• Nuclear Medicine and Molecular Imaging
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• 제40권5호
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• pp.275-278
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• 2006

We report the case of a 73-year-old man who had prostate cancer with bone metastases. Tc-99m HDP Whole body bone scan revealed multiple areas of increased bony uptake consistent with widespread bone metastases. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) demonstrated mild F-18 FDG uptake in the lymph nodes of neck, abdomen, and pelvis. However, abnormal F-18 FDG uptake was not seen in the skeletal system. Biopsy and immunohistochemical stains of left supraclavicular mass showed metastatic prostate adenocarcinoma. Currently, there are a few reported cases of F-18 FDG PET/CT evaluation of bone metastases in prostate cancer. We discuss the discrepancy between F-18 FDG PET/CT and bone scan in the detection of osseous metastases of prostate cancer.

• 대한핵의학회지
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• 제33권6호
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• pp.512-518
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• 1999

목적: 3시간과 24시간 골신티그라피 영상에서 골전이와 급성 및 치유기 골절을 감별하는데 병변/비병변 방사능 섭취비의 24시간/3시간 비율(24 hour/3 hour radio-uptake ratio: 24/3 RUR)이 유용한지 알아보고자 하였다. 대상 및 방법: 총 63명($26{\sim}81$세, 남자 32명, 여자 31명)외 90개 병변(골 전이 30예, 외상 2개월 이내의 급성 골절 30예, 외상 2개월 이상의 치유기 골절 30예)을 대상으로 하였으며 골신티그라피는 $^{99m}Tc$-MDP 740 MBq를 정맥 주사하고 시간과 24시간 후에 영상을 얻었다. 각각의 영상에서 병변과, 인접한 정상 부위의 방사능 섭취비를 측정하여 24시간/3시간 비율(24/3 RUR: [lesion/non-lesion RUR at 24 hour]/[lesion/nonlesion RUR at 3 hour])을 구하여 세 질환을 감별하는데 의의가 있는 지를 분석하였다. 결과: 24/3 RUR의 평균치는 골전이 $1.22{\pm}0.18$, 급성 골절 $1.25{\pm}0.14$, 치유기 골절 $0.99{\pm}0.15$였으며 골 전이와 급성 골절의 24/3 RUR은 유의한 차이가 없었고 골 전이와 치유기 골절, 그리고 급성 골절과 치유기 골절간에는 유의한 차이가 있었다(p<0.001). 24/3 RUR 기준점을 1.0 이상인 경우 골 전이로 진단할 때 민감도는 100% (30/30)였고, 골 전이를 급성 골절로부터 구분하는 소견으로서 특이도는 0% (0/30), 골 전이를 치유기 골절로부터 구분하는 소견으로서 특이도는 47% (14/30)였다. 또한 기준점을 1.2로 설정했을 때는 골전이로 진단하는 소견으로서 민감도 53% (16/30), 골 전이를 급성골절로부터 구분하는 소견으로서 특이도 37% (l1/30), 골 전이를 치유기 골절로부터 구분하는 소견으로서 특이도 100% (30/30)였다. 결론: 24/3 RUR은 골 전이와 치유기 골절을 감별하는데 유용했으나 골 전이와 급성 골절의 감별에는 도움이 되지 않았다. 24/3 RUR이 1.0 미만인 경우는 치유기 골절을, 1.2 이상인 경우는 골 전이나 급성 골절을 시사하는 소견으로 생각된다.

• 대한핵의학회지
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• 제37권5호
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• pp.336-339
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• 2003

Purpose: A 6-year-old boy with osteogenic sarcoma of the left humerus underwent bone scintigraphy. Tc-99m MDP was accumulated not only in the primary tumor but also in the osseous and extraosseous (pulmonary and pericardial) metastases. Osteogenic sarcoma directly produces osteoid, both in the primary and metastatic lesions. Tc-99m MDP is avidly taken up by tumor osteoid. At initial presentation, only 2% of cases have both pulmonary and osseous metastases. The patient had osseous, pulmonary, and pericardial metastases at presentation. This case presents that increased uptakes of Tc-99m MDP by the primary and metastatic tumor were demonstrated on bone scintigraphy at presentation.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4331-4334
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• 2012

Aim and Background: The aim of the present study was to evaluate correlations between serum osteocalcin, osteoprotegerin and NTX (Cross-linked N-telopeptides of Type I Collagen) and urinary NTX in breast and lung cancer patients with bone metastases. These four markers are considered to have important roles in bone formation, resorption and metastases. Methods: Four markers were determined in the sera of 60 breast cancer and 21 lung cancer patients and healthy controls (n=30). Serum levels were studied using ELISA and EIA. Results: The median levels of serum osteoprotegerin (p<0.001) and osteocalcin (p=0.003) were higher in patients. Significant correlations were observed between the serum NTX-osteocalcin (r=0.431; p<0.001), serum NTX-osteoprotegerin (r=0.42; p=0.003) and serum NTX - urine NTX (r=0.255; p=0.022). Conclusion: We conclude that osteocalcin, osteoprotegerin and NTX are independent diagnostic tools. Due to the ease of urine collection, urine NTX may be applied routinely to allow early detection of bone metastases and indicate progression of the disease.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7689-7694
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• 2015

Background: Bone tumors are neoplasias with a high overall mortality; one of the main factors that reduce survival is their high capacity to develop metastases. It has been reported that finding lung metastases at diagnosis of osteosarcoma (OS), chondrosarcoma (CS) and giant cell tumor of bone (GCTb) is quite common. In this study, we inquire the relationship of metastases caused by these tumors with different clinical and pathological aspects, in order to guide medical personnel in the diagnosis and opportune treatment of metastases or micro metastases. Materials and Methods: We collected data of 384 patients with clinical, radiological and histopathological diagnosis of OS, GCTb and CS that attended the National Rehabilitation Institute (INR) during 2006 to 2014. Chi-square and Fisher's exact tests were performed for data analysis. Results: In the three tumor types, the presence of metastases at diagnosis was variable (p=0.0001). Frequency of metastases was 36.7%, 31.7% and 13.2% for OS, CS and GCTb respectively. The average age had no significant difference (p>0.05) in relation to metastases, even so, patients with OS and GCTb and metastases, were older while patients with CS and metastases were younger, in comparison to patients without metastases. Males had a higher frequency of metastases (68.2%, p = 0.09) in contrast to CS and GCTb, in which the metastases was more frequent in women with 51.9% (p = 0.44) and 57.9% (p = 0.56) respectively. Broadly, metastasis was associated with primary tumors located in the femur (44.4%), followed by the tibia (15.6%); metastases was more frequent when primary tumor of GCTb and OS were in the same bones, but were located in the hip (26.3%) for CS. Conclusions: The frequency of metastases in OS, GCTb and CS is high in our population and is determined by different clinicopathological variables related to the kind of tumor. Further studies are needed in order to evaluate metastases subsequent to diagnosis and associations with survival and clinicopathological factors, as well as to determine the sensitivity and specificity of current methods of detection.

• Imaging Science in Dentistry
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• 제49권4호
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• pp.281-286
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• 2019

Purpose: The purpose of this study was to evaluate the morphology of the mandibular cortex in cases of medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis or bone metastases using a computer programme. Materials and Methods: Fifty-four patients with MRONJ (35 with osteoporosis and 19 with bone metastases) were examined using panoramic radiography. The morphology of the mandibular cortex was evaluated using a computer programme that scanned the mandibular inferior cortex and automatically assessed the mandibular cortical index (MCI) according to the thickness and roughness of the mandibular cortex, as follows: normal (class 1), mildly to moderately eroded (class 2), or severely eroded (class 3). The MCI classifications of MRONJ patients with osteoporosis or bone metastases were evaluated with the Pearson chi-square test. In these analyses, a 5% significance level was used. Results: The MCI of MRONJ patients with osteoporosis(class 1: 6, class 2: 15, class 3: 14) tended to be higher than that of patients with bone metastases(class 1: 14, class 2: 5, class 3: 0)(P=0.000). Conclusion: The use of a computer programme to assess mandibular cortex morphology may be an effective technique for the objective and quantitative evaluation of the MCI in MRONJ patients with osteoporosis or bone metastases.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1405-1410
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• 2016

Background: The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Bone Metastases Module (EORTC QLQ-BM22) is a recently designed supplement to EORTC Quality of Life Questionnaire-C30 (EORTC QLQ-C30). Additional psychometric properties, especially using confirmatory factor analysis (CFA) and the Rasch model, are warranted. Materials and Methods: A total of 573 patients with bone metastases were enrolled from eight countries with a mean${\pm}$SD age of $55.8{\pm}13.7years$. Slightly more than two thirds of them were female (n=383; 66.8%). CFA was used to examine the BM22 framework; Rasch models were applied to understand misfit items and differential item functioning (DIF). Results: The fit indices were satisfactory in CFA (comparative fit index=0.972, Tucker-Lewis index=0.964, root mean square error of approximation=0.076, and standardized root mean square residual=0.045). All items fit well in the Rasch models (mean square values were between 0.5 and 1.5), and only one item (number 17) displayed DIF across gender. However, there were six DIF items across Canada and Taiwan, ten across Canada and Iran, and six across Taiwan and Iran. Conclusions: The BM22 has satisfactory psychometric properties, and could assess the QoL of patients with bone metastases specifically focusing on their symptoms. Clinicians may want to use it to capture the underlying QoL for patients with bone metastases. However, the score of item 17 should be interpreted with caution when comparing male and female patients. In addition, researchers should note that variation in DIF items may occur when conducting an international study.

• Tuberculosis and Respiratory Diseases
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• 제55권3호
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• pp.280-286
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• 2003

목 적 : 폐암의 골전이 진단을 위해 흔히 이용하는 골주사는 예민도는 높으나 특이도가 낮아서, 악성 병변과 양성 병변을 구분하는 데에는 유용성이 낮다. 최근 전신 촬영이 가능한 $^{18}FDG$ PET이 암 진단에 널리 이용되고 있으므로 폐암의 골전이를 진단하는데 있어서 골주사와의 차이를 비교하기 위해 후향적 연구를 시행하였다. 방 법 : 폐암으로 진단된 환자 중 골수사와 전신 $^{18}FDG$ PET를 시행한 시간 차이가 1달 이내인 92명을 대상으로 하였다. 골전이의 판정은 골주사와 $^{18}FDG$ PET에서 이상 부위를 단순 X-선, 자기공명영상으로 평가하거나, 추적 영상검사로 확진하였다. 결 과 : 폐암의 골전이를 판정하는데 있어서 골주사의 민감도, 특이도, 정확도는 각각 59%, 71%, 68%이었으며, $^{18}FDG$ PET의 경우 각각 82%, 94%, 91%으로 $^{18}FDG$ PET이 골주사보다 특이도와 정확도에서 유의하게 우월하였다(p<0.0001). 결 론 : 폐암의 골전이를 평가하는데 있어서 $^{18}FDG$ PET은 전통적인 골주사보다 유용한 검사로 생각된다.

• Journal of Hospice and Palliative Care
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• 제17권4호
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• pp.207-215
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• 2014

암의 다발성 뼈 전이는 폐암, 유방암, 전립선암, 신장암 등 다양한 암에서 흔히 관찰된다. 뼈 전이는 뼈에 발생한 이차적인 암으로 통증, 골절, 그리고 체중을 지지하는 뼈의 불안정성을 유발할 수 있어 신체활동과 삶의 질을 저하시킨다. 뼈 전이 치료 시 병리조직소견, 환자의 전신 상태, 침범 부위, 그리고 환자의 신경학적 소견등 다양한 요인을 고려하여 진통제, 수술, 항암화학요법 그리고 방사선 치료 등을 시행하게 된다. 외부 방사선 치료는 전통적으로 국소 뼈 전이로 인한 통증의 치료에 이용되어왔지만 특히 유방암이나 전립선암의 다발성 골형성 뼈 전이의 경우 $^{89}Sr$, $^{186}Re$, $^{188}Re$, $^{153}Sm$ and $^{117m}Sn$ 등의 방사성동위원소를 이용한 치료가 시행되고 있는데, 약제 투여의 간편함, 낮은 부작용, 방사능 피폭위험에서의 안전성, 높은 치료 반응 등 다양한 장점을 가진 치료로 임상에서의 유용성이 점차 증가되고 있다.

• 대한핵의학회지
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• 제27권1호
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• pp.98-103
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• 1993

The present study was purposed to evaluate the incidence and the characteristics of metastatic "cold" lesions in $^{99m}Tc$-MDP bone scans of adult patients with solid malignancies. There were 29 cold lesions in 24 patients. The incidence of cold lesions was about 1% of total cases of bone scans for the patients with malignancy, or 2.5% of cases with bone metastases. Th primary sites of malignancies were lung (four cases), uterine cervix (three cases), kidney, nasopharynx, thyroid, urinary bladder, prostate, lymphoma (two cases each other), liver, breast and others (one case each other). But the relative incidence of cold lesion in lung cancer and breast cancer was low. The most frequent site of cold lesion was spine, and pelvis, skull and rib were followed. The incidence of cold lesion was related to the regional incidence of bone metastases. The size of the cold lesions was greater than that of the hot. There were six cases of single cold lesion without any other abnormalities and two cases of cold lesion which were initially hot. So it should be considered that bone metastases might be presented as cold lesions in bone scan.