• Journal of Oral Medicine and Pain
• /
• v.30 no.1
• /
• pp.107-119
• /
• 2005

Temporomandibular joint arthritides is divided into osteoarthritis, osteoarthrosis and polyarthritis. Because the signs, symptoms and radiographical features of osteoarthritis and osteoarthrosis are similar without arthralgia, diffenential diagnosis is difficult. Also non-radiographically change in early Osteoarthritis leads to misdiagnose. Planar bone scan and SPECT are useful to detect bone change early. This study was carried out in order to make diagnostic criteria of planar bone scan and SPECT. Three hundred and four temporomandibular joints were examined with clinical examination, computerized tomograph, planar bone scan, and SPECT. The obtained results were as follows. 1. If temporomandibular joint simple uptake ratio of patient in twenties is over 1.397%, it's condition may be osteoarthritis. And simple uptake ratio over in thirties-fourties may mean osteoarthritis. 2. It may mean osteoarthritis of temporomandibular joint that the number of coronal and transverse SPECT frame with hot spot is over four. 3. Destructive stage may goes on, if simple uptake ratio is over 1.370% in tweenties and over 1.104% in thirties-fourties. 4. If the number of coronal SPECT frame with hot spot is over four, temporomandibular joint may be on destructive stage in tweenties, thirties-fourties. And if the number of transverse SPECT frame with hot spot is over three, it may be on destructive stage in all ages. 5. When patient complains subjective arthralgia and palpation arthralgia, bone change may be more active than each arthralgia. 6. Osteoarthritis may progress gradually worse in 4.5 anamnesis. And then it may be stable gradually and turn to osteoarthrosis.

• The Korean Journal of Nuclear Medicine
• /
• v.26 no.1
• /
• pp.160-163
• /
• 1992

유골골종(osteoid osteoma)은 특징적으로 직경 약 1cm미만의 원형 또는 타원형의 유골질제부(nidus)가 병소의 중심부에 있고, 그 주위는 반응성골질로 둘러싸여 있다. 그러므로 반응성골질 병소에서 제부의 확인은 유골골종의 진단에 매우 중요하다. 더우기 유골골종의 치료는 반드시 제부를 제거하여야 하기 때문에, 제부의 위치를 정확히 아는 것이 중요하다. 그러나, 유골골종의 제부는 단순 X-선 촬영상에서 잘 안나타나는 경우가 많아 진단에 어려움이 있다. 또한 골스캔도 유골골종의 진단에 많이 이용되고 있으나, 단순 신티그램에서 제부의 정확한 위치 파악은 어렵다. 이에 저자들은 바늘구멍조준기 골스캔을 시행하여 유골골종 제부에는 아주 진한 동위원소 집적이 보였고 주위의 반응성 골질 부위에는 제부보다 약한 동위원소 집적이 보여 특징적인 '이중 농도 집적' 소견을 얻었기에 바늘구멍조준기 골스캔이 유골골종의 진단에 매우 유용한 검사로 사료되어 보고하는 바이다.

• Nuclear Medicine and Molecular Imaging
• /
• v.41 no.1
• /
• pp.30-41
• /
• 2007

Purpose: Bone metastasis in breast cancer patients are usually assessed by conventional Tc-99m methylene diphosphonate whole-body bone scan, which has a high sensitivity but a poor specificity. However, positron emission tomography with $^{18}F-2-deoxyglucose$ (FDG-PET) can offer superior spatial resolution and improved specificity. FDG-PET/CT can offer more information to assess bone metastasis than PET alone, by giving a anatomical information of non-enhanced CT image. We attempted to evaluate the usefulness of FDG-PET/CT for detecting bone metastasis in breast cancer and to compare FDG-PET/CT results with bone scan findings. Materials and Methods: The study group comprised 157 women patients (range: $28{\sim}78$ years old, $mean{\pm}SD=49.5{\pm}8.5$) with biopsy-proven breast cancer who underwent bone scan and FDG-PET/CT within 1 week interval. The final diagnosis of bone metastasis was established by histopathological findings, radiological correlation, or clinical follow-up. Bone scan was acquired over 4 hours after administration of 740 MBq Tc-99m MDP. Bone scan image was interpreted as normal, low, intermediate or high probability for osseous metastasis. FDG PET/CT was performed after 6 hours fasting. 370 MBq F-18 FDG was administered intravenously 1 hour before imaging. PET data was obtained by 3D mode and CT data, used as transmission correction database, was acquired during shallow respiration. PET images were evaluated by visual interpretation, and quantification of FDG accumulation in bone lesion was performed by maximal SUV(SUVmax) and relative SUV(SUVrel). Results: Six patients(4.4%) showed metastatic bone lesions. Four(66.6%) of 6 patients with osseous metastasis was detected by bone scan and all 6 patients(100%) were detected by PET/CT. A total of 135 bone lesions found on either FDG-PET or bone scan were consist of 108 osseous metastatic lesion and 27 benign bone lesions. Osseous metastatic lesion had higher SUVmax and SUVrel compared to benign bone lesion($4.79{\pm}3.32$ vs $1.45{\pm}0.44$, p=0.000, $3.08{\pm}2.85$ vs $0.30{\pm}0.43$, p=0.000). Among 108 osseous metastatic lesions, 76 lesions showed as abnormal uptake on bone scan, and 76 lesions also showed as increased FDG uptake on PET/CT scan. There was good agreement between FDG uptake and abnormal bone scan finding (Kendall tau-b : 0.689, p=0.000). Lesion showed increased bone tracer uptake had higher SUVmax and SUVrel compared to lesion showed no abnormal bone scan finding ($6.03{\pm}3.12$ vs $1.09{\pm}1.49$, p=0.000, $4.76{\pm}3.31$ vs $1.29{\pm}0.92$, p=0.000). The order of frequency of osseous metastatic site was vertebra, pelvis, rib, skull, sternum, scapula, femur, clavicle, and humerus. Metastatic lesion on skull had highest SUVmax and metastatic lesion on rib had highest SUVrel. Osteosclerotic metastatic lesion had lowest SUVmax and SUVrel. Conclusion: These results suggest that FDG-PET/CT is more sensitive to detect breast cancer patients with osseous metastasis. CT scan must be reviewed cautiously skeleton with bone window, because osteosclerotic metastatic lesion did not showed abnormal FDG accumulation frequently.

• The Journal of the Korean bone and joint tumor society
• /
• v.18 no.1
• /
• pp.45-49
• /
• 2012

Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.

• The Korean Journal of Nuclear Medicine
• /
• v.30 no.3
• /
• pp.332-337
• /
• 1996

Purpose : It has been known that the activity of extracellular matrix degradative enzymes such as collagenase correlate well with the metastatic potential of various tumor cells in experimental study. This study was aimed at comparing the activities of type IV collagenase with bone scan findings in patients with breast cancer. Materials and Methods : We retrospectively correlated bone scan findings with the results of immunohistochemical staining for 92kDa, 72kDa type IV collagenase in 28, and 30 patients with metastatic breast cancer, respectively, as well as 23, and 27 patients with primary breast cancer, respectively. The immunohistochemical staining was performed with tissue specimens obtained from primary or metastatic breast tumor lesions. The amounts of the enzyme were graded from 0 to 4 and scored by multiplication with the percentage of tumor cells. The confidence of bone scan interpretation for metastasis was also scored from 1 to 5 with increasing probability. Results : There was a significant difference in enzyme scores between patients with and without metastasis. In patients with primary breast cancer group, the frequency of patients with enzyme score of less than 170 were 96%(26/27) and 100%(26/26) with 92kDa and 72kDa collagenase, respectively. In contrast, in patients with metastatic breast cancer group, the frequency of patients with enzyme score of more than 200 were 93%(28/30) and 87%(26/30) with 92kDa and 72kDa collagenase, respectively. All patients with each enzyme score of less than 170 show no active bony metastasis, however, there were variable bone scan findings in patients with each enzyme score of more than 200. Conclusion : Bone scan is useful to confirm, localize or follow up of bony metastasis in patients with each enzyme scores of more than 200. Acitve metastatic lesions were hardly seen on the bone scintigraphy in patients with collagenase scores of less than 170.

• Journal of Oral Medicine and Pain
• /
• v.37 no.2
• /
• pp.125-133
• /
• 2012

TMJ Osteoarthritis is a degenerative disease caused by overload on joint tissue, and often accompany with local tenderness on the joint, crepitus by mandibular movement, restriction of mandibular movement, and anterior openbite. In general, panoramic radiography, TMJ panoramic radiography, and transcranial radiography are conducted to diagnose osteoarthritis after clinical examination, however, these radiographic evaluations are limited in detecting minute bony changes of early pathologic lesion. The aim of this pilot study was to evaluate the limitation and usefulness of several TMJ imaging techniques, so we compare the findings from clinical examination, plain film radiographs, tomograph, and bone scan from 81 patients with temporomandibular joint disorder. The proportion of patients showing same findings in plain film radiographs, TMJ tomograph, and bone scan was high, however, it is desirable that clinician should conduct phased imaging examinations according to the clinical findings due to the possibilities of false negative findings in diagnosis of osteoarthritis.

• The Korean Journal of Nuclear Medicine
• /
• v.28 no.3
• /
• pp.377-383
• /
• 1994

Objective : We retrospectively analysed $^{99m}Tc$-MDP bone and $^{67}Ga$ scans to evaluate therapeutic response of bone lymphoma among patients with complete remission. Subjects and Methods : We reviewed 35 cases with an increased uptake finding $^{99m}Tc$-MDP bone scans and 16 $^{67}Ga$ scans that were follow-up studies during and after therapy. The $^{99m}Tc$-MDP bone and $^{67}Ga$ scans were graded visually from 1 to 4 in which grade 3 means same uptake density as that of normal sacroiliac articulation in bone scan and normal liver in $^{67}Ga$ scan, respectively. Results: The improvement findings during and after therapy were found in 66.0% (19/ 29) and 72.7% (24/33) with $^{99m}Tc$-MDP bone scan, 84.6% (l1/13) and 86.7% (13/15) with $^{67}Ga$ scan, respectively. The mean grades of the uptake density in $^{99m}Tc$-MDP bone scan were 3.06 before, 2.34 during, 1.75 after therapy. Those in the $^{67}Ga$ scan were 3.22 before, 1.42 during 1.30 after therapy. Conclusion. $^{67}Ga$ scans appeared more sensitive than bone scans in evaluating therapeutic response of bone lymphoma.

• The Korean Journal of Nuclear Medicine
• /
• v.29 no.4
• /
• pp.504-510
• /
• 1995

Avascular necrosis(AVN) of bone can be resulted from various causes that distrub vascular supply to bone tissue, including steroid therapy after renal transplantation. In this study, we determine the prevalence of the avascular necrosis of bone after renal transplantation and compare the role of the bone scan, SPECT and MRI. In 301 patients with transplanted kidney, the prevalence of avascular necrosis was deter-mined clinically. Site of bone necrosis was evaluated by clinical symptom, bone scan, SPECT and MRI. Bone scan was done in all patients with AVN. Bone SPECT and MRI were done in six cases; and MRI was done in two cases. The prevalence of AVN was 3.3% (10/301), and the site of AVN was 16 femoral heads in 10 patients (bilateral: 60%) and bilateral calcaneal tuberosity in one patient. Bone scan showed typical AVN (cold area with surrounding hot uptake) in 13 lesions, only hot uptake in three lesions (including two calcaneal tuberosities), decreased uptake in one lesion, and normal in one lesion. Decreased uptake and normal lesion showed an equivacal cold area without surrounding hot uptake on SPECT. A symptomatic patient with positive bone SPECT showed normal finding on MRI. The prevalence of AVN of bone after renal transplantation was 3.3%, and whole body bone scan showed multiple bone involvement. Two symptomatic hip Joints without definite lesion on whole body bone scan or MRI showed cold defect on SPECT. Therefore, we conclude that bone SPECT should be perfomed in a symptomatic patient with negative bone scan or MRI in case with high risk of AVN after renal transplantation.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.3
• /
• pp.249-252
• /
• 2008

• 대한핵의학회:학술대회논문집
• /
• 1986.05a
• /
• pp.125.1-125.1
• /
• 1986