• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.5
• /
• pp.495-498
• /
• 2009

Brown tumor is the benign bone lesion consists of woven bone and fibrous tissue without matrix, which develop due to chronic excessive osteoclastic activity such as hyperparathyroidism. Usually they appear with normal uptake or occasionally focally increased uptake on bone scan. We present a case with brown tumor shown more increased uptake and more number of lesions on bone scan after parathyroidectomy, and lesser increased uptake on serial bone scans without any other treatment through several months. This finding is thought to be similar to 'flare phenomenon' which is occasionally seen after treatment of metastatic bone lesions of malignant cancer, and may represent curative process of brown tumor with rapid normal bone formation.

• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.2
• /
• pp.154-155
• /
• 2009

A 45-year-old man presented with fatigue and weight loss underwent a Tc-99m MDP bone scan because of increased serum alkaline phosphatase. Delayed images at 4 hours demonstrated diffuse increased activity throughout both lobes of the thyroid in the absence of activity of the stomach and salivary glands. Thyroid laboratory indices and a Tc-99m pertechnetate thyroid scan suggested Graves' hyperthyroidism.

• Journal of Digestive Cancer Research
• /
• v.4 no.1
• /
• pp.39-42
• /
• 2016

A 67-year-old male was admitted due to abdominal pain. Abdominal CT scan performed in a local clinic showed about 2 cm sized pancreatic tail mass with extensive liver and multiple regional lymph node metastasis. Histology of liver biopsy revealed poorly differentiated adenocarcinoma. He underwent chemotherapy with gemcitabine and erlotinib for 5 cycles followed by 8 cycles of second line chemotherapy with 5-fluorouracil and cisplatin. At 12 months after diagnosis, follow-up abdominal CT scan revealed marked reduction of tumor mass in the liver and pancreas with small residual tumor. After one month of last chemotherapy, he complained radiating pain along left leg. Blood chemistry revealed isolated elevation of alkaline phosphatase (ALP) and multiple bone metastasis were demonstrated in bone scan. Palliative radiation therapy to pelvic bone was performed for the relief of bone pain. The prognosis of advanced pancreatic cancer is extremely poor. We report late occurrence of multiple bone metastasis in a patient with well controlled advanced pancreatic cancer with chemotherapy.

• Journal of Chest Surgery
• /
• v.35 no.6
• /
• pp.454-459
• /
• 2002

Clinical analysis of the relation between the clinical data of chest trauma patients and bone scan results was done to investigate the sensitivity and specificity of bone scan for the diagnosis of rib or chondral fracture. Material and Method： 445 patients treated due to chest trauma in Dongguk University Kyungju Hospital from July 1998 to December 2001 were studied. Age and sex distribution, causes of chest trauma, interval from the injury to arrival at hospital, final diagnosis, relationship between the chest pain and bone scan results, relationship between local tenderness and bone scan results, and sensitivity and specificity of bone scan were studied. Result： The male was 61.6% and the female was 38.4%. Age distribution was nearly even from the twenties to the sixties. The traffic accident was the most common cause of chest injury(60.4%). Most patients(76.6%) were arrived to the hospital within 6 hours after chest trauma. Rib fracture was the most common final diagnosis(46.5 %). The relationship between the duration of chest pain and tenderness and the bone scan results were significant, and the same in the relationship between the duration of local tenderness and the bone scan results, but the latter is more significant. The sensitivity of bone scan was 99.4% and the specificity was 90.4%. Conclusion： If the patient complains the chest pain continuously and the local tenderness around the chest is continued over 3 weeks, it is good to perform the bone scan. Further study including the MRI may be helpful for more evaluation in chest trauma patients.

• Journal of Veterinary Clinics
• /
• v.18 no.4
• /
• pp.465-468
• /
• 2001

Elbow hygroma and hypertrophic osteodystrophy were diagnosed in Doberman referred to Veterinary Teaching Hosptial of Chungbuk national University. Physical examination, plain radiography, and bone scan were performed in the patient. The radiography revealed soft tissue swelling on the caudal region of the elbow and irregular radiolucent zone involving the metaphysis subjacent and parallel to the distal radial and ulnar physes. The bone scan of the forelimbs revealed increased uptake in region where the soft, fluid-filled mass on the elbow was present. But the radiolucent areas (the distal radial and ulnar physes) were seen normal bone uptake. Therefore, hypertrophic osteodystrophy ruled out the diagnosis. $^{99m}Tc-MDP$ scan is suitable to routine clinical use for soft tissue inflammation and bone lesions detection.

• Brain Tumor Research and Treatment
• /
• v.6 no.2
• /
• pp.68-72
• /
• 2018

We report a rare case of arachnoid granulations mimicking multiple osteolytic bone lesions. A 66-year-old woman was admitted to a local clinic for a regular checkup. Upon admission, brain CT showed multiple osteolytic lesions in the occipital bone. These needed to be differentiated from multiple osteolytic bone tumor. Subsequent brain MRI revealed that the osteolytic lesions were isointense to cerebrospinal fluid, hyperintense on T2-weighted image, hypointense on T1-weighted image, and with subtle capsules around the osteolytic lesions that were visible after gadolinium injection. A bone scan revealed no radiotracer uptake. The lesions were in both the transverse sinuses and the torcular herophili. With typical radiological appearances of the lesions, the osteolytic lesions were diagnosed as multiple arachnoid granulations. No further treatment was planned. A 1-year follow-up brain CT scan revealed no change. We should consider the possibility of arachnoid granulations when multiple osteolytic lesions are observed in the occipital bone.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.3
• /
• pp.1187-1191
• /
• 2016

Background: The prevalence of prostate cancer (PCa) has been increasing in recent years. Treatment strategies are largely based on the results of bone scan screening. Therefore, our aim was to investigate predictors of positive bone metastasis in newly diagnosed PCa patients. Materials and Methods: After extensive review, 336 consecutive patients newly diagnosed with PCa between April 2010 and November 2013 at our institution were enlisted in the study. Patients were divided into two groups according to bone scan results. Univariate analyses (Chi-square test for discrete variables and independent t-test for continuous variables) were applied to determine the potentially significant risk factors associated with distant bone metastasis. Binary logistic regression analyses were used to further investigate the influence of these factors on bone metastasis. Results: The patient mean age was $71.9{\pm}8.6years$ (range: 48 to 94 years). The mean prostate specific antigen (PSA) level and biopsy Gleason score were $260.2{\pm}1107.8ng/mL$ and $7.4{\pm}1.5$, respectively. The body mass index (BMI) for the series was $24.5{\pm}3.4kg/m^2$. Sixty-four patients (19.0%) had a positive bone scan result. Patients with positive bone scan results had a significantly lower BMI ($23.3{\pm}3.5$ vs. $24.8{\pm}3.3$; p=0.003), a higher Gleason score ($8.5{\pm}1.1$ vs. $7.1{\pm}1.5$; p < 0.001), and a higher PSA level ($1071.3{\pm}2337.1$ vs. $69.4{\pm}235.5$; p < 0.001) than those without bone metastasis. Multivariate logistic regression analysis employing the above independent predictors demonstrated that a Gleason score of ${\geq}7$, clinical stage ${\geq}T3$, $BMI{\leq}22kg/m^2$, and an initial PSA level of ${\geq}20ng/mL$ were all independent predictors of bone metastasis. Conclusions: A bone scan might be necessary in newly diagnosed PCa patients with any of the following criteria: clinical stage T3 or higher, a Gleason score of 7 or higher, BMI equal to or less than 22, and a PSA level of 20 or higher.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.3
• /
• pp.218-228
• /
• 2008

Purpose: Our purpose was to evaluate spinal bony metastasis which could be missed on an F-18 FDG PET/CT (FDG PET/CT) alone, and to characterize discordant metastatic lesions between FDG PET/CT and bone scan. Material and Methods: FDG PET/CT and bone scans of 43 patients with spinal bony metastasis were analyzed retrospectively. A McNemar test was performed comparing the FDG PET/CT alone to the FDG PET/CT plus bone scan in the spinal bony metastases. A one-way chi-square test was performed to characterize the metastases that were missed on the FDG PET/CT alone. To evaluate discordant lesions between FDG PET/CT and bone scan, we performed logistic regression analyses. The independent variables were sites (cervical, thoracic, and lumbar), size (large and small), and maximum SUVs, and the dependant variable was bone scan uptake (positive and negative MDP uptake). Results: A significant difference was found between the FDG PET/CT alone and the FDG PET/CT combined with the bone scan (p < 0.01). Using the FDG PET/CT only, diffuse osteoblastic metastasis was missed with a significantly higher frequency (p = 0.04). In the univariate analysis, cervical vertebra and small size were related to negative MDP uptake, and thoracic vertebra and large size were related to positive MDP uptake. However, in the multivariate analysis, only the large size was related to positive MDP uptake. Conclusion: A bone scan in addition to the FDG PET/CT increased the ability to evaluate spinal bony metastases, especially for diffuse osteoblastic metastasis. Large metastasis was related to positive bone scan uptake in spinal bony metastasis.

• The Korean Journal of Nuclear Medicine
• /
• v.27 no.2
• /
• pp.298-304
• /
• 1993

To estimate the bone marrow involvement of leukemia, we peformed scintigraphies using $^{99m}Tc$ antimony sulfide colloid and Gallium-67. Total 13 patients were included and obtained 14 study sets of $^{99m}Tc$ antimony sulfide colloid and gallium-67 and compared with bone marrow aspiration biopsy and clinicolaboratory datas. $^{99m}Tc$ Antimony scan showed localized defect in 4 patients who had relapse. No false positive or negative results were observed. Gallium 67 showed localized increased uptake in 2 of 4 relapsed patients. Therefore, bone marrow scan is useful for the evaluation of marrow infiltration in ieukemic patients.

• 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.