scholarly journals Role of Whole-Body Tc 99m MDP Bone Scintigraphy for Evaluating Skeletal Metastasis in Patients with Lung Cancer

2017 ◽  
Vol 42 (3) ◽  
pp. 132-136
Author(s):  
Rawnak Afrin ◽  
Fatema Sultana Haque ◽  
Shankar Kumar Biswas ◽  
Sanowar Hossain ◽  
Mahmood Uz Jahan
Keyword(s):  
Lung Cancer ◽  
Cell Carcinoma ◽  
Bone Scintigraphy ◽  
Bone Scan ◽  
Metastatic Cancer ◽  
Lumbar Vertebrae ◽  
Cost Effective ◽  
Skeletal Metastasis ◽  
Whole Body ◽  
Thoracic Vertebrae

Lung cancer is the third most common site of origin of metastatic cancer deposits in bone, after breast and prostate. It’s metastasis to bone is one of the most aggressive tumors and has a very unfavorable prognosis.  This retrospective descriptive study was designed to detect the skeletal metastasis of   carcinoma (Ca) lung patient by Tc 99m MDP bone scan. The medical records of all patients attended between January 2015 and July 2015 with a diagnosis of lung cancer were reviewed. Lung cancer in all patients was confirmed pathologically, and patients underwent whole-body bone scan for evaluating skeletal metastasis.  Patient with clinical and laboratory evidence of infection, trauma, metabolic disease or arthropathy were not included in the study. Bone scan was done after three hours of   intravenous administration of 20mci Tc 99m MDP   (methylene diphosphonate) and images were obtained on a gamma camera.  The mean age of the patients was Mean ± SD was 55.5 ± 12.5   with range from 31 to 90 years.  Out of 47 cases, 36 (76.59%) were diagnosed as positive for skeletal metastasis by bone scan and 11 (23.41%) were negative for bony metastasis. Among 36 positive patients, 28 patients (77.86%) were histopathologically diagnosed as adenocarcinoma, 7 patients (19.44%) had squamous cell carcinoma and only one patient (2,7%) had small cell carcinoma. Bone scan findings were compared by either conventional X-ray/CT scan/MRI /pathologically. In present study, the distribution of lesions in bone scan had recorded. Maximum 47.22 % lesions were found in ribs, 27.77% lesions were in lumbar vertebrae, 19.44% in thoracic vertebrae, 19.44% in joints, 16.66% in long bones (femur and humerus), 11.11% in skull bones, 22.22% in pelvic bones, 5.55% in clavicle and 2.77% in scapula. Tc 99m MDP bone scan plays a pivotal role for detection of skeletal metastasis which is very essential to manage Ca lung patient. As bone scintigraphy is very cost effective in govt. nuclear medicine centre in comparison to other imaging modalities, so it can play a major role in detecting skeletal metastasis in ca lung patients in a developing country like Bangladesh.

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

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 

Automated detection of skeletal metastasis of lung cancer with bone scans using convolutional nuclear network

2021 ◽  
Author(s):  
Tongtong Li ◽  
Qiang Lin ◽  
Yanru Guo ◽  
Shaofang Zhao ◽  
Xianwu Zeng ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Bone Metastasis ◽  
Image Classification ◽  
Bone Scan ◽  
Data Augmentation ◽  
Skeletal Metastasis ◽  
Automated Classification ◽  
Data Preparation ◽  
Region Extraction ◽  
Multi Class Classification

Abstract Bone scan is widely used for surveying bone metastases caused by various solid tumors. Scintigraphic images are characterized by inferior spatial resolution, bringing a significant challenge to manual analysis of images by nuclear medicine physicians. We present in this work a new framework for automatically classifying scintigraphic images collected from patients clinically diagnosed with lung cancer. The framework consists of data preparation and image classification. In the data preparation stage, data augmentation is used to enlarge the dataset, followed by image fusion and thoracic region extraction. In the image classification stage, we use a self-defined convolutional neural network consisting of feature extraction, feature aggregation, and feature classification sub-networks. The developed multi-class classification network can not only predict whether a bone scan image contains bone metastasis but also tell which subcategory of lung cancer that a bone metastasis metastasized from is present in the image. Experimental evaluations on a set of clinical bone scan images have shown that the proposed multi-class classification network is workable for automated classification of metastatic images, with achieving average scores of 0.7392, 0.7592, 0.7242, and 0.7292 for accuracy, precision, recall, and F-1 score, respectively.

scholarly journals Is there a role of whole-body bone scan in patients with esophageal squamous cell carcinoma

BMC Cancer ◽  
2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Shau-Hsuan Li ◽  
Yung-Cheng Huang ◽  
Wan-Ting Huang ◽  
Wei-Che Lin ◽  
Chien-Ting Liu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Bone Scan ◽  
Whole Body ◽  
Body Bone

scholarly journals Evaluation of asymptomatic skeletal metastasis by 99mTc MDP bone scans in NSCLC patients attending INMAS, Rajshahi

2018 ◽  
Vol 20 (2) ◽  
pp. 110
Author(s):  
Munshi Md Arif Hosen ◽  
Nasrin Begum ◽  
Pervez Ahmed ◽  
Mosharrof Hossain ◽  
Kabiruzzaman Shah ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Bone Metastasis ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Bone Scan ◽  
Skeletal Metastasis ◽  
Small Cell ◽  
Small Cell Lung ◽  
Bone Scans ◽  
Nsclc Patients

<p><strong><em>Background: </em></strong>Lung cancer is the leading cause of cancer deaths worldwide. Lung cancer is often insidious, producing no symptoms until the disease is well advanced. In approximately 7-10% of cases, lung cancer is diagnosed in asymptomatic patients. Some patients are asymptomatic for skeletal metastasis and a recent prospective study showed that in staging of non-small cell lung cancer (NSCLC), failure to perform a bone scan could miss asymptomatic bone metastasis in 14–22% of patients. Radionuclide bone scintigraphy with <sup>99m</sup> Tc MDP (Technetium-99mmethylene diphosphonate) is very useful nuclear imaging tool to detect skeletal metastasis with a sensitivity of 98.2% and a specificity of 95.2%. The aim of this study was to detect the asymptomatic skeletal metastasis of non-small cell lung cancer patients by <sup>99m</sup>Tc MDP bone scan.</p><p><strong><em>Patients and methods:</em></strong> It is a retrospective study, carried out from January 2015 to December 2016 in Institute of Nuclear Medicine and Allied Sciences, Rajshahi. Bone scan was performed by an intravenous bolus injection of 20 m Ci <sup>99m</sup>Tc MDP. Bone phase images were taken at three hours after injection of the radiotracer.</p><p><strong><em>Results:</em></strong> A total of 52 patients were enrolled in the study. The mean age of the patients was 57.6 ± 14.5 years (mean ± SD) with range from 36 to 75 years and 42 (80.77%) were male and 10 (19.23%) were female. Out of 52 patients, only 06 (11.54%) patients were diagnosed as positive and 46 (88.46%) were negative for bone metastasis. Out of 06 patients with positive skeletal metastasis 04 (66.67%) patients had multiple sites (two or more) and 02 (33.33%) patients had solitary site of bone involvement. Common sites of metastasis were in thoracic (83.33%) and lumbar spine (83.33%), ribs (50%), pelvic bones (33.33%), long bones (16.66%), skull (16.66%) and other bony sites including clavicle, sternum, scapula, sacrum (16.66%). Regarding staging prior to bone scan, out of 06 bone scan positive patients 03 (50%) patients were in stage III, 02 (33.33%) patients were in stage IV and 01(16.67%) patient was in stage II. On the basis of histopathology, out of 06 skeletal metastatic patients 04 (66.67%) patients had adenocarcinoma, 01 (16.67%) patient had squamous cell carcinoma and 01 (16.67%) had large cell carcinoma. The exclusion of bone metastasis is important in the initial staging of non-small cell lung cancer.</p><p><strong><em>Conclusion:</em></strong> There is debate about whether bone scans should be performed routinely or restricted to patients who present with clinical or laboratory indicators suggesting skeletal metastasis. The present study indicates that if bone scans were done only in patients reporting skeletal symptoms an important number of patients (11.54%) would have been miss-staged due to asymptomatic bone metastasis. As bone scan is very cost effective in comparison to other imaging modalities (MRI / PET-CT), it can play a vital role in detecting asymptomatic skeletal metastasis in NSCLC patients.</p><p>Bangladesh J. Nuclear Med. 20(2): 110-114, July 2017</p>

Skeletal metastases in advanced pancreatic ductal adenocarcinoma (PDAC): A retrospective analysis.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 245-245
Author(s):  
Akshjot Puri ◽  
John Chang ◽  
Tomislav Dragovich ◽  
Patricia Lucente ◽  
Madappa N. Kundranda
Keyword(s):  
Retrospective Analysis ◽  
Cervical Vertebrae ◽  
Lumbar Vertebrae ◽  
Skeletal Metastasis ◽  
Ductal Adenocarcinoma ◽  
Skeletal Metastases ◽  
Initial Symptom ◽  
Intractable Pain ◽  
Thoracic Vertebrae ◽  
Pathological Fractures

245 Background: Skeletal metastasis (SM) in advanced PDAC is an infrequent occurrence and has been previously reported to be < 2.5%. However; pathological fractures in these patients can result in intractable pain, immobilization and a significant deterioration in quality of life. Methods: A retrospective analysis was conducted of patients (pts) with advanced PDAC receiving palliative chemotherapy. Data collection included age, gender, ECOG, sites of disease, and overall survival (OS). Statistical analysis included Kaplan Meier survival analysis. Results: The 135 pts included had a median age of 65.8 years (range: 53.7–91.3); 5 (31.2%) were women and 11 (68.7%) had an ECOG performance status of 0 or 1. A majority of patients received combination therapy that was either gemcitabine or 5-flurouracil based. Sixteen pts (11.8%) had skeletal metastasis with the primary tumor located in the pancreatic body/tail (11 pts - 68.7%).The sites of SM included thoracic vertebrae (8), lumbar vertebrae (5), pelvis (5), ribs (4), sacrum (4), scapula (3), acetabulum (2), cervical vertebrae (2), femoral head (2), sternum (1) and humerus head (1). A majority of the lesions were osteolytic (62.5%) with a median time of diagnosis of SM from initial diagnosis being 1.25 months (range 0-33). Bone pain was observed as the initial symptom in 5 pts (32%), 1 pt (6.2%) had a pathological fracture. The mOS for patients with SM was 6.5 months (range 0-38) when compared to 8 months (range 0-147) without SM.The mOS for pts treated with gemcitabine based regimen was 5.75 months (range 2.5-14), and patients who received multiple lines of therapy including gemcitabine and 5-FU based regimens was 15 months (range 5-38). Survival from onset of skeletal metastases ranged from 0-14 months (mOS: 4 months). Conclusions: More effective systemic therapies which improve mOS are likely to result in increased incidence of SM. The most common sites observed were the thoracic and lumbar vertebrae and pathological fractures in these sites can be catastrophic. Therefore careful evaluation of skeletal signs and symptoms, early detection and intervention will be important to prevent morbidity and mortality from pathological fractures.

Tc-99m MDP Bone Scan Evaluation in Breast Cancer: A Study on 425 Patients

2018 ◽  
Vol 30 (2) ◽  
pp. 49-52
Author(s):  
MM Arif Hosen ◽  
Nasrin Begum ◽  
Mosharrof Hossain ◽  
Parvez Ahmed ◽  
Pupree Mutsuddy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Bone Scan ◽  
Metastatic Breast ◽  
Cost Effective ◽  
Skeletal Metastasis ◽  
Developed Countries ◽  
Skeletal Metastases ◽  
Breast Cancer Patients ◽  
Phase Images

Breast cancer is the most frequent female cancer, especially in 'developed' countries. 30-85% of metastatic breast cancer patients will develop bone metastases during the course of the disease. The objective of this study was to evaluate the skeletal metastases in breast cancer patients by using Tc-99m MDP bone scan. A retrospective study was conducted on 425 consecutive female breast carcinoma patients referred for bone scan to Institute of Nuclear Medicine and Allied Sciences, Rajshahi from January 2015 to November 2017. Bone scan was performed by an intravenous bolus injection of 20 mCi Tc99m-MDP (technetium 99m methylenediphosphonate). Bone phase images were taken at three hours after injection of the radiotracer. Out of 425 patients, 290 patients (68.24%) had either normal bone scan or negative for skeletal secondaries and 135 patients (31.76%) were positive for skeletal metastases.Out of 135 positive bone scans 114 (84.44%) patients had multiple sites (two or more) and 21 (15.56%) patients had solitary site of bony involvement. Highest number of skeletal metastases was noted in thoraco-lumbar spine (81.48%). Other sites of metastases were in cervical spine (22.96%), pelvic bones (54.81%), ribs (40.74%), sternum (16.30%), scapula (19.26%), upper extremities (28.15%), lower extremities (36.30%), skull bone (12.60%) and clavicle (13.33%). Tc-99m MDP bone scan is very cost effective in comparison to other imaging modalities (CT, MRI, and PET) and play a major role in early detection of skeletal metastasis in breast cancer patients.Medicine Today 2018 Vol.30(2): 49-52

Prognostic value of different standard uptake values (SUV) of primary tumor measured with FDG-PET in resectable non-small cell lung cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7214-7214
Author(s):  
W. K. De Jong ◽  
H. F. Van der Heijden ◽  
J. Pruim ◽  
W. J. Oyen ◽  
H. J. Groen
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Cell Lung Cancer ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Small Cell ◽  
Whole Body ◽  
Small Cell Lung

7214 Background: The SUV is a measure for the preferential uptake of a radiopharmaceutical in a tumor compared with a homogenous distribution in a body. SUV can be based on the maximum value (SUVmax) or on the mean value in a region outlined by isodensity contours, e.g., 70% and 50%. The prognostic value of the different SUVs in non-small cell lung cancer (NSCLC) is not clear. We evaluated the prognostic value of SUVmax, SUV 70% and SUV 50% in patients (pts) with resectable NSCLC. Methods: All consecutive pts who underwent an attenuation corrected whole body FDG-PET scan were selected. All data were reconstructed iteratively. Only pts with stage I through IIIA NSCLC were included. By adjusting the isocontour in the region of interest, the SUVmax, SUV 70% and SUV 50% of the primary tumor were calculated. Cox regression analysis was used to calculate the relation between the different SUVs and survival. Results: Eighty-four pts (67 males, median age 64 years, range 38–86) were included. Histology was squamous cell carcinoma (n = 43), adenocarcinoma (n = 27), large cell carcinoma (n = 13), and 1 patient with bronchoalveolar carcinoma. Nineteen pts had stage IA, 28 stage IB, 4 stage IIA, 19 stage IIB, and 14 stage IIIA. Median (range) SUVmax, SUV 70%, and SUV 50% were 6.9 (1.6–32.5), 5.5 (1.0–23.2), and 4.5 (0.9–21.9), respectively. Analysis of residuals of SUVmax as a continuous variable suggests no cut-off point and no indication of time-dependency. By univariate analysis, all pts with a SUV higher than the median value had a worse survival than pts with a SUV lower than median (Hazard ratio’s for SUVmax, SUV70% and SUV 50% were 2.3 (p = 0.024), 2.5 (p = 0.015), and 2.7 (p = 0.010), respectively). Conclusions: SUVmax, SUV 70% and SUV 50% measured with FDG-PET have a similar prognostic impact. No cut-off point for SUVmax has been observed. No significant financial relationships to disclose.

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