgeon, provided to obey minimum technical constraints concerning the examination procedures. The interpretation must take into account all available data and the specific problem in each of orthopedic surgery. (N.C.)

  8. Exploration of the S.A.P.H.O. syndrome: PET/CT with {sup 18}FNa vs planar osseous scintigraphy; Exploration du syndrome SAPHO: TEP/TDM au {sup 18}FNa vs scintigraphie osseuse planaire

    Ben Ali, K.; Poisson, T.; Hayem, G.; Lebtahi, R.; Sarda-Mantel, L.; Burg, S.; Meyer, O.; Le Guludec, D. [Groupe hospitalier Bichat-Claude-Bernard, 75 - Paris (France)

    2010-07-01

    Our purpose was to study the interest of the PET/CT with {sup 18}FNa (F Na-PET/CT) in the assessment of the lesions synovitis acne pustulosis hyperostosis osteitis (S.A.P.H.O.) syndrome compared to bone planar scintigraphy with hydroxy-methylene diphosphonate (H.M.D.P.) labelled with {sup 99m}Tc. The preliminary results suggest an increase of sensitivity of the F Na-PET/CT compared to bone scintigraphy in the S.A.P.H.O. syndrome exploration ( particularly for the rachis injuries, tips and enthesopathies), without loss of specificity. (N.C.)

  9. Scintigraphy for diagnosis of avulsions of the origin of the suspensory ligament in horses: 51 cases (1980-1993)

    The medical records of 34 horses with a diagnosis of avulsion of the origin of the suspensory ligament that had been admitted to the veterinary medical teaching hospital between 1980 and 1993 were identified. In addition to clinical examination, 21 of 34 horses had scintigraphy and radiography performed during their examination. The usefulness of scintigraphy and radiography were assessed by comparing the initial findings reported in the medical record to those obtained in a retrospective review of the images. Thirty other horses with scintigraphic lesions of the proximal aspect of the third metacarpal/metatarsal bone but with a confirmed diagnosis other than avulsion of the suspensory ligament served as controls for lesion specificity. Scintigraphy (bone phase, n = 21) revealed increased uptake in all horses in both reviews. Only 14 of 21 (67%) horses radiographed, however, had at least 1 lesion during the initial radiographic evaluation that was reported to be suggestive of avulsion. When the radiographs were reviewed retrospectively, the radiologist identified 18 of 21 (86%) horses with lesions consistent with avulsion. The interpretation of scintigraphy appeared to be a more repeatable and sensitive diagnostic method than radiography. However, though scintigraphy was sensitive in identifying inflammation of the proximal aspect of the metacarpal/metatarsal region, no specific diagnosis of avulsion could be made without coincident radiography; the specificity of scintigraphy in diagnosing avulsion of the suspensory ligament was only 41% (21/51)

  10. Detection of synovial pseudarthrosis by 99mTc scintigraphy: application to treatment of traumatic nonunion with constant direct current

    A prospective study utilizing technetium scintigraphy to evaluate nonunion patients prior to the electrical stimulation of osteogenesis is reported. Roentgenographic evaluation and scintigraphy must include four views (anteroposterior, lateral and both obliques). Although all nonunion technetium scans showed increased uptake of the radionuclide at the fracture site, three bone scan patterns were identified: (1) intense, uniformly increased uptake at the nonunion site (69.5%); (2) photon deficient (cold) cleft between two intense areas of uptake (23.4%); and (3) indeterminate pattern (7.1%). The presence of a cold cleft between two intense areas of uptake on scintigraphy correlated closely with the presence of a synovial pseudarthrosis at surgery. Nonunions of the humerus were most frequently associated with synovial pseudarthrosis (57.1%). The presence of a synovial pseudarthrosis as suggested by technetium scintigraphy mandates open excision of the lining membrane at the time of electrode insertion

  11. Technetium-99m human immunoglobulin scintigraphy in psoriatic arthropathy: first results

    Preliminary results of this study reveal that 99mTc human immunoglobulin (HIG) scintigraphy demonstrates a typical premature pattern of extradermal psoriatic disease in digits indicative of the early stage of psoriatic arthritis. This pattern was also found in a rare case of psoriatic arthropathy without skin lesions. 99mTc-HIG scintigraphy appears to reveal the initial inflammatory characteristics of later bone lesions. In the advanced stage of psoriatic arthritis, 99mTc-MDP and 99mTc-HIG scans were found to be equally sensitive in the detection of the affected joints. Thus 99mTc-HIG scintigraphy seems to be useful in the early detection of psoriatic arthropathy and also in advanced psoriatic arthritis, as well as for the detection of psoriatic arthropathy without skin lesions. (orig./MG)

  12. Technetium-99m human immunoglobulin scintigraphy in psoriatic arthropathy: first results

    Stoeger, A. (Dept. of Radiodiagnostics, Univ. Hospital, Innsbruck (Austria)); Mur, E. (Dept. of Internal Medicine, Univ. Hospital, Innsbruck (Austria)); Penz-Schneeweiss, D. (Dept. of Dermatology, Univ. Hospital, Innsbruck (Austria)); Moncayo, R. (Dept. of Nuclear Medicine, Univ. Hospital, Innsbruck (Austria)); Decristoforo, C. (Dept. of Nuclear Medicine, Univ. Hospital, Innsbruck (Austria)); Riccabona, G. (Dept. of Nuclear Medicine, Univ. Hospital, Innsbruck (Austria)); Fridrich, L. (Dept. of Nuclear Medicine, Univ. Hospital, Innsbruck (Austria))

    1994-04-01

    Preliminary results of this study reveal that [sup 99m]Tc human immunoglobulin (HIG) scintigraphy demonstrates a typical premature pattern of extradermal psoriatic disease in digits indicative of the early stage of psoriatic arthritis. This pattern was also found in a rare case of psoriatic arthropathy without skin lesions. [sup 99m]Tc-HIG scintigraphy appears to reveal the initial inflammatory characteristics of later bone lesions. In the advanced stage of psoriatic arthritis, [sup 99m]Tc-MDP and [sup 99m]Tc-HIG scans were found to be equally sensitive in the detection of the affected joints. Thus [sup 99m]Tc-HIG scintigraphy seems to be useful in the early detection of psoriatic arthropathy and also in advanced psoriatic arthritis, as well as for the detection of psoriatic arthropathy without skin lesions. (orig./MG)

  13. Characteristic focal hot spots of bone marrow scintigraphic finding in aplastic anemia

    The bone marrow scintigraphy with 99mTc sulfur colloid has been performed in 168 patients with Aplastic anemia(AA) and 100 patients with others hematological disorders. Bone marrow imaging is a useful method to demonstrate the existence of active hematopoietic foci in living body. The features and clinical significance of these focal hot spots have been discussed. The bone marrow scintigraphy is proved to be helpful in diagnosis, therapy and assessing prognosis of A.A

  14. Liver scintigraphy of fulminant hepatitis

    The liver scintigraphies of five patients with fulminant hepatitis were examined. Scintiphotos using sup(99m)Tc-phytate were taken within two weeks after the onset. Scintiphotos of 12 normal subjects, 11 cases with acute hepatitis, 17 cases with liver cirrhosis were served as control. Their scintiphotos showed reduction of the size, well-maintained uptake, mostly homogenous RI distribution, and no left lobe enlargement, which could differentiate them from the chronic liver dysfunction. In one of the cases chronological changes in liver scintigraphy were observed. The size of the liver was reduced progressively until the 16th day and re-enlarged at the 30th day and thereafter. Three indices [S/W, (R + L)/W, and L/R] were calculated. S: area of liver, R or L: longitudinal length of the right or left lobe, W: body width. Relative size of the liver expressed by S/W or (R + L)/W showed significant reduction in fulminant hepatitis compared with acute hepatitis. However, they were not different significantly from those of normal subjects. Except for liver cirrhosis, L/R (left lobe swelling index) did not show significant differences among fulminant hepatitis, normal subjects, and acute hepatitis. These indices were also useful in follow-up study of the liver scintigraphy. The liver scintigraphy in the early phase of fulminant hepatitis seems to reflect the degree of massive hepatic necrosis. It is also useful to differentiate chronic hepatic failure. Apparant reduction in scintigraphical liver size seems to suggest poor prognosis, however, it should also kept in mind that the size of the liver in this condition might change quite rapidly and greatly. (author)

  15. Isotopic scintigraphy in kidney grafting

    Isotopic explorations of kidney transplants were performed on sixty-six patients. Three scintigraphic techniques were used: labelled ferrous ascorbate scintigraphy, sequential 99m technetium DTPA scintigraphy and the 131I hippuran nephrogram. The aim of this study is to analyse the results obtained under different pathological circumstances affecting the transplant, to discuss the advantages of the techniques and to propose a working procedure. The most reliable and accurate technique is the 131I hippuran nephrogram combined with sequential 99mTc DTPA, by which renal vascularisation may be judged labelled ferrous ascorbate on the other hand is too insensitive. Although the information supplied is mostly contained in the scintigraphic images, the nephrographic curves and the blood radioactivity decay time and rad V/rad R ratio measurements are very helpful in the early diagnosis and differential diagnosis of complications affecting the transplant. The proper use of isotopic scintigraphy in kidney grafting should provide optimum conditions for better survival of the transplant at minimum risk to the patient

  16. The role of gallium scintigraphy in the age of PET

    67Ga-citrate was introduced to the clinical practice in 1969. Despite of the development in new radiopharmaceuficals, gallium holds a good position for the availability to image viable tumour cells and inflammations lesions. Nowadays gallium scintigraphy is a classical method of nuclear medicine. It provides important diagnostic and prognostic data especially in patients with malignant lymphomas and malignant melanomas. In inflammatory diseases gallium scintigraphy, besides imaging, can assess the activity of inflammation. Methods: In the Department of Nuclear Medicine in Hradec Kralove gallium scintigraphy has been used since 1973o Till December 2003, in 5532 patients scintigraphic imaging with gallium have been carried out here. No side effects and interactions were ever observed. Our standard protocol presents i.v. injection of 160-250 MBq 67Ga-citrate (in adults), whole body scan or spot images at 48-72 hours and delayed images of suspicious areas. Laxatives or enemas were employed prior scan of abdomen. In the last 10 years dual heads SPECT gamma cameras equipped with 300 keV collimators were used. SPECT increased the sensitivity and specificity of examination. Results: The most frequent indications in the last 5 years (2327 patients): a/malignant melanoma- metastases, success of treatment, recurrences (41%) b/lymphomas- staging, recurrences, monitoring of treatment's success, residual lymphadenopathy after treatment (34%) c/others tumours - dif. dg., metastases (6%) d/sarcoidosis - determination of activity, staging (7%) e/lung fibrosis and alveolitis - determination of activity (4%) f/inflammations of bones and joints (2%) g/undetermined conditions with clinical and laboratory signs of malignity or inflammation, non-elucidated by other imaging Methods (6%) The sensitivity of gallium scintigraphy is high in indications a/-f/, in g/is lower but for frequently unexpected findings the method is in favour with clinical physicians. Conclusions: During the last

  17. Parathyroid scintigraphy during hypocalcaemia in primary hyperparathyroidism

    Øgard, Christina G; Thomsen, Jørn Bo; Jakobsen, Henrik;

    2005-01-01

    Minimally invasive parathyroid surgery in patients with primary hyperparathyroidism (PHPT) demands high imaging accuracy. By increasing blood flow to the parathyroid adenoma before injection of a perfusion marker, we intended to improve the parathyroid scintigraphy. We have named the technique...... stimulated parathyroid scintigraphy (SPS)....

  18. 99mTc-MDP scintigraphy of femoral head necrosis following femoral neck fracture

    Secondary ischemic necrosis of femoral head due to loss of blood supply following to femoral neck fracture is well known. The regional distribution of bone-seeking radiopharmaceuricals in the skeleton can depend on a number of factors, but bone blood flow is a major physiological determinant of regional skeletal uptake of Tc-99m polyphosphate and bone imaging may thus be used for the evaluation of vascularity of the femoral head. The authors made a comparative study of scintigraphic findings and operative findings of 28 cases of femoral neck fracture treated at Kyung Hee University Hospital from April 1980 to May 1984. The results were as follows: 1. In 16 cases of proven avascular necorsis of femoral head, scintigraphy showed absent or decreased activity in 14 cases (87.5%), while radiography showed increased density in 10 cases (62.5%). 2. In 12 cases of proven vital femoral head, scintigraphy showed increased activity in 9 cases (75%) and radiography showed decreased density in 9 cases (75%). 3. 99mTc-MDP scintigraphy was an excellent and useful method for assessing bone vitality of femoral head

  19. Scintigraphy of the pancreas head

    Emphasis is placed on the considerable improvement due to the computer in pancreatic scintigraphy, which has become more exact as a result. A liver subtraction technique is used. From the data acquired in this method two matrices are established, one for selenomethionine 75 and the other for gold 198. For processing the data are integrated in two broad hepatic areas, of coordinates identical in the two scintigrams, and their ratio is found; the computer multiplies the specifically hepatic matrix by this ratio then subtracts one from the two scintigrams thus normalized. The background can be subtracted from the resulting image

  20. FEASIBILITY OF WHOLE BODY DIFFUSION WEIGHTED IMAGING IN DETECTING BONE METASTASIS ON 3.0T MR SCANNER

    Xian Xu; Lin Ma; Jins-han Zhang; You-quan Cai; Bai-xuan Xu; Liu-quan Chen; Fei Sun; Xing-gao Guo

    2008-01-01

    Objective To evaluate the feasibility of whole body diffusion weighted imaging (DWI) in bone metastasis detection using bone scintigraphy as comparison.Methods Forty-five patients with malignancy history were enrolled in our study. All the patients received the whole body DWI and bone scintigraphy scan within 1 week. The magnetic resonance (MR) examination was performed on 3.0T MR scanner using embedded body coil. The images were reviewed separately by two radiologists and two nuclear medicine physicians, who were blinded to the results of the other imaging modality. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the two techniques for detecting bone metastasis were analyzed.Results A total of 181 metastatic lesions in 77 regions of 34 patients were detected by whole body DWI, and 167 metastatic lesions in 76 regions of 31 patients were identified by bone scintigraphy. The patient-based sensitivity and PPV of whole body DWI and bone scintigraphy were similar (89.5% vs. 81.6%, 97.1% vs. 91.2%), whereas, the patient-basod specificity and NPV of whole body DW1 were obviously higher than those of bone scintigraphy (85.7% vs. 57.1%, 60.0% vs. 36.4%). Ten regions negative in scintigraphy but positive in whole body DWI, mainly located in spine, pelvis, and femur; nine regions only detected by scintigraphy, mainly located in skull, sternum, clavicle, and scapula. The region-based sensitivity and specificity of whole body DWI were slightly higher than those of bone scintigraphy (89.5% vs. 88.4%, 95.6% vs. 87.6%). Conclusion Whole body DWI reveals excellent concordance with bone scintigraphy regarding detection of bone metastasis, and the two techniques are complementary for each other.

  1. Bone and bone marrow - nuclear medicine in the diagnosis of disorders of the hematopoetic system

    Significant progress has been achieved during the last years regarding therapy of neoplastic and non-neoplastic diseases of the hematopoietic system by introduction of new therapeutic modalities like highdose chemotherapy, bone marrow and stem cell transplantation, interferon-therapy and others. Diagnosis is still based on biopsy and histopathology of bone marrow. Imaging methods, however, provided by radiology and nuclear medicine, are now increasingly employed to give an additional macroscopic view over morphological and functional changes of the entire bone marrow. Bone marrow scintigraphy either using radiocolloids or immunoscintigraphy against granulocyte-antigenes may be performed as an alternative or an addition to nuclear magnetic resonance imaging. Bone scintigraphy has been successful in the detection of additional bony lesions for more than two decades. Positron emission tomography using 18-fluorine-deoxyglucose has recently been employed as a new and promising tool also for assessment of bone marrow infiltration in malignant lymphomas. (orig.)

  2. {sup 123}I-MIBG scintigraphy/SPECT versus {sup 18}F-FDG PET in paediatric neuroblastoma

    Melzer, Henriette Ingrid; Bartenstein, Peter; Pfluger, Thomas [Ludwig Maximilian University of Munich, Department of Nuclear Medicine, Munich (Germany); Coppenrath, Eva [Ludwig Maximilian University of Munich, Department of Radiology, Munich (Germany); Schmid, Irene; Albert, Michael H. [Ludwig Maximilian University of Munich, Department of Paediatric Haematology/Oncology, Munich (Germany); Schweinitz, Dietrich von [Ludwig Maximilian University of Munich, Department of Paediatric Surgery, Munich (Germany); Tudball, Coral [Royal Children' s Hospital, Department of Nuclear Medicine, Melbourne, VIC (Australia)

    2011-09-15

    To analyse different uptake patterns in {sup 123}I-MIBG scintigraphy/SPECT imaging and {sup 18}F-FDG PET in paediatric neuroblastoma patients. We compared 23 {sup 123}I-MIBG scintigraphy scans and 23 {sup 18}F-FDG PET scans (mean interval 10 days) in 19 patients with a suspected neuroblastic tumour (16 neuroblastoma, 1 ganglioneuroblastoma, 1 ganglioneuroma and 1 opsomyoclonus syndrome). SPECT images of the abdomen or other tumour-affected regions were available in all patients. Indications for {sup 18}F-FDG PET were a {sup 123}I-MIBG-negative tumour, a discrepancy in {sup 123}I-MIBG uptake compared to the morphological imaging or imaging results inconsistent with clinical findings. A lesion was found by {sup 123}I-MIBG scintigraphy and/or {sup 18}F-FDG PET and/or morphological imaging. A total of 58 suspicious lesions (mean lesion diameter 3.8 cm) were evaluated and 18 were confirmed by histology and 40 by clinical follow-up. The sensitivities of {sup 123}I-MIBG scintigraphy and {sup 18}F-FDG PET were 50% and 78% and the specificities were 75% and 92%, respectively. False-positive results (three {sup 123}I-MIBG scintigraphy, one {sup 18}F-FDG PET) were due to physiological uptake or posttherapy changes. False-negative results (23 {sup 123}I-MIBG scintigraphy, 10 {sup 18}F-FDG PET) were due to low uptake and small lesion size. Combined {sup 123}I-MIBG scintigraphy/{sup 18}F-FDG PET imaging showed the highest sensitivity of 85%. In 34 lesions the {sup 123}I-MIBG scintigraphy and morphological imaging findings were discrepant. {sup 18}F-FDG PET correctly identified 32 of the discrepant findings. Two bone/bone marrow metastases were missed by {sup 18}F-FDG PET. {sup 123}I-MIBG scintigraphy and {sup 18}F-FDG PET showed noticeable differences in their uptake patterns. {sup 18}F-FDG PET was more sensitive and specific for the detection of neuroblastoma lesions. Our findings suggest that a {sup 18}F-FDG PET scan may be useful in the event of discrepant or inconclusive

  3. Use of nuclear medicine imaging: Scintigraphy in diagnosis of equine orthopedic disease

    Kovač Milomir; Nowak Michael; Petzoldt S.; Tambur Zoran

    2002-01-01

    This study describes techniques, indications and findings of nuclear medicine imaging – scintigraphy of 42 horses with acute and chronic lameness of unknown origin. Most horses showed increased uptake of 99mTc-methylene diphosphonate in the tarsal joint (linked to the osteoarthritis and distal tarsal synovitis), the distal sesamoid bones (linked to the navicular disease), proximal attaches of the musculus interoseus medius on the palmar/plantar region of the metacarpus or metatarsus (linked t...

  4. The clinical value of radionuclide scintigraphy in the assessing of multiple myeloma

    Nuclear medicine imaging modalities, including 18F-FDG, 99Tc-MIBI, 201Tl, radionuclide labeled antibody and other radio agent, had got certain value in detecting multiple myeloma. These methods were useful complement of planar X photo, CT and MRI. Radionuclide scintigraphy can demonstrate the condition of whole body bone, stage of the disease and follow up the therapy result, but it needs other examinations to increase its diagnosis accuracy

  5. Radionuclide scintigraphy of bacterial nephritis

    Pyelonephritis is a leading cause of renal failure and is expected to cost as much as three billion dollars in 1984. The diagnosis of urinary tract infection is usually not difficult. However, localization of the infection within the renal parenchyma as opposed to the collecting system is much more difficult. Flank pain, fever, bacteiuria and evidence of parenchymal involvement by intravenous urography may be absent or unrecognized particularly in the infant. Ultrasound and Nuclear Medicine are advocated as better methods to define parenchymal involvement. Such definition is important in the consideration of treatment since parenchymal involvement of the kidney carries a much more ominous potential outcome than infection restricted to within the collecting system. 38 children with a clinical diagnosis of urinary tract infection were studied. 26 of the patients demonstrated abnormal renal parenchymal findings with Gallium-67 Citrate or Tc-99m Glucoheptonate scintigraphy. Intravenous urography was notably ineffective with only 5 of the 20 interpreted as abnormal due to parenchymal disease or decreased function. 11 were entirely normal while only 5 demonstrated scars or hydronephrosis. Only 10 of 17 patients demonstrated intranvesicoureteral reflux on x-ray or nuclear cystography. Ultrasound depicted 6 of 20 patients as having parenchymal abnormalities. Seven were normal. Nonspecific findings such as dilitation of the renal pelvis or renal enlargement was noted in 11 of the 20 patients. Radionuclide Scintigraphy is the most efficacious modality to detect since acute bacterial nephritis

  6. Platelet scintigraphy in atherothrombotic disease

    Isaka, Yoshinari (Osaka National Hospital (Japan))

    1993-01-01

    Indium-111 platelet scintigraphy for the measurement of in vivo thrombogenicity is a useful noninvasive technique with a number of applications. From 1982 to 1989, we explored clinical relevance of this method for 576 consecutive patients with atherothrombotic disease. There was a disease-related difference in the percentage of positive platelet accumulation; 85% in patients with Dacron bifurcation graft, 75% in abdominal or thoracic aneurysm, 40% in intra-cardiac thrombi, 33% in arteriosclerosis obliterans and 25% in ischemic cerebrovascular disease. Labelled platelets accumulated frequently in the lesion with severe arteriographic abnormality. Aspirin clearly inhibited platelet accumulation on carotid atheroma but the effect of ticlopidine has been less conclusive. Short-term orally active PGI[sub 2] analogue had inhibitory effects on platelet accumulation in carotid atheroma and platelet aggregability, but did not cause significant reduction in plaque size. The results suggest the usefulness of platelet scintigraphy for monitoring the thrombogenicity in various atherothrombotic diseases. It will be necessary, however, to simplify the labelling procedures and to develop a new [sup 99m]Tc-labelled thrombus imaging agent, if thrombus imaging is to be considered for more generall use for patients with atherosclerosis. (author).

  7. Platelet scintigraphy in atherothrombotic disease

    Indium-111 platelet scintigraphy for the measurement of in vivo thrombogenicity is a useful noninvasive technique with a number of applications. From 1982 to 1989, we explored clinical relevance of this method for 576 consecutive patients with atherothrombotic disease. There was a disease-related difference in the percentage of positive platelet accumulation; 85% in patients with Dacron bifurcation graft, 75% in abdominal or thoracic aneurysm, 40% in intra-cardiac thrombi, 33% in arteriosclerosis obliterans and 25% in ischemic cerebrovascular disease. Labelled platelets accumulated frequently in the lesion with severe arteriographic abnormality. Aspirin clearly inhibited platelet accumulation on carotid atheroma but the effect of ticlopidine has been less conclusive. Short-term orally active PGI2 analogue had inhibitory effects on platelet accumulation in carotid atheroma and platelet aggregability, but did not cause significant reduction in plaque size. The results suggest the usefulness of platelet scintigraphy for monitoring the thrombogenicity in various atherothrombotic diseases. It will be necessary, however, to simplify the labelling procedures and to develop a new 99mTc-labelled thrombus imaging agent, if thrombus imaging is to be considered for more generall use for patients with atherosclerosis. (author)

  8. Facial bone scanning by emission tomography

    A single-photon emission tomographic system was used to study the normal anatomy of the facial bones and the usefulness of emission computed tomography in evaluating diseases of the bones of the face. The examination was performed following routine bone scintigraphy and took an additional 20 to 30 min. The anatomy of the facial bones was well defined, with clear separation of deep and superficial structuress. Early experience with tumor, infection, bone grafts, and postirradiation osteonecrosis indicates that useful added diagnostic information can be obtained by this method

  9. Adrenal scintigraphy using 131I-Adosterol

    131I-Adosterol (6β-iodomethyl-19-norcholest-5(10)-3β-ol) was administered to evaluate adrenal grand in 20 patients including 9 patients with primary aldosteronism, 5 with Cushing's syndrome, one with pheochromocytoma, one with retroperitoneal tumor, 3 with essential hypertension and one with obesity. Standard scintigraphies were performed at 3rd day and again 6th day after administration of 131I-adosterol (1-1.5 mCi). Suppression scintigraphies were obtained while the patients were taking dexamethasone 2 to 3 mg daily from 3 days prior to injection of the tracer until adrenal imaging. In the cases with essential hypertension and obesity, both adrenal glands were delineated equally by standard scintigraphy, and in one patient, undergone suppression scintigraphy, the uptake of 131I-adosterol by both glands were completely inhibited by dexamethasone administration. In primary aldosteronism, six of the 9 patients demonstrated the increased radioactivity in one side, and were diagnosed as aldosteronoma. In 3 cases, failed to show the lesions on standard scintigraphy, the lesions could be detected by suppression scintigraphy, and aldosteronomas measuring 1 x 1 x 0.7, 2 x 2 x 1 and 1.7 x 1.5 x 0.8 cm were confirmed by operation. In Cushing's syndrome, standard scintigraphy could easily distinguish between adenoma (one case) and bilateral hyperplasia (4 cases). Adrenal scintigraphy was also a useful method in order to assess the effect of pituitary irradiation therapy in the case of hyperplasia. In pheochromocytoma and retroperitoneal tumor, the side of the lesion was identified by the absence of a functioning gland. Suppression scintigraphy was particularly useful in detecting the localization of the small tumor in primary aldosteronism. (auth.)

  10. Engineering of scintigraphy equipment - the basic design

    Basic design of scintigraphy equipment for imaging small organs has been made. The equipment is a mini gamma camera. The function of the equipment is provide images of metabolism process in a body organ. The result of the equipment can be used to diagnose an illness. Radiation detection from a body organ is designed using single scintillation crystal detector which is coupled to a position sensitive photomultiplier tube (PSPMT). With this basic design of scintigraphy equipment is expected that scintigraphy equipment engineering activity can be carried out. (author)

  11. Scintigraphy of ORL tumours with cobalt bleomycin

    Our experiences with cobalt bleomycin scintigraphy in the treatment planning of ORL tumors are described. 142 scintigrams taken from 127 patients have been examined. As is shown by our investigation, cobalt bleomycin scintigraphy is a good examination method, however, too much expenditure is needed to have the necessary data for therapy planning. To our opinion, the information obtained in oto-rhino-laryngology by an exact clinical examination is as good as that of cobalt bleomycin scintigraphy. Our treatment schemes had only to be revised in some exceptional cases. (orig.)

  12. Hypertrophic osteopathy characterized by nuclear scintigraphy in a horse

    A five year old American Saddlebred gelding was admitted to the University of Illinois Veterinary Medical Teaching Hospital with a history of multiple leg lameness, depression and intermittent fever for a duration of six months. Physical examination revealed the horse to be underweight, depressed and a febrile. No abnormalities were detected during auscultation of the heart and lungs. All limbs possessed multiple hard swellings of the distal long bones and digits. The horse walked witha stiff gait and was reluctant to trot. Nuclear scintigraphy of the distal limbs revealed multiple areas of focally increased uptake in all limbs. Radiographs of several sites on the distal limbs showed evidence of periosteal new bone production corresponding to the areas of abnormal uptake. The horse was euthanized and at necropsy chronic, multifocal, fibrous pericarditis and epicarditis were observed grossly. The left atrial myocardium contained areas of osseous metaplasia. Histological evaluation of the distal long bones revealed proliferative periosteal new bone formation consistent with a diagnosis of hypertrophic osteopathy

  13. Modern aspects of application of tree-phase bone scan in diagnosis of locomotor system disorders

    The technique of 3-phase bone scan is featured; the investigations to its applications to its application are described. The peculiarities of scintigraphy data and their interpreting at some benign pathological processes of the locomotor system

  14. Scintigraphy in postoperative follow-up of osteosynthesis of the femur with a bridge plate associated with an intramedullary pin in rabbits

    N.F. Borges

    2013-08-01

    Full Text Available The objective of this work was to monitor the consolidation of the femur after osteosynthesis with a bridge plate associated with the intramedullary pin using scintigraphy. We used seven New Zealand breed male rabbits, at 4 months of age, with a mean weight of 3.5 kg. We performed a three-phase bone scintigraphy with technetium-labeled methylene diphosphonate (99mTc-MDP before and after surgery, and 20, 50 and 90 days postoperatively. The activity index (AI was calculated by dividing the average number of uptake counts in the region of the osteotomy by the average number of counts in the corresponding region in the contralateral limb. Radiography was performed before surgery, after surgery, and 15, 30, 45, 60 and 90 days postoperatively. We found a direct relationship between the activity index and progress of bone scintigraphy in the evaluation sequence over the period of observation. Scintigraphy allows monitoring of bone metabolism and measurement of vascularization and/or bone or tissue perfusion. The images obtained in the blood pool and static phases are the most appropriate for assessing bone metabolism in the context of this study. The bridge plate associated with the intramedullary pin promotes osteosynthesis with sufficient stability to allow bone consolidation.

  15. Current imaging techniques in rheumatology: MRI, scintigraphy and PET

    The first-line imaging technique for diagnosis inflammation in musculo-skeletal organs in rheumatoid arthritis (RA) is planar X-ray examination, which was for many years the first and the only single tool for RA diagnostics and response evaluation. Today, in the era of more aggressive RA treatment, ultrasound examination (US) and magnetic resonance imaging (MRI) are also frequently used. US is used to detect early signs of inflammation within the soft tissue. MRI allows to assess the soft tissue and bone marrow involvement in case of inflammation and/or infection. MRI is capable of detecting more inflammatory lesions and erosions than US, X-ray, or CT. Standard scintigraphy plays a crucial role, and data from positron emission tomography (PET) are also promising. These functional imaging techniques are used in detection of inflammation and/or infection in case of ambiguous results being obtained by other techniques or at other clinics. In patients with RA, scintigraphy plays a key role in the differential diagnosis of hip, knee, etc. endoprosthesis disorders, including mechanical or septic loosening

  16. Guidelines for MIBG-scintigraphy in children

    These ''Empfehlungen'' are the german translation of the Guidelines on MIBG-Scintigraphy in Children, which were published by the Paediatric Committee of the European Association of Nuclear Medicine. (orig.)

  17. Evaluation of biliary disease by scintigraphy

    Ram, M.D.; Hagihara, P.F.; Kim, E.E.; Coupal, J.; Griffen, W.O.

    1981-01-01

    The value of biliary scintigraphy was studied in 180 patients with suspected biliary tract disease. Most of the patients were investigated additionally by conventional techniques such as cholecystography, cholangiography and ultrasonography. It is concluded that biliary scintigraphy is a simple and safe technique for visualization of the biliary tract. It is particularly useful in the evaluation of acute cholecystitis, in patients with iodine sensitivity obstructive from nonobstructive jaundice.

  18. Parathyroid Adenoma: is Sestamibi scintigraphy mandatory?

    Chandrasekar Maharajan; Sucharitha Vedachalam

    2013-01-01

    Localization of parathyroid adenoma using 99mTc scintigraphy is the standard of care. However, of late, ultrasound has been employed to this end with increasing frequency.1, 2, 3 The employment of intra-operative PTH estimation (IOPTH) has further augmented the cure rate of hyperparathyroidism due to parathyroid adenomas.4 While ultrasound is widely available, scintigraphy is available only in tertiary health-care centres. With this background, a prospective study was conducted in the ...

  19. Arteriovenous fistula detected by perfusion pulmonary scintigraphy

    A case of arteriovenous fistula in the right pulmonary lobe was diagnosed by perfusion scintigraphy. 100 MBq 99mTc-macroaggregated albumin was injected and scintigraphy was carried out with a gamma camera. In the statistic scintigram a lack of radioactivity whereas in the dynamic measurement increased filling was observed. The kinetic curves of the ROIs offered a direct proof of the arterio-venous shunt. (L.E.)

  20. Dynamic renal scintigraphy at hydronephrosis

    The aim of the study was to estimate the clinical relevance and accuracy of dynamic renal scintigraphy (DRS) in case of obstructed kidneys as hydronephrosis is among the complications at different renal diseases, like nephrolithiasis and urolithiasis. Twenty-one patients mainly with unilateral hydronephrosis were studied. DRS with 99mTc-MAG3 or 99mTc-EC was done and quantitative parameters of the morphological and functional status of every kidney were assessed. At 24 % of the patients accumulation curves typical for obstructed by hydronephrosis kidneys were obtained. At 38 % the type of renograms of the affected kidneys was intermediate one, closer to that at the cases with nephrosclerosis, with lower uptake and severe parenchymal changes. The rest 38 % of the cases showed normal renograms or slightly delayed downslope. DRS is a very precise and sensitive method for evaluation of the degree of kidney damage in cases with hydronephrosis

  1. Biliary scintigraphy in acute pancreatitis

    A prospective study was carried out in 60 patients to determine the efficacy of 99/sup m/Tc-PIPIDA scintigraphy in differentiating biliary pancreatitis from nonbiliary pancreatitis. Forty patients were classified as having biliary pancreatitis and 20 patients as having the nonbiliary type. Scintigraphic scans were divided into five main types according to the time to visualization of the gallbladder and the time to excretion of 99/sup m/Tc-PIPIDA into the intestinal tract. Normal scans were obtained in 95% of patients (19/20) with nonbiliary pancreatitis; 22.5% of patients (9/40) with biliary pancreatitis had normal scans. It is concluded that elevated amylase levels together with an abnormal biliary scan, as defined by the criteria presented here, indicate biliary pancreatitis, while a normal scan largely excludes such diagnosis

  2. Biliary scintigraphy in acute pancreatitis

    A prospective study was carried out in 60 patients to determine the efficacy of /sup 99m/Tc-PIPIDA scintigraphy in differentiating biliary pancreatitis from nonbiliary pancreatitis. Forty patients were classified as having biliary pancreatitis and 20 patients as having the nonbiliary type. Scintigraphic scans were divided into five main types according to the time to visualization of the gallbladder and the time to excretion of /sup 99m/Tc-PIPIDA into the intestinal tract. Normal scans were obtained on 95% of patients (19/20) with nonbiliary pancreatitis; 22.5% of patients (9/40) with biliary pancreatitis had normal scans. It is concluded that elevated amylase levels together with an abnormal biliary scan, as defined by the criteria presented here, indicate biliary pancreatitis, while a normal scan largely excludes such diagnosis

  3. Static and dynamic thyroid scintigraphy

    Static images as isolated investigation in thyroid diagnosis mainly provides morphologic information, and therefore sonography is largely applied for this purpose. 99mTc-pertechnetate scans or 123I-scans are indicated in cases of malpositions and serve to clarify lesions of unknown dignity. Additionally 201Tl-chloride is suited for examinations with regard to metabolically active thyroid tissue, whereby differential diagnostic laboratory tests must be carried out to exclude parathyroid adenoma. Dynamic thyroid scans before and after regulation tests (suppression, stimulation) reflect the physiological correlation between the iodine avidity of the thyroid, the peripheral thyroid hormone concentrations and the hypophyseal regulation in the TRH-test. The main application of this procedure is the clarification of thyroid autonomy, i.e. indication, detection, quantification or exclusion of thyroid autonomy. For the treatment of immunogenic thyrotoxicosis, dynamic thyroid scintigraphy provides important information about the onset of remission, thus permitting to end thyreostatic therapy. (orig.)

  4. White blood cell scintigraphy with monoclonal antibodies in the study of the infected endoprosthesis

    Sciuk, J.; Puskas, C.; Schober, O. (Muenster Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin); Greitemann, B. (Muenster Univ. (Germany). Klinik und Poliklinik fuer Allgemeine Orthopaedie)

    1992-07-01

    Forty-three patients with suspected infection of a hip or a knee prosthesis were studied with white blood cell scintigraphy (WBC), using technetium-99m (n=37) or iodine-123 (n=6) labelled monoclonal mouse antibody (MOA). Previously, all patients had undergone skeletal scintigraphy, which was performed as a three-phase study in 33 cases. The final diagnosis was established by open surgery, histology and culture in 37 cases, by puncture and cultere in 3 cases, and by clinical follow-up of at least 6 months in 3 cases. Eighteen prostheses were infected, 25 uninfected. The delayed phase of skeletal scintigraphy had a sensitivity of 92%, a specificity of 24% and an accuracy of 48% in the detection of infection. The perfusion and blood pool activity of the three-phase bone scan had a sensitivity of 67%, a specificity of 71% and an accuracy of 70%. The diagnostic value of WBC was sensitivty 89%, specificity 84% and accuracy 86%. WBC with {sup 99m}-Tc-MOA is easy to perform and always available. Its diagnostic accuracy is similar to conventional WBC scintigraphy with either indium-111 or {sup 99m}-Tc. (orig.).

  5. Clinical significance of scintigraphy in pulmonary aspergilloma

    In order to study the scintigraphic findings related to the pathophysiology of pulmonary aspergilloma, chest scintigraphy with Tl-201 chloride and perfusion lung scintigraphy were performed in 18 and 19 patients with pulmonary aspergilloma, respectively. In Tl-201 scintigraphy, accumulation of Tl-201 in the diseased areas related to Aspergillus infection was observed in 18 of 19 foci. Roentgenographic findings related to the accumulation of Tl-201 in the lesion were thickness of the cavity wall and pleural thickening adjacent to the cavity, but they showed no relation to the size of the fungus ball, and 2 cases without fungus ball showed positive results. Moreover, in Tl-201 single photon emission computed tomography, accumulation of Tl-201 was demonstrated in the area surrounding fungus ball. In addition, findings of inflammation such as leukocytosis, elevated erythrocyte sedimentation rate, positive CRP and fever were observed in more than 50% of all cases. These results suggest that tissues surrounding the fungus ball, including the cavity wall and thickned pleura undergo inflammatory process secondary to infection by Aspergillus. Perfusion lung scintigrams showed decreased perfusion in all of 19 cases, which was more marked than that expected from the chest radiograph in many cases. In Tl-201 myocardial scintigraphy, visualization of the right ventricle was observed in 15 of 18 cases. Tl-201 chest scintigraphy and perfusion lung scintigraphy are useful for evaluation of the activity of the disease process, right ventricular overloading, and regional perfusion in pulmonary aspergilloma. (author)

  6. An accurate and useful tool in multiple myeloma for disease management: Technetium 99m-Sestamibi scintigraphy

    Aim: To demonstrate Technetium-99m-Sestamibi is useful tool in patients with multiple myeloma, as its increased uptake indicate myeloma activity. We propose Tc-Sestamibi scintigraphy is sign of myeloma bone disease related to gammopathies. Material and Method: we have enrolled 20 pts. affected by multiple myeloma and we have performed whole body scans after administration of 740 MBq of 99mTc-Sestamibi. Results: 16 pts. showed a negative scan; 4 pts. showed a low increased uptake of the tracer. The uptake is strictly correlated to the clinical variables. In follow-up chemotherapy treatment the 4 pts. shows a negativeness of uptake. X-Ray shows negative results in all the pts. Conclusions: This method by 99mTc-Sestamibi whole body scintigraphy indicate disease activity in bone marrow, with high sensitivity and specificity and is a very useful tool in myeloma bone disease management

  7. Imaging of bone spavin. A radiographic and scintigraphic study of degenerative joint disease in the distal tarsus in Icelandic horses

    Radiography and scintigraphy are commonly used for the diagnosis of skeletal disorders in horses. Icelandic Horses have a high prevalence of degenerative joint disease of the distal tarsus, generally known as bone spavin (BS). The purpose of this study was to evaluate and develop the use of radiography and scintigraphy for the detection of BS in Icelandic Horses

  8. Evaluation of the inflammatory activity in chronic osteomyelitis. Contribution of the scintigraphy with polyclonal antibodies; Avaliacao de atividade inflamatoria em osteomielite cronica. Contribuicao da cintilografia com anticorpos policlonais

    Sapienza, Marcelo Tatit

    1996-07-01

    Active chronic osteomyelitis or complicating osteomyelitis (superimposed on diseases that changes the normal bone structure fractures, post-surgery, prosthesis) can be difficult to diagnose by anatomic radiological imaging modalities, like plain radiograph and CT. These diseases frequently cause also increased bone remodeling, leading to nonspecific uptake of Tc-99m-bone scan agents and gallium-67. New radiopharmaceuticals with greater inflammation/infection avidity and specificity are being developed, including the nonspecific polyclonal immunoglobulin (IgG) labeled with technetium-99. Tc-99m-IgG may be available as a ready to use kit, with no reported side effects, low patient absorbed radiation dose and low cost. The mechanism of IgG uptake at the inflammation site has not been fully elucidated yet. Specific (receptor linking, physico-chemical immunoglobulin properties) and nonspecific mechanisms (enhanced vascular permeability and macromolecular exudate) has been suggested. IgG scintigraphy results are affected by the isotope, labeling procedure adopted and characteristics of the inflammatory focus. Nineteen patients with suspected osteomyelitis (active chronic osteomyelitis or violated bone osteomyelitis) were studied by Tc-99m-IgG scintigraphy (directly labeled polyclonal immunoglobulin, Sandoglobuilina - Sandoz). All patients also underwent standard three-phase bone scintigraphy using methylene diphosphonate (Tc-99m-MDP), gallium-67 scintigraphy and plain radiographs. Infection was found in 8 sites. Sensitivity and specificity for Tc-99m-MDP, gallium-67 and Tc 99m-IgG scintigraphy were, respectively, 88 and 36%, 75 and 73%,88 and 82%. All patients with false positive IgG scintigraphies had previous surgery. Other current scintigraphic procedures used in the diagnosis of osteomyelitis are also reviewed. (author)

  9. Usefulness of {sup 67}Ga scintigraphy in deciding surgical indication in secondary hyperparathyroidism

    Otsuka, Nobuaki; Mimura, Hiroaki; Sone, Teruki; Tamada, Tsutomu; Yanagimoto, Shinichi; Tomomitsu, Tatsushi; Fukunaga, Masao [Kawasaki Medical School, Kurashiki, Okayama (Japan); Katagiri, Makoto

    1999-07-01

    In order to evaluate the usefulness in deciding surgical indication in secondary hyperparathyroidism (SHP), {sup 67}Ga scintigraphy was performed in 37 patients of SHP before parathyroidectomy (PTx). The radionuclide accumulation in skull and submandible was classified into 4 patterns (skull-submandibular pattern, skull pattern, submandibular pattern and normal pattern). Serum alkaline phosphatase levels were significantly elevated in patients of skull-submandibular pattern (13 cases) compared with skull pattern (6 cases), submandibular pattern (6 cases) and normal pattern (12 cases). Serum intact parathyroid hormone levels were significantly elevated in patients of skull-submandibular and skull patterns compared with normal pattern. No significant difference was observed among the weight of resected parathyroid glands. In 4 of 6 patients of normal pattern on {sup 67}Ga scintigram, bone scintigraphy showed a characteristic pattern of SHP including an increased accumulation in the skull and submandible. Bone mineral density (BMD) in the distal radius was increased within six to twelve months after PTx in 10 of 11 patients of skull-submandibular pattern on {sup 67}Ga scintigram, whereas only one patient showed an increase in BMD in 9 patients of normal pattern. In summary, it was concluded that {sup 67}Ga scintigraphy could provide a useful information in deciding the indication for PTx in secondary hyperparathyroidism. (author)

  10. Diagnosis of parathyroid adenoma - the role of two phase mibi scintigraphy (abstract)

    Dual radionuclide imaging using a combination of /sup 201/Ti with/sup 99m/Tc pertechnetate is a useful procedure in the localization of parathyroid adenomas. Recently /sup 99m/Tc Sesta - Methoxy Isobutyle Isonitrile (MIBI) has been used for detection and localization of parathyroid adenoma in patients with hyperparathyroidism as a single radionuclide imaging procedure (Double phase study). In our study 4 female patients with picture of metabolic bone disease on bone scintigraphy and raised serum parathyroid hormone levels and raised levels of serum calcium, were subjected to two phase parathyroid MIBI scintigraphy. Cervicothoracic planar images (Anterior view) were acquired at 15-20 minutes and 2-4 hours after an intravenous injection of 15-20 mCi /sup 99m/Tc MIBI. A positive scan was defined as an area of increased focal uptake in normal tissue, which progressively decreased over time. All the 4 patients had a positive scan for parathyroid adenoma which was confirmed by histopathological examination of the excised tumor. It was concluded that the two phase 99mTc-MIBI parathyroid scintigraphy is a specific and sensitive modality for detection, localization and even diagnosis of parathyroid adenoma. (author)

  11. Combined ventilation-perfusion scintigraphy for demonstration of pulmonary embolism

    In 34 patients with suggested pulmonary emboli, ventilation scintigraphy with 133Xe and perfusion scintigraphy with 99Tcsup(m)-labelled albumin spheres were carried out. The combined ventilation-perfusion scintigraphy had a significantly higher diagnostic specificity (1.0, confidence limit 0.69-1.0) than perfusion scintigraphy alone (0.48, 0.26-0.70). Both methods had a diagnostic sensitivity of 1.0. (Auth.)

  12. 99mTc-MIBI scintigraphy and beta-2-microglobulin in patients with multiple myeloma

    Multiple myeloma is malignancy characterizing with autoimmune proliferation of malignant plasma cells. The aim of the study was to investigate the clinical usefulness of 99mTc-MIBI scintigraphy and serum beta-2-microglobulin for diagnosis, staging and therapy control in patients with multiple myeloma. 67 patients with multiple myeloma were investigated. 42 patients ware in active state and 25 patients were in remission. Planar images and/ or SPECT were performed on the rotating gamma camera (Siemens) 30 minutes and 3 hours after i.v. injection of 555-740 MBq 99mTc-MIBI. The uptake patterns were grouped as normal, diffusely increased and focal increased. Beta-2-microglobulin levels were measured by radioimmunoassay. The scintigraphy with 99mTc-MIBI was true positive in 40 patients with MM. From them, 21 patients were with diffuse uptake and 19 were with focal uptake with 29 lesions. 99mTc-MIBl marrow uptake correlated with the percentage of bone marrow plasma cells. All samples from patients in active state had a serum beta-2-microglobulin above the normal range. In two patients with false negative scan, the results were compared with the data of CT images. Positive clinical findings and increased value of tumour marker were found in these patients. One patient was with false positive scintigraphy. After therapy, the scintigraphy was true negative in 25 patients. In these patients in remission, the levels of the serum beta-2-microglobulin were near to the normal levels. In conclusion, our results demonstrated the effectiveness of both methods - 99mTc-MIBI scintigraphy and serum beta-2-microglobulin in different stage of the disease for the diagnosis, staging and therapy control by patients with multiple myeloma. (authors)

  13. 99mTc-HMPAO-labelled leucocyte scintigraphy in the diagnosis of infection after total knee replacement arthroplasty

    This study was performed to evaluate the usefulness of 99mTc-HMPAO-labelled leucocyte scintigraphy for diagnosing prosthetic infection after total knee replacement arthroplasty without the aid of following bone marrow scintigraphy. The study subjects were 25 prostheses of 17 patients (one man and 16 women, mean age: 65 years) who had total knee replacement arthroplasty. After injection of 99mTc-HMPAO-labelled leucocyte, the whole body planar and knee SPECT images were obtained in all patients. The subjects were classified into three groups according to clinical suspicion of prosthetic infection: Group A (n=11) with high suspicion of infection; Group B (n=6) with equivocal suspicion of infection, and Group C (n=8) with asymptomatic contralateral prostheses. Final diagnosis of infection was based on surgical, histological and bacteriological data and clinical follow-up. Infection was confirmed in 13 prostheses (11 in Group A and 2 in Group B). All prostheses in Group A were true positive. There were two true positive, one false positive and three true negative in Group B, and six true negatives and two false positive in Group C. Overall sensitivity, specificity, and accuracy for diagnosis of the infected knee prosthesis were 100%, 75% and 88%, respectively. 99mTc-HMPAO-labelled leucocyte scintigraphy is a sensitive method for the diagnosis of infected knee prosthesis. However, false positive uptakes even in asymptomatic prosthesis suggest that bone marrow scintigraphy may be needed to achieve improved specificity

  14. Use of nuclear medicine imaging: Scintigraphy in diagnosis of equine orthopedic disease

    Kovač Milomir

    2002-01-01

    Full Text Available This study describes techniques, indications and findings of nuclear medicine imaging – scintigraphy of 42 horses with acute and chronic lameness of unknown origin. Most horses showed increased uptake of 99mTc-methylene diphosphonate in the tarsal joint (linked to the osteoarthritis and distal tarsal synovitis, the distal sesamoid bones (linked to the navicular disease, proximal attaches of the musculus interoseus medius on the palmar/plantar region of the metacarpus or metatarsus (linked to the insertations desmopathie and in the dorsal processes of thoracic vertebrae (linked to the kissing spine syndrome. The interpretation of scintigraphy appeared to be a more reliable and sensitive diagnostic method than radiography in diagnosing these equine orthopedic disease.

  15. Rater agreement in lung scintigraphy

    Purpose: The PIOPED criteria in their original and revised forms are today's standards in the interpretation of ventilation-perfusion scintigraphy. When the PIOPED criteria are used by experienced raters with training in consensus interpretation, the agreement rates have been demonstrated to be excellent. Our purpose was to investigate the rates of agreement between 2 experienced raters from different hospitals who had no training in consensus interpretation. Material and Methods: The 2 raters investigated a population of 195 patients. This group included 72 patients from a previous study who had an intermediate probability of pulmonary embolism and who had also been examined by pulmonary angiography. Results: The results demonstrated moderate agreement rates with a kappa value of 0.54 (0.45-0.63 in a 95% confidence interval), which is similar to the kappa value of the PIOPED study but significantly lower than the kappa values of agreement rates among consensus-trained raters. There was a low consistency in the intermediate probability category, with a proportional agreement rate of 0.39 between the experienced raters. Conclusion: The moderate agreement rates between raters from different hospitals make it difficult to compare study populations of a certain scintigraphic category in different hospitals. Further investigations are mandatory for accurate diagnosis when the scintigrams are in the category of intermediate probability of pulmonary embolism. (orig.)

  16. Spleen Scintigraphy in Hodgkin's Disease

    The authors give the results of scintigraphic studies carried out on patients suffering from Hodgkin's disease. They first give the technical details of the study, stressing the need for rigorous procedures in corpuscle labelling and alteration, and also the importance of collimation and of scanning at different angles of incidence; they then describe the different morphological characteristics encountered in scanning; in particular, they analyse dimensional and structural attributes of the image; among the latter they distinguish homogeneous and diffuse heterogeneous structures and also heterogeneous structures with gaps. They study these characteristics in relation to the age of the disease and relate them to the clinical and paraclinical context. The changes in the scanning image during treatment are also described and the authors stress the value of the scintigraphic method for checking on the development of splenic symptoms in the course of the disease. Lastly, they discuss the data obtained from analysis of blood and spleen radiation curves and give details on the findings of spleen scintigraphy. (author)

  17. Gamma-scintigraphy; La gammascintigraphie

    Desgrez, H.A. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1960-06-15

    Gamma-scintigraphy is a medical technique making it possible to fix the image of certain organs after the concentration in these of emitting radioactive products. It is already widely used in the case of the thyroid gland with iodine-132 by applying the isotope iodine 131. The study of the liver and gall bladder is carried out using colloidal gold 198 and Bengal pink marked with iodine 131. Serum albumin marked with iodine 131 makes it possible to study rachidian blockages. Other applications can already be foreseen in this direction. (author) [French] La gammascintigraphie est une technique medicale permettant de faire l'image de certains organes apres concentration dans ceux-ci de produits radioactifs emetteurs. Son utilisation deja repandue en ce qui concerne la thyroidine et l'iode-131 est possible avec l'iode-132 pour cette meme glande. Avec l'or colloidal 198 et le rose bengale marque a l'iode-131, on pratique des etudes du foie et de la vesicule biliaire. La serumalbumine marquee a l'iode-131 permet d'etudier les blocages rachidiens. D'autres possibilites sont des maintenant envisageables dans cette direction. (auteur)

  18. Sequential Scintigraphy in Renal Transplantation

    Based on experience gained from more than 1600 patients with proved or suspected kidney diseases and on results on extended studies with dogs, sequential scintigraphy was performèd after renal transplantation in dogs. After intravenous injection of 500 μCi. 131I-Hippuran scintiphotos were taken during the first minute with an exposure time of 15 sec each and thereafter with an exposure of 2 min up to at least 16 min.. Several examinations were evaluated digitally. 26 examinations were performed on 11 dogs with homotransplanted kidneys. Immediately after transplantation the renal function was almost normal arid the bladder was filled in due time. At the beginning of rejection the initial uptake of radioactive Hippuran was reduced. The intrarenal transport became delayed; probably the renal extraction rate decreased. Corresponding to the development of an oedema in the transplant the uptake area increased in size. In cases of thrombosis of the main artery there was no evidence of any uptake of radioactivity in the transplant. Similar results were obtained in 41 examinations on 15 persons. Patients with postoperative anuria due to acute tubular necrosis showed still some uptake of radioactivity contrary to those with thrombosis of the renal artery, where no uptake was found. In cases of rejection the most frequent signs were a reduced initial uptake and a delayed intrarenal transport of radioactive Hippuran. Infarction could be detected by a reduced uptake in distinct areas of the transplant. (author)

  19. Infrared laser and bone metabolism; A pilot study

    Gordjestani, M.; Dermaut, L. (Department of Orthodontics, University of Ghent (Belgium)); Thierens, H. (Institute of Medical Physics, University of Ghent (Belgium))

    1994-01-01

    A circular defect in each parietal bone of six Wislander rats was created. The animals were divided into two three-unit subgroups. The experimental group received infrared laser radiation on the left defect. The control group was sham irradiated. After 28 days, the bone metabolism was evaluated by technetium-99m methylene diphosphonate scintigraphy. The obtained results revealed no differences in bone metabolic activity between the laser-treated and the control defects. (au) (18 refs.).

  20. Perfusion scintigraphy in acute myocardial infarction

    The Tc-99m sestamibi perfusion SPECT scintigraphy in acute myocardial infarction is a feasible method to assess the size of area at risk and the residual blood flow to this area as the most important determinants of final infarct size without any delay in treatment. In combination with a follow-up study final infarct size as well as myocardial salvage can be quantified. Clinical indications for the use of Tc-99m sestamibi scintigraphy are the noninvasive identification of arterial occlusion in patients suspected to acute myocardial infarction without electrocardiographic ST-elevation and the assessment of reperfusion success. In clinical trials Tc-99m sestamibi scintigraphy has proven to be a useful method to assess the impact of varying reperfusion therapies. The present review article discusses the indication, the study protocol, the interpretation of results and the clinical and scientifically importance of this method. (orig.)

  1. Experience in thyroid scintigraphy with Ethiopian patients

    One thousand and thirty seven thyroid scintigraphy examinations done in the Nuclear Medicine Unit of Tikur Anbesma Hospital, Addis Abeba, Ethiopia between December 1984 and September 1989 were analyzed to assess their diagnostic value. Thirty one percent of the referrals were to investigate clinically detectable solitary nodules, and of these fifty-six percent had ''cold'' nodules and twenty-three percent ''hot'' nodules. Fifty-five percent of the referrals for evaluation of goitre were for multi nodular goitres and twelve percent for diffuse. Thirteen of fifty-three cases with suspected ectopic thyroid tissue were positive. Little useful information was obtained in the evaluation of goitre. It is concluded that thyroid scintigraphy was an unnecessary investigation in the evaluation of goitres in euthyroid patients. Its primary role was in the investigation of the solitary nodule, ectopic thyroid tissue and the retresternal goitre. Therefore, only selected patients should be investigated with thyroid scintigraphy

  2. PARATHYROID ADENOMA: IS SESTAMIBI SCINTIGRAPHY MANDATORY?

    Chandrasekar Maharajan

    2013-01-01

    Full Text Available Localization of parathyroid adenoma using 99mTc scintigraphy is the standard of care. However, of late, ultrasound has been employed to this end with increasing frequency.1, 2, 3 The employment of intra-operative PTH estimation (IOPTH has further augmented the cure rate of hyperparathyroidism due to parathyroid adenomas.4 While ultrasound is widely available, scintigraphy is available only in tertiary health-care centres.With this background, a prospective study was conducted in the department of endocrine surgery of a tertiary care hospital to analyse the efficacy of surgeon-performed ultrasound (SPUS in comparison to that of 99mTc Sestamibi scintigraphy in the localization of parathyroid adenomas.

  3. Dynamic esophageal scintigraphy in patients with achalasia

    Background: Dynamic esophageal scintigraphy has been proven as an efficient technique of diagnosis of esophageal dysmotility. Methods: The authors monitored the transit velocity, anti-peristalsis and the retention of radioactivity in the esophagus by dynamic esophageal scintigraphy in a group of 50 patients (37 control patients and 13 patients with achalasia). Results: They found a significantly longer period of radioactivity passage via the esophagus compared to the control group (p < 0.001%). Conclusions: We observed the statistically significant transit prolongation of radioactivity through the esophagus during dynamic esophageal scintigraphy (41.2 seconds) in our group of patients with achalasia compared to the control group (7.9 seconds). Anti-peristalsis and even the radioactivity retention have occurred statistically more frequently compared to the control group. (author)

  4. Dynamic esophageal scintigraphy in patients with achalasia

    Aim: Dynamic esophageal scintigraphy has been proven as efficient technique of diagnosis of esophageal dysmotility. Material and Methods: The authors monitored the transit velocity, anti-peristalsis and the retention of radioactivity in esophagus by dynamic esophageal scintigraphy in the group of 50 patients (37 control patients and 13 patients with achalasia). Results: They found a significantly longer period of radioactivity passage via esophagus compared to the control group (p < 0.001 %). Conclusions: We observed the statistically significant transit prolongation of radioactivity through esophagus during dynamic esophageal scintigraphy (41.2 seconds) in our group of the with achalasia compared to the control group (7.9 seconds). Anti-peristalsis and even the radioactivity retention have occurred statistically more frequently compared to the control group

  5. Two cases of hepatobiliary scintigraphy of liver transplantation in rejection

    Kanegawa, Kimio; Nishiyama, Syouji; Muraji, Toshihiro (Kobe Children' s Hospital, Hyogo (Japan)); Ishii, Kazunari; Kouno, Michio

    1992-04-01

    We report two patients with liver transplantation who underwent hepatobiliary scintigraphy in rejection. In the first patient, hepatobiliary scintigraphy showed dilatation of bile duct but it showed good clearance from the liver. In the second patient, hepatobiliary scintigraphy showed delayed clearance from the liver. Both patients recovered from rejection. There were four main complications, including vascular and biliary abnormality, infection, and rejection, after liver transplantation. Hepatobiliary scintigraphy showed almost the same findings except for biliary complication, so it was difficult to distinguish between infection and rejection. But hepatobiliary scintigraphy may be useful to evaluate transplanted liver function in rejection. (author).

  6. Two cases of hepatobiliary scintigraphy of liver transplantation in rejection

    We report two patients with liver transplantation who underwent hepatobiliary scintigraphy in rejection. In the first patient, hepatobiliary scintigraphy showed dilatation of bile duct but it showed good clearance from the liver. In the second patient, hepatobiliary scintigraphy showed delayed clearance from the liver. Both patients recovered from rejection. There were four main complications, including vascular and biliary abnormality, infection, and rejection, after liver transplantation. Hepatobiliary scintigraphy showed almost the same findings except for biliary complication, so it was difficult to distinguish between infection and rejection. But hepatobiliary scintigraphy may be useful to evaluate transplanted liver function in rejection. (author)

  7. Indium 111 leucocyte scintigraphy in abdominal sepsis

    We have studied the clinical utility of indium 111 autologous leucocyte scintigraphy retrospectively in 45 patients presenting with suspected intra-abdominal sepsis. The sensitivity was 95% (21/22) and the specificity was 91% (21/23). Some 34 of the studies (17 positive and 17 negative) were considered helpful in furthering patient management (76%) and 8, unhelpful (18%). In 3, the study results were misleading and led to inappropriate treatment. Indium 111 scintigraphy, whether positive or negative, provides information in patients with suspected intra-abdominal sepsis upon which therapeutic decisions can be based. (orig.)

  8. Procedure guideline for thyroid scintigraphy. Version 2

    The version 2 of the procedure guideline for thyroid scintigraphy is an update of the procedure guideline published in 1999. The procedure guideline considers the current amendment of legislative rules (Richtlinie Strahlenschutz in der Medizin 2002). Indication and use of radiopharmaceuticals have to be confirmed by the specialist in nuclear medicine. Activities of 75 MBq technetium-99m, respectively of 10 MBq iodine-123 should not be exceeded without an individual justification. The interpretation of the scintigraphy requires the knowledge of the patients' history, the palpation of the neck, the laboratory parameters, and of the sonography. The interpretation of the technetium-99m uptake requires the knowledge of TSH concentration. (orig.)

  9. Biliary scintigraphy in neonatal cytomegalovirus cholestasis

    Diagnostic value of hepatobiliary scintigraphy using mebrofenin-Te-99m was assessed in three newborns with cytomegalovirus (CMV) hepatitis and one baby with hepatitis B jaundice. All cases were affected by persistent jaundice with predominately conjugated bilirubin, alcoholic stools, anemia. One of this newborns (case number 1) was suspected of having biliary atresia due to the absence of intestinal excretion of the tracer. After three weeks intestinal passage was seen in scintiscan late after 24 h. Hepatobiliary scintigraphy represents a non-invasive diagnostic procedure which enables the detection of permeability of the biliary tract. (Author)

  10. Guidelines for radioiodinated MIBG scintigraphy in children.

    Olivier, Pierre; Colarinha, Paula; Fettich, Jure; Fischer, Sibylle; Frökier, Jörgen; Giammarile, Francesco; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Piepsz, Amy; Porn, Ute; Sixt, Rune; van Velzen, Jeannette

    2003-05-01

    These guidelines on the use of radioiodinated (99m)Tc-MIBG scintigraphy in children, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They have been influenced by the conclusions of the "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncological Committee of the French Society of Nuclear Medicine. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations. PMID:12658506

  11. The bone scan in tarsal coalition: a case report

    De Lima, R.T. [Department of Radiology, Division of Nuclear Medicine, Harbor-UCLA Medical Center, Torrance, CA (United States); Mishkin, F.S. [Department of Radiology, Division of Nuclear Medicine, Harbor-UCLA Medical Center, Torrance, CA (United States)

    1996-10-01

    Tarsal coalition is abnormal fusion of two or more tarsal bones. The union may be fibrous, cartilaginous, or osseous and can be congenital or acquired in response to infection, articular disorders, trauma, or surgery. We report a case of fibrous talocalcaneal coalition in a 15-year-old boy in whom bone scintigraphy employing pinhole lateral views confirmed the clinical diagnosis when plain radiographs showed minimal changes and computed tomography was equivocal. The diagnosis of symptomatic tarsal coalition is important in that it is a common remediable cause of peroneal spastic flat foot, a frequently encountered condition. Scintigraphy provides important information about the presence and localization of this condition. (orig.). With 3 figs.

  12. The bone scan in tarsal coalition: a case report

    Tarsal coalition is abnormal fusion of two or more tarsal bones. The union may be fibrous, cartilaginous, or osseous and can be congenital or acquired in response to infection, articular disorders, trauma, or surgery. We report a case of fibrous talocalcaneal coalition in a 15-year-old boy in whom bone scintigraphy employing pinhole lateral views confirmed the clinical diagnosis when plain radiographs showed minimal changes and computed tomography was equivocal. The diagnosis of symptomatic tarsal coalition is important in that it is a common remediable cause of peroneal spastic flat foot, a frequently encountered condition. Scintigraphy provides important information about the presence and localization of this condition. (orig.). With 3 figs

  13. Osseous scintigraphy and auxiliary graft. Scintigraphie osseuse et greffe d'appoint

    Khelifa, F.; Siles, S. (Hopital de la Timone, 13 - Marseille (France)); Puech, B.

    1992-12-01

    The scintigraphy could be a good way to survey the osseous graft: three cases are studied in which were recognized the presence of a graft, surinfection, graft lysis, pseudo-arthrosis, algodystrophy. 8 refs., 5 figs.

  14. Effects of renal failure and metabolic diseases upon bone scanning in children

    Metabolic disorders of bone most commonly affect the entire skeleton but also lead to focal abnormalities. Bone scintigraphy provides useful data on the presence, severity and response to therapy of the underlying systemic bone disease by visually grading of easily recognizable metabolic features and even more by quantitative assessment of bone turnover. This can be done by measurement of the 24-hr whole-body retention of Tc-99m diphosphonate or, more accurately in patients with renal failure, by evaluation of bone clearance of Tc-99m MDP. As far as combined with quantitative measurements bone scintigraphy is more sensitive but less specific in the detection of metabolic bone disease than conventional radiography. However, assessment of metabolic activity is more complicated in children than in adults, because of an inhomogeneous and age dependent tracer uptake in bone

  15. MIBI-99mTc mammary scintigraphy

    121 patients suspected of breast cancer were studied with MIBI-99mTc to evaluate the suitability of the mammary scintigraphy in patients with doubtful cancer diagnosis.The results show 93 % sensitivity and 95 % specificity and indicate the usefulness of this procedure to increase the accuracy of the diagnosis

  16. Somatostatin analogue scintigraphy and tuberculosis: case report

    Scintigraphy using a radiolabelled somatostatin analogue (111 In-pentetreotide) is useful in the detection of neuroendocrine tumors. But this radiopharmaceutical accumulates also in solid tumours or in inflammatory diseases such as granulomatosis. We present a case of 111 In-pentetreotide uptake in a tuberculous adenopathy. (author)

  17. The significance of scrotal scintigraphy for varicocele

    The purpose of this study is to develop a non-invasive diagnostic method for varicocele and reflux of internal spermatic vein (ISV) by scrotal scintigraphy. The subjects consisted of 90 males with infertility and scrotal areas pain ranging from 13 to 61 years of age. The severity of varicocele was classified in Grade 0 to 3, based on Suzuki's classification. Scrotal scintigraphy was taken with 99mTc-HSA-DTPA (740 MBq). Upright dynamic image, upright and supine static image were obtained. On scrotal scintigraphy, the severity was classified by time-activity curve (TAC) pattern on dynamic study in scrotal area, and position and venous pool in varicocele on a static image. TAC pattern of rapid filling and rapid drainage on dynamic image was seen in most of the Grade 3 cases. The position and venous pool were more clearly demonstrated in the upright than in the supine study, due to gravitational effect. In Grade 2 and 3 cases, venous pool was prominent. Scrotal scintigraphy is useful to assess the varicocele by means of identification of its position, hemodynamics analysis, and measurement of venous pool. (author)

  18. Quantitative evaluation of dysphagia using scintigraphy

    To evaluate dysphagia objectively and quantitatively, and to clarify the effect of neck position and viscosity changes in patients with aspiration and laryngeal penetration. We studied 35 patients with dysphagia and 21 normal controls using videofluoroscopy and scintigraphy. Videofluoroscopy was performed with barium with three different viscosity, and scintigraphy was done with water, yogurt, and steamed egg mixed with Tc-99m tin colloid. If aspiration was found during videofluoroscopic examination, patient's neck position was changed and study repeated. Videofluoroscopy was analyzed qualitatively. We calculated 7 quantitative parameters from scintigraphy. According to the videofluoroscopic findings, we divided patients into 3 subgroups; aspiration, laryngeal penetration, and no-aspiration group. The result of videofluoroscopy revealed that the most common finding was the delay in triggering pharyngeal swallow. Pharyngeal transit time (PTT) and pharyngeal swallowing efficiency (PSE) in patients with aspiration were significantly different from other groups. After neck position change, aspiration could be reduced in all of 7 patients, and laryngeal penetration reduced by about 82%. PTT and PSE were also improved after position change. Aspiration and laryngeal penetration occurred more frequently in thin liquid swallowing than in thin liquid and solid swallowing. PTT and PSE were useful for the evaluation of dysphagia. Aspiration and laryngeal penetration could by reduced when appropriate position assumed. We could decrease the chance of aspiration by changing the patient diet consistency. Scintigraphy might be useful tool to quantitate and follow up these changes

  19. Dual isotope scintigraphy in stroke patients

    Platelet scintigraphy is a useful technique to detect atherosclerotic lesions of the neck vessels in stroke patients. The habitual one isotope technique causes false positive and false negative results due to circulating platelet-bound activity. To eliminate these confusing results we performed a dual isotope technique on 20 stroke patients. The new method consists of simultaneous injections of 111-Indium labelled blood platelets and 99mTc labelled red cells, and achieves a calculation of the ratio 111-In/99mTc. Thus the subtraction of the red cell blood flow image can render a pure thrombus formation visible. The habitual visually evaluated one isotope scintigraphy showed positive scans in 11 out of 20 patients, whereas under dual isotope scintigraphy 3 patients showed no 111-Indium excess after subtraction of the red cell image; they can thus be qualified as false positive. In the case of another patient with a visually negative image a thrombus formation could be observed after the subtraction procedure. It seems, that the dual isotope technique in platelet scintigraphy is a valuable refinement on the way to verifiable results. (orig.)

  20. An atlas of normal skeletal scintigraphy

    This atlas was compiled to provide the neophyte as well as the experienced radiologist and the nuclear medicine physician with a reference on normal skeletal scintigraphy as an aid in distinguishing normal variations in skeletal uptake from abnormal findings. Each skeletal scintigraph is labeled, and utilizing an identical scale, a relevant skeletal photograph and radiograph are placed adjacent to the scintigraph

  1. Bone-seeking TRAP conjugates: surprising observations and their implications on the development of gallium-68-labeled bisphosphonates

    Notni, Johannes; Plutnar, Jan; Wester, Hans-Jürgen

    2012-01-01

    Background Bisphosphonates possess strong affinity to bone. 99mTc bisphosphonate complexes are widely used for bone scintigraphy. For positron emission tomography (PET) bone imaging, Ga-68-based PET tracers based on bisphosphonates are highly desirable. Findings Two trimeric bisphosphonate conjugates of the triazacyclononane-phosphinate (TRAP) chelator were synthesized, labeled with Ga-68, and used for microPET imaging of bone in male Lewis rats. Both Ga-68 tracers show bone uptake and, thus,...

  2. Bone tumor

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  3. Bone Grafts

    A bone graft transplants bone tissue. Surgeons use bone grafts to repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some ...

  4. Contribution of technetium-99m hexamethylpropylene amine oxime labelled leucocyte scintigraphy to the diagnosis of diabetic foot infection

    We conducted a prospective study in order to evaluate the contribution of technetium-99m hexamethylpropylene amine oxime (HMPAO) labelled leucocyte scintigraphy to the diagnosis and follow-up of osteomyelitis in the diabetic foot. The study was conducted between October 1992 and November 1996 and included 42 patients (30 men and 12 women; mean age 63 years) with diabetes mellitus (type 1, n = 22, type 2, n = 20) who had a total of 56 diabetic foot ulcers. The initial exploration included standard radiography, three-phase bone scintigraphy and 99mTc-HMPAO labelled leucocyte scintigraphy (HMPAO-LS), performed within a 3-day interval. For the 56 ulceration sites, 26 cases of osteomyelitis were diagnosed: ten on the basis of radiographic and histological/bacteriological criteria after bone biopsy, 11 after radiographic follow-up and five on the basis of biopsy results alone. No osteomyelitis was present at 30 sites, there were seven cases of cellulitis. The sensitivity and specificity of 99mTc-HMPAO-LS were 88.4% and 96.6% respectively (23 true-positives, 29 true-negatives, one false-positive, three false-negatives). The accuracy of radiography, 99mTc-methylene diphosphonate and HMPAO-LS was 69.6%, 62.5%, and 92.9%, respectively. Follow-up scintigraphy (n = 14) 4 months after initial diagnosis and 1 month after antibiotic withdrawal confirmed cure of osteomyelitis despite the absence of complete clinical regression of the ulcers. In conclusion, 99mTc-HMPAO labelled leucocyte scintigraphy was found to be an excellent method for the diagnosis of osteomyelitis in the diabetic foot. It can contribute to follow-up, particularly when clinical regression of perforating ulcers is incomplete and cure of osteomyelitis must be confirmed in order that antibiotic treatment may be discontinued. (orig.)

  5. Contribution of technetium-99m hexamethylpropylene amine oxime labelled leucocyte scintigraphy to the diagnosis of diabetic foot infection

    Devillers, A.; Moisan, A.; Garin, E.; Bourguet, P. [CRLCC Eugene Marquis, Service de Medecine Nucleaire, Rennes (France); Hennion, F.; Poirier, J.Y. [CHRU Pontchaillou, Service d`Endocrinologie, Rennes (France)

    1998-02-01

    We conducted a prospective study in order to evaluate the contribution of technetium-99m hexamethylpropylene amine oxime (HMPAO) labelled leucocyte scintigraphy to the diagnosis and follow-up of osteomyelitis in the diabetic foot. The study was conducted between October 1992 and November 1996 and included 42 patients (30 men and 12 women; mean age 63 years) with diabetes mellitus (type 1, n = 22, type 2, n = 20) who had a total of 56 diabetic foot ulcers. The initial exploration included standard radiography, three-phase bone scintigraphy and {sup 99m}Tc-HMPAO labelled leucocyte scintigraphy (HMPAO-LS), performed within a 3-day interval. For the 56 ulceration sites, 26 cases of osteomyelitis were diagnosed: ten on the basis of radiographic and histological/bacteriological criteria after bone biopsy, 11 after radiographic follow-up and five on the basis of biopsy results alone. No osteomyelitis was present at 30 sites, there were seven cases of cellulitis. The sensitivity and specificity of {sup 99m}Tc-HMPAO-LS were 88.4% and 96.6% respectively (23 true-positives, 29 true-negatives, one false-positive, three false-negatives). The accuracy of radiography, {sup 99m}Tc-methylene diphosphonate and HMPAO-LS was 69.6%, 62.5%, and 92.9%, respectively. Follow-up scintigraphy (n = 14) 4 months after initial diagnosis and 1 month after antibiotic withdrawal confirmed cure of osteomyelitis despite the absence of complete clinical regression of the ulcers. In conclusion, {sup 99m}Tc-HMPAO labelled leucocyte scintigraphy was found to be an excellent method for the diagnosis of osteomyelitis in the diabetic foot. It can contribute to follow-up, particularly when clinical regression of perforating ulcers is incomplete and cure of osteomyelitis must be confirmed in order that antibiotic treatment may be discontinued. (orig.) With 5 figs., 3 tabs., 28 refs.

  6. 111In-oxine labelled leukocyte scintigraphy in the detection and localization of active inflammation and sepsis

    Indium-111-oxine labelled leukocyte scintigraphy is a diagnostic technique which has recently become available for clinic evaluation within Australia. The technique was used to assess patients with suspected sepsis of inflammation after other commonly used investigations had failed to confirm a diagnosis. Four patient subgroups were evaluated: fever of unknown origin suspected abdominal or postoperative sepsis; suspected active inflammatory bowel disease; and suspected sepsis or inflammation of bones or joints. The course of all patients was followed for at least three months to establish the accuracy of the technique. The leukocyte labelling procedure took 90 min and imaging was carried out typically 3-6, 24 and occasionally 48 h after reinjection of the labelled leukocytes. Only in one patient labelling of leukocytes was unsuccessful. In the remaining 99 studies, the overall sensitivity of leukocyte scintigraphy was 88% (36 of 41 patients with a proved inflammatory or infective disease focus had positive scan findings);and the specificity was 95% (55 of 58 cases with no proved disease focus had normal scan findings). These results support the use of this method in nuclear medicine for the evaluation of suspected acute sepsis (symptoms less than four weeks' duration), of inflammatory bowel disease and of suspected infections involving appendicular bones which contain no active bone marrow. It is also a useful secondary scintigraphic procedure, after gallium-67-citrate scintigraphy, in patients with suspected infective disorders of more than four weeks' duration. 27 refs., 2 tabs., 5 figs

  7. Bone metastases in Wilms' tumour - report of three cases and review of literature

    Bone metastases are extremely rare in patients with classical Wilms' tumor (WT). We describe the clinical and radiologic features, treatment and outcome of three patients with WT (one with favorable histology and two with anaplasia) in whom bone metastases were detected at diagnosis or relapse. Bone metastases were documented by skeletal radiographs, computed tomography and/or bone scintigraphy. The patient with favourable histology WT had no evidence of pulmonary metastases and is now free of disease following aggressive chemotherapy and radiotherapy. (orig.)

  8. Scintigraphy in postoperative follow-up of osteosynthesis of the femur with a bridge plate associated with an intramedullary pin in rabbits

    N.F Borges; R. Serakides; Santos, R. G.; S.O.F. Diniz; Cardoso, V.N.; N.S. Ucros; R.C.S. Torres; S.V. Cardoso; C.M.F. Rezende

    2013-01-01

    The objective of this work was to monitor the consolidation of the femur after osteosynthesis with a bridge plate associated with the intramedullary pin using scintigraphy. We used seven New Zealand breed male rabbits, at 4 months of age, with a mean weight of 3.5 kg. We performed a three-phase bone scintigraphy with technetium-labeled methylene diphosphonate (99mTc-MDP) before and after surgery, and 20, 50 and 90 days postoperatively. The activity index (AI) was calculated by dividing the av...

  9. Technetium-99m HMPAO labelled-leukocytes and gallium-67 scintigraphies in a Munchhausen's syndrome

    We report an observation of investigations performed in a patient with several cervical abscesses in his previous history. Aim of scintigraphic examinations was to detect an evolutive infection and/or to identify a general disease like granulomatosis. Although there was no abnormality on the labelled-leucocytes scintigraphy, an infra-mandibular uptake was observed 10 days later on 67Ga, without bone involvement. This 'discrepancy' between scintigraphic results and the clinical evolution allowed to confirm its management in nuclear medicine were discussed. (author)

  10. Incidental bone scan findings in oral cavity in patients with cancer

    The main aim of the present work, done in the Nuclear medicine Center IPEN-INEN, was to identify as incidental findings, increased inflammatory uptake in oral cavity in routine bone scintigraphies for neoplasic diseases control. A descriptive and retrospective study was performed studying bone scans from patients with cancer, that came to the Nuclear Medicine Center in 2003 and revising records of those who had inflammatory uptake in the oral cavity. It is concluded that, in cancer patients these findings are underestimated. Prospective research should be needed in order to determine the frequency of inflammatory oral cavity pathology detected in bone scintigraphies. (author)

  11. Septic arthritis of a lumbar facet joint: Detection with bone SPECT imaging

    We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan. In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements

  12. Combined scintigraphic identification of acute bone marrow infarction in sickle cell disease

    This paper identifies acute bone marrow infarction in symptomatic patients with sickle cell hemoglobinopathy presenting with a clinical picture in which infarction and osteomyelitis were indistinguishable. The authors evaluated 25 patients, 14 females and 11 males, with a combination of Tc-99 sulfur colloid bone marrow and tc-99m MDP scintigraphy performed consecutively within a 24-h period, for a total of 36 combined studies. Sixty-seven sites of bone marrow infarction corresponding to sites of clinical symptoms were revealed by combined scintigraphy

  13. Septic arthritis of a lumbar facet joint: Detection with bone SPECT imaging

    Swayne, L.C.; Dorsky, S.; Caruana, V.; Kaplan, I.L. (Morristown Memorial Hospital, NJ (USA))

    1989-08-01

    We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan. In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements.

  14. Development in Belgium of pinhole tomo-scintigraphy and of its applications to human and to small animals; Developpement en Belgique de la tomoscintigraphie stenopeique et de ses applications a l'homme et au petit animal

    Seret, A. [Liege Univ., Institut de Physique, Imagerie Medicale Experimentale (Belgium)

    2006-06-15

    In Belgium, several researchers have been highly active in developing pinhole tomo-scintigraphy and have sometimes made a pioneer work. Their contributions concern as well the methodology of the technique as its applications to human and small animals. Reconstruction algorithms, of analytic and iterative type, have been developed and validated. They can reconstruct data obtained along circular, half-circular and non-circular acquisition orbits, the camera head being eventually tilted. A very performing method has been elaborated to determine the seven geometric parameters of the acquisition that are needed for an optimal reconstruction. The use of pinhole tomo-scintigraphy for thyroid exploration seems to be born in Belgium and a few validation studies were conducted in the country. Potentials of pinhole tomography application to parathyroid or bone scintigraphy have also been considered. Finally, some research groups are using pinhole tomo-scintigraphy for small animal studies. (author)

  15. Sensitivity and specificity of thallium-201 scintigraphy for the diagnosis of malignant vertebral fractures

    Objective: To evaluate the accuracy of thallium-201 (201TI) scintigraphy in distinguishing a benign from a malignant recent non-traumatic vertebral fracture. Methods: Study design--Single center, prospective study. Participants--Patients hospitalized for a recent non-traumatic vertebral fracture. Evaluation--Usual clinical, laboratory and radiological assessment; 201TI vertebral scintigraphy: patients were injected with iv 3 mCi 201TI. Early and delayed images of the fractured vertebra were obtained. Data analysis--(1) Two examinators, unaware of the other findings, rated the images as hyperfixation or not of the fractured vertebra; (2) the ratio (average count per pixel of the fractured vertebra/normal adjacent vertebrae) were calculated. The final diagnosis was established on the result of vertebral biopsy or on follow-up. Results: Twenty-one patients were included. The final diagnosis was a benign vertebral fracture in 14 patients and a malignant vertebral fracture in 7. The sensitivity, specificity, positive and negative predictive values for a malignant fracture on early 201TI vertebral scintigraphy images were 28.6, 92.9, 66.6, and 72.2%, respectively, and on delayed images were 28.6, 100, 100, and 73.7%, respectively. The ratio of lesioned over normal tissue was not increased in malignant, compared with benign fractures. Conclusion: The weak sensitivity does not support the wide use of 201TI bone scintigraphy to distinguish a benign from a malignant recent non traumatic vertebral fracture. However, the high specificity suggests that such evaluation might be proposed prior to vertebral biopsy in some difficult cases

  16. Scintigraphic Evaluation of the Stump Region After Extremity Amputation and the Effect of Scintigraphy on Treatment

    Sadic, Murat; Atilgan, Hasan Ikbal; Baskin, Aylin; Cinar, Alev; Koca, Gokhan; Demirel, Koray; Comak, Aylin; Ozyurt, Sinem; Yildirim, Sule; Korkmaz, Meliha

    2016-01-01

    Background We evaluated the stump region with scintigraphy and compared the correlation of treatment modalities and scintigraphic results. Methods Sixty-eight cases with extremity amputation were included in the study. Amputation applied cases underwent four-phase Tc-99m hydroxymethylene diphosphonate scintigraphy. Groups were performed according to the scanning time after amputation and amputation regions. After scintigraphic evaluation, results were recorded into five groups: osteomyelitis, soft-tissue infection, reactive changes secondary to surgery, chronic osteomyelitis, and normal. Post-surgical treatment modalities of the patients were determined and compared with scintigraphic results. Results In the scintigraphic evaluation of stump regions of the 68 amputated cases, 34 patients had acute osteomyelitis, one had chronic osteomyelitis, 16 had soft-tissue infection, and eight had changes secondary to the surgery. Nine of 68 cases had normal scintigraphic features. In the scintigraphic evaluation, 43 patients took antibiotic treatment and 16 had surgery. There was a strong correlation between scintigraphic results and treatment approach (P < 0.0001, r = 0.803) by means of preferred therapy and effectiveness of the therapy according to the scintigraphic results. Scintigraphy need increases with age after amputation and a negative correlation between patient age and scintigraphic need was found (P < 0.02, r = -0.339). There was no pathology in the follow-up in the cases that were scintigraphically normal. Conclusion Bone scintigraphy is a cost-effective, non-invasive, and efficient method that directs treatment in the evaluation of the stump region after amputation. PMID:26858796

  17. Diagnostic and prognostic value of {sup 99m}Tc-tetrofosmin scintigraphy in maxillofacial flaps

    Aigner, Reingard M.; Sorantin, Erich [Department of Radiology, Division of Nuclear Medicine, Karl-Franzens University Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Schultes, Guenter [Department of Oral and Maxillofacial Surgery, Karl-Franzens University Graz (Austria)

    2003-02-01

    In oro-maxillofacial malignancies, new therapeutic approaches are placing changing demands on the diverse diagnostic modalities. In contradistinction to mandibular reconstruction of former years, the transplants (microvascular anastomosed pedicled flaps, ''flaps'') now consist of one or more arteries feeding a soft tissue component attached to a piece of bone suitably fitted to fill the defect. We addressed the diagnostic value of technetium-99m tetrofosmin scintigraphy in differentiating between viability and non-viability of the soft tissue portion of flaps in the immediate postoperative assessment. A total of 60 patients who had received flaps for reconstruction of the mandible after partial resection were investigated with {sup 99m}Tc-tetrofosmin 3-5 days after surgery. Scintigraphy consisted of (a) radionuclide angiography, (b) static planar imaging in four projections starting at 10 min post injection, and (c) single-photon emission tomography (SPET) performed immediately after the planar imaging. Normal perfusion associated with no defects throughout the soft tissue portion of the transplant was observed in 46/60 patients. This scintigraphic pattern was identical to viability and normal postoperative follow-up. Hypoperfusion and small defects on planar and SPET images indicated viability and uncomplicated postoperative healing in 6/60 patients, but non-viability/inadequate healing of the flap in 4/60 patients. Absence of perfusion combined with a large defect on static planar and SPET images definitively showed the non-viability of the flap (4/60 patients). It is concluded that {sup 99m}Tc-tetrofosmin scintigraphy is a sensitive diagnostic tool for the immediate postoperative assessment of the viability and the adequacy of implantation of the soft tissue portion of flaps. Therefore tetrofosmin scintigraphy is an important modality in order (a) to define the optimal therapeutic regimen in the immediate postoperative period and (b) to

  18. Diagnostic and prognostic value of 99mTc-tetrofosmin scintigraphy in maxillofacial flaps.

    Aigner, Reingard M; Schultes, Guenter; Sorantin, Erich

    2003-02-01

    In oro-maxillofacial malignancies, new therapeutic approaches are placing changing demands on the diverse diagnostic modalities. In contradistinction to mandibular reconstruction of former years, the transplants (microvascular anastomosed pedicled flaps, "flaps") now consist of one or more arteries feeding a soft tissue component attached to a piece of bone suitably fitted to fill the defect. We addressed the diagnostic value of technetium-99m tetrofosmin scintigraphy in differentiating between viability and non-viability of the soft tissue portion of flaps in the immediate postoperative assessment. A total of 60 patients who had received flaps for reconstruction of the mandible after partial resection were investigated with (99m)Tc-tetrofosmin 3-5 days after surgery. Scintigraphy consisted of (a) radionuclide angiography, (b) static planar imaging in four projections starting at 10 min post injection, and (c) single-photon emission tomography (SPET) performed immediately after the planar imaging. Normal perfusion associated with no defects throughout the soft tissue portion of the transplant was observed in 46/60 patients. This scintigraphic pattern was identical to viability and normal postoperative follow-up. Hypoperfusion and small defects on planar and SPET images indicated viability and uncomplicated postoperative healing in 6/60 patients, but non-viability/inadequate healing of the flap in 4/60 patients. Absence of perfusion combined with a large defect on static planar and SPET images definitively showed the non-viability of the flap (4/60 patients). It is concluded that (99m)Tc-tetrofosmin scintigraphy is a sensitive diagnostic tool for the immediate postoperative assessment of the viability and the adequacy of implantation of the soft tissue portion of flaps. Therefore tetrofosmin scintigraphy is an important modality in order (a) to define the optimal therapeutic regimen in the immediate postoperative period and (b) to provide better prognosis. PMID

  19. Diagnostic and prognostic value of 99mTc-tetrofosmin scintigraphy in maxillofacial flaps

    In oro-maxillofacial malignancies, new therapeutic approaches are placing changing demands on the diverse diagnostic modalities. In contradistinction to mandibular reconstruction of former years, the transplants (microvascular anastomosed pedicled flaps, ''flaps'') now consist of one or more arteries feeding a soft tissue component attached to a piece of bone suitably fitted to fill the defect. We addressed the diagnostic value of technetium-99m tetrofosmin scintigraphy in differentiating between viability and non-viability of the soft tissue portion of flaps in the immediate postoperative assessment. A total of 60 patients who had received flaps for reconstruction of the mandible after partial resection were investigated with 99mTc-tetrofosmin 3-5 days after surgery. Scintigraphy consisted of (a) radionuclide angiography, (b) static planar imaging in four projections starting at 10 min post injection, and (c) single-photon emission tomography (SPET) performed immediately after the planar imaging. Normal perfusion associated with no defects throughout the soft tissue portion of the transplant was observed in 46/60 patients. This scintigraphic pattern was identical to viability and normal postoperative follow-up. Hypoperfusion and small defects on planar and SPET images indicated viability and uncomplicated postoperative healing in 6/60 patients, but non-viability/inadequate healing of the flap in 4/60 patients. Absence of perfusion combined with a large defect on static planar and SPET images definitively showed the non-viability of the flap (4/60 patients). It is concluded that 99mTc-tetrofosmin scintigraphy is a sensitive diagnostic tool for the immediate postoperative assessment of the viability and the adequacy of implantation of the soft tissue portion of flaps. Therefore tetrofosmin scintigraphy is an important modality in order (a) to define the optimal therapeutic regimen in the immediate postoperative period and (b) to provide better prognosis. (orig.)

  20. Omission of bone scanning according to staging guidelines leads to futile therapy in non-small cell lung cancer

    The leading European and American professional societies recommend that bone scans (BS) should be performed in the staging of lung cancer only in those patients with bone pain. This prospective study investigated the sensitivity of conventional skeletal scintigraphy in detecting osseous metastases in patients with lung cancer and addressed the potential consequences of failure to use this method in the work-up of asymptomatic patients. Subsequent to initial diagnosis of non-small cell lung cancer, 100 patients were examined and questioned regarding skeletal complaints. Two specialists in internal medicine decided whether they would recommend a bone scan on the basis of the clinical evaluation. Skeletal scintigraphy was then performed blinded to the findings of history and physical examination. The combined results of magnetic resonance imaging (MRI) of the vertebral column, positron emission tomography (PET) of skeletal bone and the subsequent clinical course served as the gold standard for the identification of osseous metastases. Bone scintigraphy showed an 87% sensitivity in the detection of bone metastases. Failure to perform skeletal scintigraphy in asymptomatic patients reduced the sensitivity of the method, depending on the interpretation of the symptoms, to 19-39%. Without the findings of skeletal scintigraphy and the gold standard methods, 14-22% of patients would have undergone unnecessary surgery or neoadjuvant therapy. On this basis it is concluded that bone scans should not be omitted in asymptomatic patients. (orig.)