Bone metastases in patients with gastrinomas: a prospective study of bone scanning, somatostatin receptor scanning, and magnetic resonance image in their detection, frequency, location, and effect of their detection on management.

1998 ◽  
Vol 16 (3) ◽  
pp. 1040-1053 ◽  
Author(s):  
F Gibril ◽  
J L Doppman ◽  
J C Reynolds ◽  
C C Chen ◽  
V E Sutliff ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Liver Metastases ◽  
Bone Metastases ◽  
Bone Scan ◽  
Somatostatin Receptor ◽  
Axial Skeleton ◽  
Bone Lesions ◽  
Endocrine Tumors ◽  
Bone Scanning ◽  
Imaging Results

PURPOSE To determine whether bone scan, magnetic resonance imaging (MRI), or somatostatin receptor scintigraphy (SRS) is best for identifying bone metastases in patients with gastrinomas, as well as their frequency and location, whether their detection affects management, and what patient subgroups should be examined. MATERIALS AND METHODS One hundred fifteen patients with gastrinoma were prospectively studied. Patients were examined yearly and those with liver metastases were reexamined every 3 months. Based on clinical history, histology, growth pattern, and development of new bone lesions, possible bone metastases were classified as to whether they were or were not bone metastases. Imaging results were correlated at different times in the disease course and with disease extent. RESULTS Bone scan was positive in 52 patients, MRI in seven, and SRS in six. Eight patients (7%) were determined to have bone metastases and MRI was correctly positive in seven, SRS in six, and bone scan in five. SRS or MRI was positive in all patients with bone metastases. Bone scan had significantly lower specificity and sensitivity, and a higher rate (P < .02) of false-negative results than MRI or SRS. Bone metastases occurred in 31% of patients with liver metastases and 0% with only lymph node metastases. The initial bone metastases were in the spine or sacrum (75%) followed in descending order by the pelvis or sacroiliac joints (38%), scapula or shoulder, and ribs. In all cases, detection of bone metastases changed the management. CONCLUSION SRS and MRI, because of high sensitivity and specificity, are recommended over bone scanning to screen for bone metastases in patients with gastrinomas. However, because bone metastases can occur initially outside the axial skeleton, SRS is the recommended initial localization method of choice. Bone metastases occur in 7% of all patients and 31% of patients with liver metastases, only occur in patients with liver metastases, are usually in the axial skeleton initially, and their detection changes management in all cases. Patients with pancreatic endocrine tumors with liver metastases should undergo SRS every 6 months to 1 year to detect bone metastases.

Detection of Liver Metastases From Endocrine Tumors: A Prospective Comparison of Somatostatin Receptor Scintigraphy, Computed Tomography, and Magnetic Resonance Imaging

2005 ◽  
Vol 23 (1) ◽  
pp. 70-78 ◽  
Author(s):  
Clarisse Dromain ◽  
Thierry de Baere ◽  
Jean Lumbroso ◽  
Hubert Caillet ◽  
Agnès Laplanche ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Liver Metastases ◽  
Somatostatin Receptor ◽  
Somatostatin Receptor Scintigraphy ◽  
Emission Computed Tomography ◽  
Endocrine Tumors ◽  
Resonance Imaging ◽  
Receptor Scintigraphy

Purpose To compare the respective sensitivity of somatostatin receptor scintigraphy (SRS), computed tomography (CT), and magnetic resonance imaging (MRI) in the detection of liver metastases from well-differentiated gastroenteropancreatic endocrine tumor (WDGEP ET) patients. To define predictive factors for “high-sensitivity SRS.” Patients and Methods Sixty-four patients with WDGEP ET underwent SRS with abdominal single-photon emission computed tomography (SPECT), spiral CT, and 1.5-T MRI within a 15-day interval, the order of which was randomized. Two readers analyzed images of each modality, blindly and independently. Results Hepatic metastases were present in 40 of the 64 patients and confirmed by pathology after liver biopsy or surgery in 32 and eight patients, respectively. SRS, CT, and MRI detected a total of 204, 325, and 394 metastases, respectively. The number of detected metastases was significantly higher with MRI than with CT (P = .02) and SRS (P < 10−4) and higher with CT than with SRS (P < 10−4). SRS was negative in seven patients with a positive CT and/or MRI. More lesions were detected in 10 patients by SPECT compared with static views. The median metastasis size was significantly correlated (P = .04) with the sensitivity of SRS. Conclusion MRI seems to have an edge over CT and SRS for the detection of liver metastases from endocrine tumors. We recommend the systematic performance of liver MRI at WDGEP ET initial staging and before major therapeutic events. The low performance of SRS was mainly explained by the impact of the metastasis size on the detection capacity of SRS.

scholarly journals Role of magnetic resonance imaging in ankle sprains

2021 ◽  
Vol 25 (1) ◽  
pp. 438-445
Author(s):  
Nawroz Othman ◽  
Salwa AL-Najjar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Evaluation ◽  
Ankle Sprain ◽  
Soft Tissues ◽  
Ankle Injuries ◽  
Bone Lesions ◽  
Ankle Sprains ◽  
Resonance Imaging ◽  
Imaging Results

Background and objective: Musculoskeletal injuries frequently occur in the ankle in both the athletic and general population. Ankle sprains are among the most frequent types of ankle injuries, which are conventionally diagnosed through clinical examinations. However, magnetic resonance imaging can provide a more precise diagnosis, leading to better injury management and prevention of consequent chronic complications. The present study aimed to examine the significance of magnetic resonance imaging in detecting and assessing changes that occur in ligaments and soft tissues in patients with ankle sprains. Methods: In a prospective study, 50 patients with ankle sprain referred to Rizgary and Erbil Teaching hospitals in Erbil city, Iraqi Kurdistan Region, from March 2018 to April 2019, were included in the study. They underwent clinical evaluation and MRI (GE general electric 1.5 Tesla). Two expert radiologists analyzed the magnetic resonance imaging images, and the results were compared. The collected data were analyzed using SPSS version 23 through descriptive statistics. Results: Most patients (64%) belonged to the age groups of 30-49 years old. Most of them (64%) were males. Most events of ankle sprain (66%) were because of sports and accidents. The clinical evaluation proved 82% of the ankle sprains. Regarding the laterality of the lesions, 60% were spotted in the right ankles and 40% in the left. According to magnetic resonance imaging results, both radiologists diagnosed that the ankle sprains included bone lesions, ligament injury, tendon injury, and effusion. There was an agreement of ≥ 96% between the two radiologists in this regard. The two radiologists were not significantly different in terms of diagnosing the ligament side. As reported by the radiologists based on the magnetic resonance imaging images, the anterior, lateral, and medial tendons were normal in most cases. Conclusion: Magnetic resonance imaging is a vitally important tool that can be utilized reliably and accurately to diagnose and evaluate changes in ligaments and soft tissues in patients with ankle sprains. Keywords: Magnetic resonance imaging (MRI); Ankle sprain; Ligaments; Injuries.

Perspectives on Spinal Precautions in Patients Who Have Cancer and Spinal Metastasis

2020 ◽  
Vol 100 (3) ◽  
pp. 554-563
Author(s):  
Ying Guo ◽  
An Thuy Ngo-Huang ◽  
Jack B Fu
Keyword(s):  
Bone Metastases ◽  
Spinal Metastasis ◽  
Axial Skeleton ◽  
Bone Lesions ◽  
Patients With Cancer ◽  
Cancer Metastases ◽  
Physical Examinations ◽  
Breast And Prostate Cancer ◽  
Bony Metastases ◽  
Spinal Load

Abstract Bones are the third most common site for cancer metastases, and the axial skeleton is the most frequent skeletal location. In a postmortem study, bone metastases were reported in 70% of breast and prostate cancer patients. Bone metastases from breast, lung, prostate, thyroid, and kidney cancers account for 80% of all bone metastases. Bone lesions exist in 60% of newly diagnosed multiple myeloma patients. With increasing numbers of people who have survived cancer, many patients with cancer and axial skeletal bony metastases will be seen by physical and occupational therapists. Guidelines are lacking on how to perform physical examinations and provide exercise programs for these patients without compromising the diseased spine. In this article, we discuss the available evidence for similar spinal conditions, the biomechanics of spinal load, and changes associated with posture and weight load. We provide recommendations on how to assess a patient’s strength, how to strengthen without compromising the diseased spine, and how to teach patients to use correct body mechanics during mobility and activities of daily living.

scholarly journals HYBRID BONE SCINTIGRAPHY IN GASTROINTESTINAL MALIGNANCIES – INSTITUTIONAL EXPERIENCE

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Nazia Rashid ◽  
Saima Riaz ◽  
Humayun Bashir ◽  
Shafqat Mehmood
Keyword(s):  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Bone Scan ◽  
Axial Skeleton ◽  
Emission Computed Tomography ◽  
Appendicular Skeleton ◽  
Osseous Metastasis ◽  
Gastrointestinal Malignancies ◽  
Metastatic Lesions ◽  
Bone Scans

Objective: Bone metastases in gastrointestinal (GI) malignancies are uncommon and known to be predominantly lytic thus rendering a limited role for conventional bone scintigraphy. The aim of the study is to review Tc99m MDP bone scans performed in patients with known GI malignancy and the utility of Single-photon emission computed tomography (SPECT)/CT in characterization of bone lesions.Methods: Retrospective review of bone scans was done from June 2014 to December 2016 in patients with known GI malignancy, using electronic Hospital Information System.Results: A total of 110 patients (60 males, 50 females; Age range: 22–84 years, Mean Age 51.4 years with SD of 14.8) had bone scan over a period of 30 months. The commonest indications for referral were suspected bone metastasis on other imaging modalities including [CT (n = 56), Magnetic resonance imaging (n = 10), Positron emission tomography/CT (n = 6)], musculoskeletal pain (n = 37), pathological fracture (n = 1), neurological symptoms (n = 1), hypercalcemia (n = 1) and others (n =14) including restaging workup etc. Metastatic lesions were identified in 32 (29%) patients whereas 78 (71%) patients had benign non-aggressive lesions leading to normal bone scans. Among 32 patients with osseous metastasis, 8 (25%) patients had unifocal lesion; axial skeleton (n = 2) appendicular skeleton (n = 6), 24 (75%) patients had multifocal lesions; axial skeleton (n = 6), appendicular skeleton (n = 6) and both axial + appendicular (n = 12). Four (12%) patients had concurrent visceral metastases. In our cohort, based on the location of primary tumour, the frequencies of osseous metastasis were; esophagus = 15 out of 43 (35%), gastric = 7 out of 18 (39 %), gastro-esophageal junction = 1 out of 8 (1.5%) and colorectal = 9 out of 40 (22.5). SPECT/CT was acquired in 29 out of 110 patients, which characterized metastatic lesions (n = 12) and benign looking non-aggressive entities (n =17). Overall, bone scan upstaged disease in 31% and down staged 15% patients.Conclusion: Bone metastases in GI malignancies, though uncommon, show an aggressive pattern, with axial and appendicular involvement, and can be readily identified with hybrid bone scintigraphy in symptomatic patients. Key words: Hybrid imaging, Tc99m MDP, bone metastases, gastrointestinal malignancies

Activity of cabozantinib (XL184) in metastatic breast cancer (MBC): Results from a phase II randomized discontinuation trial (RDT).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 535-535 ◽  
Author(s):  
Eric P. Winer ◽  
Sara Tolaney ◽  
Hovav Nechushtan ◽  
Raanan Berger ◽  
Razelle Kurzrock ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastases ◽  
Bone Scan ◽  
Tumor Regression ◽  
Objective Response ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Bone Lesions ◽  
Respiratory Compromise ◽  
Open Label

535 Background: Dysregulation of MET and VEGF signaling has been implicated in breast cancer development and progression, including tumor invasion and dissemination. Cabozantinib (cabo) is an oral, potent inhibitor of MET and VEGFR2. A RDT evaluated activity and safety in 9 tumor types, including MBC. Methods: Eligible patients (pts) were required to have progressive measurable disease per RECIST. Pts received cabo at 100 mg qd over a 12 wk Lead-in stage. Tumor response (mRECIST) was assessed q6 wks. Treatment ≥ wk 12 was based on response: pts with PR continued open-label cabo, pts with SD were randomized to cabo vs placebo, and pts with PD discontinued. Primary endpoint in the randomized discontinuation phase was progression-free survival (PFS). Results: Enrollment to this cohort is complete (n = 45); all pts are unblinded. Baseline characteristics: median age 56; invasive ductal 86%, invasive lobular 7%; ER+ 93%, HER2+ 18%, triple- 5%; visceral disease 91%; bone metastases 73%; median prior lines of therapy 3 (range 1-8), including 71% with prior anthracyclines. Median follow-up was 2.9 mos (range 0.1 -16). 21 pts (47%) completed Lead-in stage with only 9 randomized to continue cabo (n = 5) or placebo (n = 4). Median PFS from Study Day 1 was 4.1 mos. At wk 12, objective response rate was 14% and disease control rate 48%. Tumor regression was observed in 25/39 pts (64%) with ≥1 post-baseline tumor assessment. 4/10 pts evaluable by bone scan had partial resolution of bone lesions. Of 12 pts receiving narcotics for bone pain, 5 pts reported improved pain and 2 pts had decreased narcotics use, per investigator. 4/14 evaluable pts (29%) with bone metastases experienced ≥50% decline in serum NTx. Most common Grade 3/4 AEs were palmar-plantar erythrodyesthesia (13%) and fatigue (11%). One related Grade 5 AE of respiratory compromise was reported during the Lead-in stage. Conclusions: Cabo demonstrated a 14% rate of objective tumor regression in heavily pretreated MBC pts. Observed effects on bone scan and pain are consistent with those seen in other malignancies. The safety profile of cabo was comparable to that seen with other VEGFR TKIs.

Magnetic resonance imaging of the axial skeleton enables objective measurement of tumor response on prostate cancer bone metastases

The Prostate ◽  
2005 ◽  
Vol 65 (2) ◽  
pp. 178-187 ◽  
Author(s):  
Bertrand Tombal ◽  
Afshin Rezazadeh ◽  
Patrick Therasse ◽  
Paul J. Van Cangh ◽  
Bruno Vande Berg ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Bone Metastases ◽  
Tumor Response ◽  
Axial Skeleton ◽  
Objective Measurement ◽  
Resonance Imaging

Magnetic Resonance Imaging of the Axial Skeleton for Detecting Bone Metastases in Patients With High-Risk Prostate Cancer: Diagnostic and Cost-Effectiveness and Comparison With Current Detection Strategies

2007 ◽  
Vol 25 (22) ◽  
pp. 3281-3287 ◽  
Author(s):  
Frédéric E. Lecouvet ◽  
Daphné Geukens ◽  
Annabelle Stainier ◽  
François Jamar ◽  
Jacques Jamart ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
High Risk ◽  
Magnetic Resonance ◽  
Bone Metastases ◽  
Axial Skeleton ◽  
Resonance Imaging ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

Purpose To evaluate the diagnostic performance, costs, and impact on therapy of one-step magnetic resonance imaging (MRI) of the axial skeleton (MRIas) for detecting bone metastases in patients with high-risk prostate cancer (PCa). Patients and Methods Sixty-six consecutive patients with high-risk PCa prospectively underwent MRIas in addition to the standard sequential work-up (SW) of bone metastases (technetium-99m bone scintigraphy [BS] completed with targeted x-rays [TXR] in patients with equivocal BS findings and with MRI obtained on request [MRIor] in patients with inconclusive BS/TXR findings). Panel review of initial and 6-month follow-up MRI findings, BS/TXR, and all available baseline and follow-up clinical and biologic data were used as the best valuable comparator to define metastatic status. Diagnostic effectiveness of MRIas alone was compared with each step of the SW. Impact of MRIas screening on patient management and costs was evaluated. Results On the basis of the best valuable comparator, 41 patients (62%) had bone metastases. Sensitivities were 46% for BS alone, 63% for BS/TXR, 83% for BS/TXR/MRIor, and 100% for MRIas; the corresponding specificities were 32%, 64%, 100%, and 88%, respectively. MRIas was significantly more sensitive than any other approach (P < .05, McNemar). MRIas identified metastases in seven (30%) of 23 patients considered negative and eight (47%) of 17 patients considered equivocal by other strategies, which altered the initially planned therapy. Economic impact was variable among countries, depending on reimbursement rates. Conclusion MRIas is more sensitive than the current SW of radiographically identified bone metastases in high-risk PCa patients, which impacts the clinical management of a significant proportion of patients.

Osseous metastases of gastro- entero - pancreatic neuroendocrine tumours

2012 ◽  
Vol 51 (03) ◽  
pp. 95-100 ◽  
Author(s):  
F. Heinemann ◽  
S. Guhlke ◽  
M. Muckle ◽  
W. Willinek ◽  
H.-J. Biersack ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Functional Imaging ◽  
Peptide Receptor Radionuclide Therapy ◽  
Rank Test ◽  
Bone Lesions ◽  
Time To Progression ◽  
Effective Treatment Option ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Imaging Results

SummaryAim: Peptide receptor radionuclide therapy with 177Lu-octreotate is an effective treatment option for metastatic gastroenteropancreatic neuroendocrine tumors (GEP NET) and allows intratherapeutic imaging through a 177Lu-octreotate scan (LuS). The diagnostic value of this treatment scan is not yet established. This study aims to compare the sensitivity of LuS and bone scintigraphy (BS) regarding bone metastases and investigate potential implications of functional imaging results. Patients, methods: We retrospectively analyzed 29 consecutive GEP NET patients with bone metastases and baseline BS treated with 177Lu-octreotate. A semi-quantitative scoring system was used for the comparative evaluation. Treatment outcome (time-to-progression of bone metastases) was correlated with the intra-individual imaging discrepancy (Kaplan- Meyer curves, log-rank test, p < 0.05). Results: In 19 of 29 patients (65.5%) LuS was superior (LuS > BS), whereas in 10 patients (34.5%) both modalities were comparable. BS showed no additional (LuS-negative) metastatic bone lesions in our cohort. None of the investigated baseline characteristics was associated with Imaging discrepancy. On the other hand, functional imaging discrepancy had no impact on treatment response (p = 0.43) or time-to-progression (p = 0.92). Conclusions: Intra-therapeutic 177Lu-octreotate imaging is superior over bone scintigraphy for detection of bone metastases in GEP NET. BS may help to distinguish osseous from non-osseous localization. The presence of an osteoblastic correlate in BS seems to have no impact on therapeutic outcome

scholarly journals Prostate Cancer Presenting with Parietal Bone Metastasis

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Brahima Kirakoya ◽  
Abdoul Karim Pare ◽  
Babagana Mustapha Abubakar ◽  
Moussa Kabore
Keyword(s):  
Prostate Cancer ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Metastatic Prostate Cancer ◽  
Axial Skeleton ◽  
Parietal Bone ◽  
Cranial Bone ◽  
Bone Lesions ◽  
Urological Symptoms ◽  
Left Parietal Bone

Bone metastases from prostate cancer are very common. They are usually located on the axial skeleton. However, cranial bone metastases especially to the parietal bone are rare. We report a case of metastatic prostate cancer presenting with left parietal bone metastasis in a patient with no urological symptoms or signs. We should consider prostate cancer in any man above 60 years presenting unusual bone lesions.

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