Bone scintigraphy is a very sensitive and cost-effective diagnostic method for detecting bony metastases of malignant neoplasm. However it has been reported that bone scan is less sensitive for early bony metastases, especially vertebral metastases. PET is a non-invasive clinical imaging methodology that can be used to assess such biochemical disturbance in tissue in vivo quantitatively with high resolution.We experienced two cases of small cell lung cancer with multiple bony metastases which were detected on PET imaging but not on planar bone scan. This case report suggests that FDG-PET will be a very effective diagnostic tool for bony metastases especially in clinically suspected case despite a normal planar bone scan.
Bone and Bones ; Neoplasm Metastasis* ; Radionuclide Imaging ; Small Cell Lung Carcinoma*

BACKGROUND: 99mTechnetium methylene diphosphonates(99mTc MDP) bone scintigraphy is current method of choice for the detection of bone metastases, but whole body 18F-fluoro-deoxy-D-glucose positron emission tomography(18FDG PET) offers superior spatial resolution and improved sensitivity. So we compared whole body 18FDG PET with 99mTc MDP bone scintigraphy in patients with skeletal metastases from lung cancer. PATIENTS AND METHODS: Ninety-two patients with lung cancer taken 18FDG PET together with a 99mTc MDP bone scintigraphy within 1 month between March 2000 and March 2003 were investigated retrospectively. RESULTS: The sensitivity, specificity and accuracy of the 99mTc MDP bone scintigraphy versus 18FDG PET for the detection of bone metastases in lung cancers were 59% vs 82%, 71% vs 94%, and 68% vs 91%, respectively. In the diagnosis of bone metastases from lung cancer, 18FDG PET was statistically superior to 99mTc MDP bone scintigraphy in its specificity and accuracy(P<0.0001). CONCLUSIONS: Whole body 18FDG PET may be useful in detecting bone metastases among patients with lung cancer.
Diagnosis ; Electrons ; Fluorodeoxyglucose F18* ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Radionuclide Imaging* ; Retrospective Studies

OBJECTIVEThis study was to assess the reliability of perfusion/ventilation (Q/V) lung scintigraphy in the diagnosis and quantitative analysis of chronic thromboembolic pulmonary hypertension (CTEPH).

METHODSA total of 78 in-patients with pulmonary hypertension who had no history of congenital heart disease, valvular disease and acute pulmonary embolism were included in this study. All patients underwent Q/V scintigraphy for detecting CTEPH. The sensitivity, specificity and accuracy of Q/V scintigraphy were defined by comparing with the results of pulmonary angiography. Percentage of Perfusion Defect score (PPDs%) was calculated in patients with CTEPH confirmed by pulmonary angiography. The correlations between PPDs% and mPAP, PPDs% and SPAP were analyzed.

RESULTSThe sensitivity, specificity and accuracy of a high-probability Q/V scintigraphy interpretation were 96.0%, 81.1% and 86.9%, respectively, compared with 100%, 69.8% and 79.5% for the combination of high- and intermediate- probability Q/V scintigraphy interpretation. PPDs% was significantly correlated with mPAP and SPAP (r = 0.538 for mPAP, P < 0.01 and r = 0.456 for SPAP, P < 0.05).

CONCLUSIONPerfusion/ventilation lung scintigraphy is a valuable technique for diagnosis and quantitative analysis of CTEPH.

Humans ; Hypertension, Pulmonary ; diagnostic imaging ; Lung ; diagnostic imaging ; Pulmonary Embolism ; diagnosis ; diagnostic imaging ; Radionuclide Imaging ; Sensitivity and Specificity ; Ventilation-Perfusion Ratio

Thoracic splenosis is an autotransplantation of splenic tissue to thorax resulting from splenic and diaphragmatic injury. Thoracic splenosis is usually discovered incidentally on routine thoracic imaging as single or multiple left-sided pleural-based masses without symptoms. Traditionally, patients often undergo an invasive diagnostic procedures including thoracotomy to acquire tissue samples in order to exclude other causes of lung mass. The combination of imaging findings and clinical history make it avoid unnecessary invasive diagnostic procedure to confirm. Therefore, thoracic splenosis should be considered in the differential diagnosis of asymptomatic patients with multiple, left-sided pleural-based nodules and previous history of thoracoabdominal injury and splenectomy. Here we report a case of thoracic splenosis diagnosed without invasive procedure.
Autografts ; Diagnosis* ; Diagnosis, Differential ; Humans ; Lung ; Radionuclide Imaging ; Splenectomy ; Splenosis* ; Thoracotomy ; Thorax

Primary lung cancer is a leading cause of cancer-related deaths in Korea. Approximately 50% of patients have metastatic disease at the time of presentation. The preferential sites of extrapulmonary spread include lymph nodes, liver, brain, adrenal glands, and bones. Gastrointestinal metastasis from primary lung cancer is extremely rare and only a few case reports have been published. Herein, we report a case of metastatic colon cancer from primary lung adenocarcinoma, presenting multiple cecal polypoid masses.
Adenocarcinoma/*diagnosis/radionuclide imaging/*secondary ; Aged ; Colonic Neoplasms/diagnosis/etiology/*secondary ; Diagnosis, Differential ; Humans ; Lung Neoplasms/*diagnosis/pathology/radionuclide imaging ; Male ; Tomography, X-Ray Computed

A 50-yr-old man presented with intermittent hemoptysis and was diagnosed small cell lung cancer. 18F-FDG PET/CT for staging demonstrated extensive hypermetabolic lesions throughout the skeleton and liver. Interestingly, skeletal muscles of limbs, mediastinum, bowel, and especially brain showed very low FDG uptake. Because of some characteristics in common with super scan on skeletal scintigraphy, this case could be considered as 'metabolic super scan'.
Carcinoma, Small Cell/complications/radionuclide imaging ; Fluorine Radioisotopes/diagnostic use ; Fluorodeoxyglucose F18/*diagnostic use ; Hemoptysis/complications/radionuclide imaging ; Humans ; Liver Neoplasms/diagnosis/secondary ; Lung Neoplasms/complications/radionuclide imaging ; Male ; Middle Aged ; *Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use

The radiologic appearance of multiple discrete pulmonary nodules in immunocompetent patients, with cryptococcal infection, has been rarely described. We describe a case of pulmonary cryptococcosis, presenting with bilaterally and randomly distributed nodules on a computed tomography, mimicking hematogeneous metastases. Positron emission tomography does not demonstrate 18F-fluorodeoxyglucose (FDG) uptake, suggesting a low probability for malignancy, which is a crucial piece of information for clinicians when making a management decision. We find the absence of FDG uptake correlates with the pathologic finding of an infectious nodule, composed of fibrosis and necrosis.
Cryptococcosis/metabolism/*radionuclide imaging ; Fluorodeoxyglucose F18/*diagnostic use/pharmacokinetics ; Humans ; Immunocompetence ; Lung Diseases, Fungal/metabolism/*radionuclide imaging ; Lung Neoplasms/radionuclide imaging ; Male ; Middle Aged ; Multimodal Imaging/*methods ; Multiple Pulmonary Nodules/radionuclide imaging ; Positron-Emission Tomography/*methods ; Radiopharmaceuticals/*diagnostic use/pharmacokinetics ; Tomography, X-Ray Computed/*methods

Congenital cystic adenomatoid malformation is a rare bronchopulmonary malformation resulting from an arrest in lung development between 4th and 7th week of fetal life. It typically presents as respiratory distress in the neonatal period and recurrent pulmonary infections in adults; and is sometimes associated with other congenital abnormalities [especially CCAM Type II]. Chest roentgenograms and CT scan are the usual modalities of choice in its initial evaluation and histopathology done post-operatively establishes the diagnosis. Ventilation-Perfusion [VQ] scintigraphy is of paramount importance in the routine assessment of CCAM patients but is often disregarded. This paper presents the incremental value of doing a lung perfusion scintigraphy and aims to emphasize the significance of performing a VQ scan in such cases.
Human ; Female ; Adult ; RADIONUCLIDE IMAGING ; SCINTIGRAPHY ; DIAGNOSTIC IMAGING ; CYSTIC ADENOMATOID MALFORMATION OF LUNG, CONGENITAL ; CONGENITAL CYSTIC ADENOMATOID MALFORMATION OF LUNG ; LUNG DISEASES ; TOMOGRAPHY SCANNERS, X-RAY COMPUTED

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

Extramedullary pulmonary hematopoiesis is a rare entity with a limited number of case reports in the available literature only. We report the case of a 66-year-old man with known primary myelofibrosis, in whom a Technetium-99m sulfur colloid bone marrow scan with single-photon emission computed tomography (SPECT)/CT revealed a pulmonary hematopoiesis as the cause of pulmonary hypertension and severe tricuspid regurgitation. To the best of our knowledge, this is the first description of Technetium-99m sulfur colloid SPECT/CT imaging in this rare condition.
Aged ; Bone Marrow/*radionuclide imaging ; *Hematopoiesis, Extramedullary ; Humans ; Hypertension, Pulmonary/*etiology/radionuclide imaging ; Lung/*radionuclide imaging ; Male ; Primary Myelofibrosis/complications ; Technetium Tc 99m Sulfur Colloid/diagnostic use ; Tomography, Emission-Computed, Single-Photon/methods ; Tomography, X-Ray Computed ; Tricuspid Valve Insufficiency/*etiology/radionuclide imaging