One hundred and sixty patients having bronchogenic carcinoma were evaluated for bone metastasis by means of 99mTc-monodiphosphate bone scanning, correlative radiographic bone survey and their clinical findings. In all patients, diagnosis was histologically proved. Bone scan demonstrated the possible evidence of bone metastasis in 75 patients (46.9%) and radiography, in 29 patients (18.1%). False negative was noted in 1 patient-Bone scan correlated with radiography in 37.3%, and with accompanying bone pain in 52% of the patients. But there was no correlation with the level of serum calcium, inorganic phos- phorus and alkaline phosphatase. In connection with their clinical stages before scanning, bone scans were positive in 33.3% of clinical stage I, 10.8% of clinica1 stage II and 54.1% of clinical stage III. Our Study suggests that bone scanning with 99m-monodiphosphate detected early bone metastasis in patients with bronchogenic carcinoma before their lesions became evident clinically or radiographically, and also important to determine operability.
Adult ; Aged ; Bone Neoplasms/radiography ; Bone Neoplasms/radionuclide imaging ; Bone Neoplasms/secondary* ; Bone and Bones/radionuclide imaging* ; Carcinoma, Bronchogenic/radiography ; Carcinoma, Bronchogenic/radionuclide imaging* ; Comparative Study ; Female ; Human ; Lung Neoplasms/radiography ; Lung Neoplasms/radionuclide imaging* ; Male ; Middle Age ; Technetium/diagnostic use ; Tomography, Emission-Computed

We report an unusual case of osteoblastic metastasis from gastric carcinoma. In this case, bone metastasis was the initial manifestation of the cancer. The laboratory findings revealed mild hypocalcemia and markedly elevated alkaline phosphatase levels. Plain X-ray showed mottled osteoblastic changes in the pelvis. Bone marrow and bone biopsy of the pelvis revealed metastatic adenocarcinoma with increased osteoblastic activity. An extensive search for the primary site revealed advanced gastric carcinoma, which was confirmed by endoscopic biopsy.
Adenocarcinoma/diagnosis/*secondary ; Adult ; Bone Neoplasms/*diagnosis/pathology/*secondary ; Case Report ; Female ; Human ; *Osteoblasts/radiography ; *Pelvis/radiography ; Radionuclide Imaging ; Stomach Neoplasms/*diagnosis ; Tomography, X-Ray Computed

We report an unusual case of osteoblastic metastasis from gastric carcinoma. In this case, bone metastasis was the initial manifestation of the cancer. The laboratory findings revealed mild hypocalcemia and markedly elevated alkaline phosphatase levels. Plain X-ray showed mottled osteoblastic changes in the pelvis. Bone marrow and bone biopsy of the pelvis revealed metastatic adenocarcinoma with increased osteoblastic activity. An extensive search for the primary site revealed advanced gastric carcinoma, which was confirmed by endoscopic biopsy.
Adenocarcinoma/diagnosis/*secondary ; Adult ; Bone Neoplasms/*diagnosis/pathology/*secondary ; Case Report ; Female ; Human ; *Osteoblasts/radiography ; *Pelvis/radiography ; Radionuclide Imaging ; Stomach Neoplasms/*diagnosis ; Tomography, X-Ray Computed

OBJECTIVETo investigate the indication of bone scan for patients with newly diagnosed prostate cancer.

METHODSThe clinical data of continual 95 patients with newly diagnosed prostate cancer was involved between January 2006 and December 2010. The relationship between age, PSA, Gleason scores, clinical stage and positive bone scans was respectively compared.

RESULTSThe 33 patients (34.7%) with positive bone scans and 62 patients (65.3%) with negative bone scans. The mean age was (74±7) years and (76±7) years respectively in 2 groups respectively. PSA was (70.7±38.1) ng/ml and (28.4±27.2) ng/ml respectively, the difference was significant (t=-5.499, P=0.000). Clinical stage had positive correlation with positive bone scan, the OR value was 4.684. If the Gleason score>7, the sensitivity, specificity, positive predictive value and negative predictive value of positive bone scan was 64%, 63%, 48% and 77% respectively. If PSA>50 ng/ml, sensitivity, specificity, positive predictive value and negative predictive value was 67%, 86%, 71% and 83% respectively. If Clinical stage>T2, sensitivity, specificity, positive predictive value and negative predictive value was 82%, 81%, 69% and 89% respectively.

CONCLUSIONSFor patients with PSA≤10 ng/ml or simultaneously PSA≤50 ng/ml and Gleason score≤7 and clinical stage≤T2, bone scan is not necessary. Patients with newly diagnosed prostate cancer and PSA>50 ng/ml or Gleason score>7 or clinical stage>T2 should undergo bone scan.

Aged ; Aged, 80 and over ; Bone Neoplasms ; diagnostic imaging ; secondary ; Bone and Bones ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; Radionuclide Imaging ; Retrospective Studies ; Sensitivity and Specificity

AIMSTo determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer.

METHODSBetween November 2005 and July 2006, 317 men with prostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. Prostate-specific antigen (PSA) cut-offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biopsy Gleason scores and age were performed to determine when a bone scan study is likely to be of value.

RESULTSOnly 1/61 men (1.6%) with a serum PSA 20 ng/mL had a positive bone scan. However, 2/38 men (4.7%) with a serum PSA 20.1-40.0 ng/mL, 3/20 men (15%) with a serum PSA 40.1-60.0 ng/mL, 7/19 men (36.8%) with a serum PSA 60.1-100.0 ng/mL and 19/38 men (50%) with a serum PSA > 100.0 ng/mL had positive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these groups.

CONCLUSIONBased on our findings, a bone scan is of limited value in asymptomatic prostate cancer patients presenting PSA =or< 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemplated. Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis.

Aged ; Aged, 80 and over ; Analysis of Variance ; Bone Neoplasms ; diagnostic imaging ; secondary ; Bone and Bones ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prostate-Specific Antigen ; analysis ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; Radionuclide Imaging ; Radiopharmaceuticals ; Retrospective Studies ; Technetium Tc 99m Medronate

OBJECTIVETo evaluate the feasibility and clinical value of whole body diffusion weighted magnetic resonance imaging (WB-DWI) in detection of bone metastases.

METHODSTotally 38 patients with malignant tumors and suspected bone metastases were enrolled. All patients underwent WB-DWI and bone scintigraphy within 2 weeks. The skeletal system was divided into 13 regions: skull, sternum, clavicle, cervical spine, thoracic spine, lumbar spine, sacrum, ribs, pelvic bone, scapula, humerus, femur, and tibia/fibula. Bone metastases were assessed for both modalities in a separate consensus reading and apparent diffusion coefficient (ADC) values were calculated.

RESULTSWB-DWI identified 214 pathological lesions in 20 patients, while bone scintigraphy demonstrated 197 lesions in 20 patients. Concordance between WB-DWI and bone scintigraphy occurred in 34 of 38 patients. There was no statistical difference between these two modalities (P = 0.488). Compared with bone scintigraphy, the regions missed by WB-DWI were mainly located in skull, thoracic spine, humerus, and tibia/fibula. WB-DWI was more sensitive in the detection of metastases to the cervical spine, lumbar spine, sacrum, pelvis, ribs and femur. No statistical significance was found among the ADC values of bone metastases in different skeletal areas, and the mean ADC value was (0.75 +/- 0.10) x 10(-3) mm2/s. Furthermore, WB-DWI revealed more metastases to the lymph lodes and extraskeletal organs. Conclusion WB-DWI has high accordance with skeletal scintigraphy in detecting bone metastases, and the two modalities are complementary to each other.

Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; diagnosis ; diagnostic imaging ; secondary ; Diffusion Magnetic Resonance Imaging ; methods ; Feasibility Studies ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Radionuclide Imaging ; Stomach Neoplasms ; pathology ; Whole Body Imaging ; methods ; Young Adult

OBJECTIVETo evaluate the therapeutic effects of strontium-89 on osseous metastases of prostate cancer by bone scanning and bone alkaline phosphatase (B-AKP) measurement.

METHODSOne week before and within 6 months after strontium-89 therapy, bone scanning and B-AKP measurement were performed in 73 patients with bone metastases of prostate cancer. 1. According to the number of osseous lesions on bone imaging, the patients were divided into Grade 0, 1, 2 and 3, and the numbers of bone lesions before and after therapy were compared by t-test. 2. Tumor to non-tumor ratios(T/NT) before and after treatment were calculated and compared. 3. Changes in B-AKP before and after therapy were compared.

RESULTS1. Among the 73 patients, bone scanning revealed 618 bone lesions, averaging 8.6 +/- 7.4 before treatment. The number decreased to 349, averaging 3.8 +/- 6.7 after treatment, which showed a significant reduction (t = 4.079, P < 0.01). 2. After therapy, T/NT of bone lesions decreased significantly (t = 7.907, P < 0.01) from 5.36 +/- 4.67 to 3.17 +/- 2.95. 3. B-AKP decreased significantly (t = 3.349, P < 0.002) from (28.4 +/- 14.8) microgram/L to (20.9 +/- 11.7) microgram/L. 4. By bone scanning combined with B-AKP measurement, 5 false positive cases and 6 false negative cases were corrected.

CONCLUSIONThere is certain complementarity between bone scanning and B-AKP measurement, and they should be used in a combined way to achieve accurate evaluation of the therapeutic effects of strontium-89.

Aged ; Alkaline Phosphatase ; analysis ; Bone Neoplasms ; enzymology ; radiotherapy ; secondary ; Bone and Bones ; diagnostic imaging ; enzymology ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; radiotherapy ; Radionuclide Imaging ; Strontium ; therapeutic use

OBJECTIVETo evaluate the feasibility of whole body diffusion weighted imaging (DWI) in bone metastasis detection using bone scintigraphy as comparison.

METHODSForty-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.

RESULTSA 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-based specificity and NPV of whole body DWI 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%).

CONCLUSIONWhole body DWI reveals excellent concordance with bone scintigraphy regarding detection of bone metastasis, and the two techniques are complementary for each other.

Aged ; Bone Neoplasms ; diagnosis ; pathology ; secondary ; Diffusion Magnetic Resonance Imaging ; instrumentation ; methods ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Radionuclide Imaging ; Sensitivity and Specificity ; Whole Body Imaging ; instrumentation ; methods

OBJECTIVETo investigate the relation of serum prostate-specific antigen (PSA) and alkaline phosphatase (ALP) levels to bone metastases in patients with prostate cancer.

METHODSWe made a retrospective study of 96 cases of prostate cancer with (29 cases ) and without (67 cases ) bone metastases and evaluated their initial levels of serum PSA and ALP as well as the radionuclide bone scan findings.

RESULTSThe median concentrations of serum PSA and ALP were both in the bone scan-positive patients statistically higher than in those the negative ones (P < 0.01). The percentages of the bone scan-positive patients with PSA > 20 microg/L or ALP > 90 U/L were also higher than those with PSA < 20 microg/L or ALP < 90 U/L (P < 0.01).

CONCLUSIONProstate cancer patients with bone metastases have higher levels of PSA and ALP than those without. Radionuclide bone scan is necessary when the serum PSA level is > 20 microg/L and/or ALP level > 90 U/L.

Aged ; Aged, 80 and over ; Alkaline Phosphatase ; blood ; Biomarkers, Tumor ; blood ; Bone Neoplasms ; diagnostic imaging ; secondary ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; pathology ; Radionuclide Imaging ; Retrospective Studies ; Sensitivity and Specificity

Positron emission tomography combined with computed tomography (PET/CT) has been receiving increasing attention during the recent years for making the diagnosis, for determining the staging and for the follow-up of various malignancies. The PET/CT findings of 58 breast cancer patients (age range: 34-79 years old, mean age: 50 years) were retrospectively compared with the PET or CT scans alone. PET/CT was found to be better than PET or CT alone for detecting small tumors or multiple metastases, for accurately localizing lymph node metastasis and for monitoring the response to chemotherapy in breast cancer patients.
Adult ; Aged ; Bone Neoplasms/*diagnosis/pathology/secondary ; Breast/pathology/radionuclide imaging ; Breast Neoplasms/*diagnosis/pathology/radionuclide imaging ; Carcinoma, Ductal, Breast/diagnosis/pathology ; Carcinoma, Intraductal, Noninfiltrating/*diagnosis/pathology/radionuclide imaging ; Contrast Media/administration & dosage ; Female ; Humans ; Lymphatic Metastasis ; Mammography/methods ; Middle Aged ; Neoplasm Recurrence, Local/*diagnosis/pathology ; Neoplasm Staging/methods ; Positron-Emission Tomography/*methods ; Radiographic Image Enhancement/methods ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods ; Ultrasonography, Mammary