Abnormal focal tracer uptake in the jaw during conventional bone scintigraphy is a quite frequent finding usually not related to malignant disease. In patients undergoing radionuclide therapy with lanthanoids or rhenium, the appearance is also quite frequent. Itʼs origin so far has not been studied in a large number of patients. Objective, to evaluate the underlying reason of abnormal focal tracer uptake in the jaw in patients who underwent 153Sm-EDTMP therapy for painful metastatic lesions. Methods, out of 138 patients, 82 revealed a positive result, 60 males and 22 females (mean age: 63.9 ± 13.9years; range 19-90 years), with metastatic bone pain were examined. Their lesions were judged by a dentist clinically and radiologically. Results, the most frequent reason of increased focal uptake in the group of mainly prostate and breast cancer patients was inflammation in 13 (24.5%) and 9 (41%) patients, respectively. In the patients below 70 years of age, inflammation was the most frequent reason with (32.7%) while in the older ones of 70 years, it was mechanically irritated by a prosthesis with (50%). In 4 of the patients, the increased uptake of 153Sm-EDTMP was due to metastatic disease as shown by PET/CT and/or MRI. Conclusion, although the number of secondary lesions in the jaw is small (4.8%), the underlying reason in conventional bone scintigraphy as well as in post-therapeutic scintigraphy should be always evaluated.
Background: Data regarding iodine deficiency disorder in Upper Egypt is rare and even limited. In this study, we aim to determine the status of variable patterns of thyroid disorders and find out the relationship between some risk factors like gender, age, family history and the occurrence of thyroid disorders among Qena population referred to our nuclear medicine clinic from January 2011 to the end of December 2012. Methods: A retrospective hospital-based descriptive and analytical study was conducted on patients referred to our nuclear medicine clinic who complained of various clinical features related to the thyroid gland. The study was performed using data collected from the registration unit in the nuclear medicine clinic. Results: A total of 46 patients (9 men and 37 non-pregnant women) were included. The collected variables were sex, age, family history, menstrual status of females, thyroid-related complaints, history of thyroidectomy and I-131 therapy. 43.5% of the patients were highly affected by thyrotoxicosis, followed by hypothyroidism (26.1%), simple nodular goiter (SNG) (17.4%) and differentiated thyroid cancer (DTC) (13%). 80.4% of patients were female and 19.6% were male. The highest number of different thyroid diseases were reported in the age group of 20-49 years. Conclusions: Different risk factors including sex, age, family history are highlighted in this study, but still the low levels of iodine in the soil and drinking water in Upper Egypt and bad nutrition are the most common factors that may cause goiter.
Purpose: Data comparing osteoblastic vs osteolytic recurrences of therapeutic response are still very limited. We aimed to answer this question in 164 female breast cancer patients (including 61 females on statin therapy) suffering from recurrent breast cancer who received a single dose of Sm-153 EDTMP for painful metastatic bone lesions. Methods: 164 female patients suffered from painful metastatic breast cancer with >1 up to 5 bone lesions, we evaluated the response of recurrences judged by CT as osteoblastic (BL), osteolytic (LY) or mixed (MI) showing up in bone scintigraphy to a single dose of 30 mci (1.1 GBq) 153 Sm-EDTMP. 116 females (70.03%) suffered from ductal, 37 (22.56%) from lobular, 10 (6.09%) from mixed and 1 (0.61%) from medullary cancer. Statin used by the 61 female patients were Simvastatin (20 or 40 mg/day orally), Atorvastatin (20 or 40 mg/day orally) and Rosuvastatin (20 mg/day orally). Results: Bone uptake and pain response did not show any difference between BL-, LY-and MI-recurrences. No correlation of pain response and its duration vs. uptake, type, number and extent of lesions, adhesion molecules (AM) and histology was seen. Out of 164 female cancer breast, females on statins exhibited a significantly (P-value<0.01) more pronounced decrease in adhesion molecules vs. non users. Conclusion: These findings indicate no significant difference in pain response between the different types of bone recurrences. Whether, the effect of statins on adhesion molecules is a direct drug effect or reflect on antitumoral action as well as, the influence on the extent of recurrences should be examined in prospective studies. KEYWORDS: therapeutic bone response breast cancer recurrences sm-153 EDTMP treatment influence statins intake.
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