Progressive Soft Tissue Uptake of Tc-99m MDP Reflecting Metastatic Microcalcification

Rd, Low; Rj, Hicks; Lb, Arkles; Gill, Gauravpal S.; Adam, W.

doi:10.1097/00003072-199208000-00011

Cited by 11 publications

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“…Furthermore, in patients with malignant hypercalcemia in association with renal failure, progressive soft tissue uptake of radiolabelled phosphates may occur due to metastatic microcalcification. This soft tissue uptake may occur at in vivo calcium phosphate ion product concentrations of > 5 mmol 2 /l 2 [ 25 , 26 ]. In patients with normal calcium levels, interactions between bisphosphonates and radiolabelled phosphates could not be confirmed.…”

Section: Discussionmentioning

confidence: 99%

Combined use of zoledronic acid and 153Sm-EDTMP in hormone-refractory prostate cancer patients with bone metastases

Lam

Dahmane

Stevens

et al. 2007

Eur J Nucl Med Mol Imaging

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Purpose153 Sm-ethylenediaminetetramethylenephosphonic acid (EDTMP; Quadramet®) is indicated for the treatment of painful bone metastases, whereas zoledronic acid (Zometa®) is indicated for the prevention of skeletal complications. Because of the different therapeutic effects, combining the treatments may be beneficial. Both, however, accumulate in areas with increased osteoblastic activity. Possible drug interactions were investigated. Methods Patients with hormone-refractory prostate cancer were treated with 18.5 MBq/kg 153 Sm-EDTMP in weeks 1 and 3 and with 37 MBq/kg in week 15. Treatment with 4 mg zoledronic acid began in week 3 and continued every 4 weeks through week 23. In weeks 3 and 15, zoledronic acid was administered 2 days before 153 Sm-EDTMP treatment. Urine was collected 48 h after injection of 153 Sm-EDTMP, and whole-body images were obtained 6, 24 and 48 h post-injection. The effect of zoledronic acid on total bone uptake of 153 Sm-EDTMP was measured indirectly by the cumulative activity excreted in the urine in weeks 1, 3 and 15. Biodistribution, safety, tolerability and effect on prostate-specific antigen level were also studied. Results The urinary excretion in week 3 divided by the urinary excretion in week 1 (baseline) times 100% was mean 98.4±11.6% (median 96.2%). From week 1 to 15, after four zoledronic acid treatments, the mean ratio was 101.9±10.7% (median 101.8%). Bioequivalence could be concluded by using a two-sample t test for both perprotocol (n=13) and full-analysis sets (n=18). Toxicity was comparable to of monotherapy with 153 Sm-EDTMP. Conclusion Zoledronic acid treatment does not influence 153 Sm-EDTMP skeletal uptake. Combined treatment is feasible and safe.

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Section: Discussionmentioning

confidence: 99%

Combined use of zoledronic acid and 153Sm-EDTMP in hormone-refractory prostate cancer patients with bone metastases

Lam

Dahmane

Stevens

et al. 2007

Eur J Nucl Med Mol Imaging

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“…Renal function remained normal in our patient and so uraemic myopathy is unlikely to have caused the bone scintigram appearance. Hypercalcaemia, a feature in this patient, may lead to microcalci®cation in soft tissues, and consequently lead to uptake of isotope [8]. Soft tissue calci®cation occurs when the calcium phosphate ion product exceeds 70 mg dl 21 .…”

Section: Discussionmentioning

confidence: 84%

Extensive soft tissue uptake of 99Tcm methylene diphosphonate in a patient with multiple myeloma.

Evans

Murphy²,

Eyes³

2000

The British Journal of Radiology

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Bone scintigraphy is not usually performed in multiple myeloma (MM), as marrow deposits characteristically show no tracer uptake. However, metastatic bone disease often mimics MM both clinically and biochemically, resulting in a substantial number of MM patients undergoing bone scintigraphy. Variable appearances in these cases have been reported, ranging from normal to a superscan, the latter a result of massive tracer uptake within bone. Soft tissue uptake has been documented, often when MM is complicated by secondary amyloidosis. This usually results in mainly solid organ uptake of tracer. We report a case of MM where massive soft tissue uptake occurred, primarily within muscles, with very little isotope elsewhere.

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“…Causes of metastatic calcification include hyperparathyroidism, chronic renal disease, sarcoidosis, amyloidosis, myeloma, malignant hypercalcemia of lymphomas, and solid tumors. [12345678910] The exact mechanism of these calcium depositions remains uncertain; however, most accepted mechanism is an increase in the production of ionized calcium (calcium-phosphate complex primarily). The precipitation of ionized calcium is mainly in the alkaline pH tissues: lung, kidneys, myocardium, liver, and stomach walls.…”

Section: Discussionmentioning

confidence: 99%

Extensive visceral calcification demonstrated on ^99mTc-MDP bone scan in patient with carcinoma penis and hypercalcemia of malignancy

Gandhi¹,

Rabadiya²

2017

Indian J Nucl Med

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Hypercalcemia is a common life-threatening complication associated with several malignancies. Parathyroid-related peptide has been shown to cause hypercalcemia in several solid tumors but rarely in penile cancer. We report a case of penile cancer with hypercalcemia causing metastatic visceral calcification in lungs, liver, and stomach detected on bone scan without significant abnormalities on CT scan.

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Progressive Soft Tissue Uptake of Tc-99m MDP Reflecting Metastatic Microcalcification

Cited by 11 publications

References 0 publications

Combined use of zoledronic acid and 153Sm-EDTMP in hormone-refractory prostate cancer patients with bone metastases

Combined use of zoledronic acid and 153Sm-EDTMP in hormone-refractory prostate cancer patients with bone metastases

Extensive soft tissue uptake of 99Tcm methylene diphosphonate in a patient with multiple myeloma.

Extensive visceral calcification demonstrated on ^99mTc-MDP bone scan in patient with carcinoma penis and hypercalcemia of malignancy

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Progressive Soft Tissue Uptake of Tc-99m MDP Reflecting Metastatic Microcalcification

Cited by 11 publications

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Combined use of zoledronic acid and 153Sm-EDTMP in hormone-refractory prostate cancer patients with bone metastases

Combined use of zoledronic acid and 153Sm-EDTMP in hormone-refractory prostate cancer patients with bone metastases

Extensive soft tissue uptake of 99Tcm methylene diphosphonate in a patient with multiple myeloma.

Extensive visceral calcification demonstrated on 99mTc-MDP bone scan in patient with carcinoma penis and hypercalcemia of malignancy

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Extensive visceral calcification demonstrated on ^99mTc-MDP bone scan in patient with carcinoma penis and hypercalcemia of malignancy