Potential Application of Bone Scintigraphy in Nasopharyngeal Carcinoma With Skull Base and Adjacent Bony Involvement

Background: Bone scintigraphy has an established role to evaluate skeletal metastasis by detecting lesions earlier compared with radiographic changes. Skull base and adjacent bony involvement could possibly be evaluated using bone scintigraphy and might influence nasopharyngeal carcinoma (NPC) treatment planning. Skull base lesions in NPC are also associated with concomitant skeletal metastases. Aim: To determine clinical characteristics of NPC patients with skull base lesions and adjacent bony involvement who underwent bone scintigraphy and their scan findings. Methods: Bone scintigraphy performed for 87 NPC patients between June 2014 and February 2018. Whole-body imaging acquired at 3 hours after 99mTc methylene diphosphonate (MDP) injection. Clinical information and scintigraphic findings were compiled. Patients with prior evidence and/or bone scintigraphic features of skull base lesions or adjacent bony involvement were included (n = 46). Synchronous malignancy or ongoing bone infection cases were excluded. Results: 17 patients had prior evidence of skull base or adjacent bony involvement that were all subsequently positive on bone scintigraphy. We detected another 29 patients with MDP-avid skull base or adjacent bony involvement. Average age of entire cohort was 51 years. Approximately 78% were males. Majority were ethnic Chinese (48%). Most patients (57%) had stage 4 diseases prior to bone scintigraphy with 9 patients demonstrating distant metastasis mainly to lungs and bones. Only 28 patients were receiving ongoing treatment. Overall, 18 patients (39%) showed concomitant MDP-avid skeletal metastases on whole-body imaging. Patients whom already had existing documented distant metastasis were significantly associated with concomitant MDP-avid skeletal metastases ( P < 0.05), while other parameters including gender, age, ethnicity, disease staging and treatment status showed no significant correlation. Conclusion: Bone scintigraphy could potentially be used to assess skull base and adjacent bony involvement besides concomitant skeletal metastasis among our cohort of NPC patients.

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SURVIVAL IMPACT OF SKELETAL METASTASIS ON BONE SCINTIGRAPHY IN PATIENTS WITH GERM CELL TUMOURS

Journal of Cancer & Allied Specialties ◽

10.37029/jcas.v2i4.88 ◽

2016 ◽

Vol 2 (4) ◽

Author(s):

Maimoona Siddique ◽

Aamna Hassan ◽

Saadiya J Khan

Keyword(s):

Germ Cell ◽

Bone Metastases ◽

Bone Scintigraphy ◽

Bone Scan ◽

Disease Free Survival ◽

Skeletal Metastasis ◽

Whole Body ◽

Skeletal Metastases ◽

Germ Cell Tumours ◽

Visceral Metastases

Objective: Our aim was to determine the frequency of skeletal metastasis in germ cell tumours (GCT) at baseline and relapse on conventional technetium-99m methylene diphosphonate (Tc-99m MDP) whole body bone scan (bone scan) and to evaluate the effect of bone metastases on survival. Materials and Methods: Electronic medical records of histologically proven GCT over 64 months were retrospectively analysed. Basic demographic and histologic information were correlated with the presence of osseous and visceral metastases. 5-year disease-free survival (DFS) and overall survival (OS) were calculated in presence, the absence of bone metastases at baseline and at relapse. Results: A total of 130 gonadal and extragonadal GCT patients underwent Tc-99m MDP bone scans; four with insuf cient data were excluded from the study. 47% were females and 53% were males with the age range of 1 month – 72 years. 105 (83%) were under 18 years of age. Osseous metastasis was detected in 12 (9.5%). Two (17%) had solitary and 10 (83%) had multifocal skeletal metastases. Clinically, 83% had localised bone pain. Osseous metastases were more frequently associated with mixed GCT and yolk sac tumour. 50% of mediastinal GCT developed bone metastases. 42% died within 4–18 months. There was a statistically signi cant impact of visceral metastases on DFS and OS. OS at 5 years in patients without bone metastases, with bone metastases at baseline and bone metastases at relapse, was 77%, 38% and 75%, respectively. 5-year DFS for the same cohort groups was 63%, 38% and 20%, respectively. Conclusion: Osseous involvement was found in 9.5% of GCT patients undergoing diagnostic Tc-99m MDP bone scan. Baseline skeletal evaluation for metastases should be done, particularly in the case of bone pains or known systemic metastases. Although skeletal relapses are rare, they have a grim outcome. Key words: Bone scintigraphy, germ cell tumours, skeletal metastases

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Scintigraphy with 99m Tc-Phosphonate and 67Gallium in Patients Suspected of Primary Bone Tumors

Nuklearmedizin ◽

10.1055/s-0037-1620567 ◽

1982 ◽

Vol 21 (04) ◽

pp. 136-139 ◽

Cited By ~ 2

Author(s):

C.-J. Edeling

Keyword(s):

Soft Tissue ◽

Bone Scintigraphy ◽

Primary Tumor ◽

Bone Tumors ◽

Whole Body ◽

Skeletal Metastases ◽

Malignant Bone Tumors ◽

67Ga Scintigraphy ◽

Primary Bone Tumors ◽

Primary Bone

Whole-body scintigraphy with both 99mTc-phosphonate and 67Ga was performed on 92 patients suspected of primary bone tumors. In 46 patients with primary malignant bone tumors, scintigraphy with 99mTc-phosphonate disclosed the primary tumor in 44 cases and skeletal metastases in 11, and 67Ga scintigraphy detected the primary tumor in 43 cases, skeletal metastases in 6 cases and soft-tissue metastases in 8 cases. In 25 patients with secondary malignant bone tumors, bone scintigraphy visualized a single lesion in 10 cases and several lesions in 15 cases, and 67Ga scintigraphy detected the primary tumor in 17 cases, skeletal metastases in 17 cases and soft-tissue metastases in 9 cases. In 21 patients with benign bone disease positive uptake of 99mTc-phosphonate was recognized in 19 cases and uptake of 67Ga in 17 cases. It is concluded that bone scintigraphy should be used in patients suspected of primary bone tumors. If malignancy is suspected, 67Ga scintigraphy should be performed in addition.

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