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

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

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

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

Pulmonary paragonimiasis is a relatively rare cause of lung disease revealing a wide variety of radiologic findings, such as air-space consolidation, nodules, and cysts. We describe here a case of pulmonary paragonimiasis in a 27-year-old woman who presented with a 2-month history of cough and sputum. Based on chest computed tomography (CT) scans and fluorodeoxyglucose positron emission tomography (FDG-PET) findings, the patient was suspected to have a metastatic lung tumor. However, she was diagnosed as having Paragonimus westermani infection by an immunoserological examination using ELISA. Follow-up chest X-ray and CT scans after chemotherapy with praziquantel showed an obvious improvement. There have been several reported cases of pulmonary paragonimiasis mimicking lung tumors on FDG-PET. However, all of them were suspected as primary lung tumors. To our knowledge, this patient represents the first case of paragonimiasis mimicking metastatic lung disease on FDG-PET CT imaging.
Adult ; Animals ; Diagnostic Errors ; Female ; Humans ; Lung Diseases, Parasitic/*diagnosis/*parasitology/radiography/radionuclide imaging ; Lung Neoplasms/*diagnosis ; Paragonimiasis/*diagnosis/*parasitology/radiography/radionuclide imaging ; Paragonimus westermani/isolation & purification ; Positron-Emission Tomography ; Tomography, X-Ray Computed

The parathyroid hormone related protein(PTHrP) is the most common causative peptide of humoral hypercalcemia of malignancy. In contrast, the serum level of parathyroid hormone(PTH) is low to undetectable in the majority of patients with malignancy associated hypercalcemia. Few cases exist in which the production and secretion of PTH by malignant nonparathyroid tumors have been authenticated. To our knowledge, there is very rare case in which a nonparathyroid tumor expressed simultaneously both the PTH and PTHrP. We report a case of squamous cell carcinoma of the lung with hypercalcemia which presented with simultaneous elevation of serum PTH and PTHrP. Severe hypercalcemia (serum calcium, 7.5mEq/L) was found in a 65-year-old man who had a squamous cell carcinoma of the lung without any body metastasis and detectable parathyroid abnormalities on isotope scintigraphy. The serum level of intact parathyroid hormone (PTH) concentration was markedly elevated as measured in two site radioimmunoreactive PTH assays (intact PTH 150pg/mL ; normal 9~55). The serum level of a PTHrP was also increased as measured in C-terminal region specific radioimmunoassay (PTHrP 99.1 pmol/L ; normal 13.8~55.3). There are no evidences of coincidental primary hyperparathyroidism in parathyroid MIBI scan and other imaging studies including neck ultrasonography and computed tomography. These results suggest that simultaneous elevation of serum PTH and PTHrP in this patient can be caused by production of both PTHrP and PTH in other nonparathyroid lesions such as squamous cell carcinoma.
Aged ; Calcium ; Carcinoma, Squamous Cell ; Humans ; Hypercalcemia* ; Hyperparathyroidism, Primary ; Lung Neoplasms* ; Lung* ; Neck ; Neoplasm Metastasis ; Parathyroid Hormone ; Parathyroid Hormone-Related Protein ; Radioimmunoassay ; Radionuclide Imaging ; Ultrasonography

BACKGROUND: The advantages of thallium (Tl)-201 whole body scan in follow-up of patients with thyroid carcinoma include no need to discontinue thyroid hormone replacement, a shorter period of time between injection and imaging, a lower radiation dose, and preservation of affinity for subsequent therapeutic dose of 131I. To evaluate the reliability of whole body scintigraphy using Tl-201 in postoperative follow-up of thyroid carcinoma, this procedure was performed in patients after total thyroidectomy for thyroid carcinoma. The results were compared with those of 131I scintigraphy. METHODS: One hundred nineteen cases (119 patients) with a median age of 43 years (range, 20 85 years) were included in the study. After optimal endogenous thyroid-stimulating hormone stimulation (>50 mIU/mL), 131I (4 mCi) scan and Tl 201 (3 mCi) scan were simultaneously performed. Concomitantly serum thyroglobulin and anti-thyroglobulin antibody levels were checked. If abnormal findings on any of the scintigraphic methods or high levels of thyroglobulin (> 10 ng/mL) were detected, high dose (150~200mCi) 131I was administered as therapy and then whole body scans were performed repeatedly after the therapy. The presence or absence of thyroid cancer was established by pathologic, radiologic, and/or high dose 131I scan findings. RESULTS: In 12 patients, ll-201 scan revealed positive accumulations which were not found on 131I scan, of whom 9 had elevated thyroglobulin levels. In these cases, 5 cases were interpreted to have normal thyroid remnant and 7 cases showed pathologic findings (1 lung, 2 lymph node, 1 bone, and 2 lung and lymph node metastasis, and 1 false positive accumulation of thallium). Metastasis were confirmed histologically in 2 and radiologically in 5 cases. Negative Tl-201 scans, despite of positive 131I scans, occurred in 20 patients, of whom 6 had abnormal thyroglobulin levels. Seventeen cases were interpreted to have thyroid remnant, 2 cases were diagnosed to have thyroid carcinoma metastasis (1 lung, 1 lung and lymph node), and 1 case was not confumed. CONCLUSION: These results suggest that 131I scan is superior to 11-201 scan for detection of residual or metastatic differentiated thyroid carcinoma. However, the use of combined modalities may provide a higher diagnostic yield. TI-201 scan can be useful especially in cases in which 'I scan is negative despite of abnormal thyroglobulin levels.
Follow-Up Studies* ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Radionuclide Imaging* ; Thallium ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyrotropin ; Whole Body Imaging

No abstract available.
Bone Marrow Cells/pathology ; Bone and Bones/radionuclide imaging ; Female ; Humans ; Lung Neoplasms/diagnosis/radiography ; Middle Aged ; Multimodal Imaging ; Multiple Myeloma/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed

OBJECTIVE: Lymphomatoid granulomatosis (LG) is a rare, aggressive extranodal Epstein-Barr virus (EBV)-positive B-cell lymphoproliferative disease. The purpose of our study was to analyze the CT and fluorodeoxyglucose positron emission tomography (FDG-PET) findings of pulmonary LG. MATERIALS AND METHODS: Between 2000 and 2009, four patients with pathologically proven pulmonary LG and chest CT were identified. Two of these patients also had FDG-PET. Imaging features of LG on CT and PET were reviewed. RESULTS: Pulmonary nodules or masses with peribronchovascular, subpleural, and lower lung zonal preponderance were present in all patients. Central low attenuation (4 of 4 patients), ground-glass halo (3 of 4 patients), and peripheral enhancement (4 of 4 patients) were observed in these nodules and masses. An air-bronchogram and cavitation were seen in three of four patients. FDG-PET scans demonstrated avid FDG uptake in the pulmonary nodules and masses. CONCLUSION: Pulmonary LG presents with nodules and masses with a lymphatic distribution, as would be expected for a lymphoproliferative disease. However, central low attenuation, ground-glass halo and peripheral enhancement of the nodules/masses are likely related to the angioinvasive nature of this disease. Peripheral enhancement and ground-glass halo, in particular, are valuable characteristic not previously reported that can help radiologists suggest the diagnosis of pulmonary LG.
Adult ; Biopsy, Needle ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Lung Neoplasms/pathology/*radiography/*radionuclide imaging ; Lymphomatoid Granulomatosis/pathology/*radiography/*radionuclide imaging ; Male ; Middle Aged ; *Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; *Tomography, X-Ray Computed