Tumor and Therapy Associated Abnormal Changes on Bone Scintigraphy Old and New Phenomena

Mp, Stokkel; Olmos, Valdés; Ca, Hoefnagel; Dj, Richel

doi:10.1097/00003072-199310000-00001

Cited by 26 publications

(9 citation statements)

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“…Many tumors are treated with radiation therapy. In the acute (early) phase of radiation osteitis, radiotracer uptake actually increases in the irradiated field as a result of inflammatory hyperemia (17). This increment, which peaks about 2-3 months after treatment, is only about 10%-20% above baseline and may not be appreciated at visual inspection of the images.…”

Section: Metastatic Diseasementioning

confidence: 99%

“…Hormonal therapy and chemotherapy may also affect bone scan findings (17). An increase in intensity or the appearance of new abnormalities from one bone scan to the next does not necessarily indicate progression of disease.…”

Section: Metastatic Diseasementioning

confidence: 99%

“…Hypertrophic osteoarthropathy is secondary to cortical periostitis that arises in connection with various intrathoracic tumors, pulmonary diseases, cardiac conditions, and intraabdominal diseases (17). It is believed that an as yet unidentified cytokine exerts an osteogenic effect (32).…”

Section: Hypertrophic Osteoarthropathymentioning

confidence: 99%

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Radionuclide Bone Imaging: An Illustrative Review

Love¹,

Din²,

Tomas³

et al. 2003

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362

191

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Bone scintigraphy with technetium-99m-labeled diphosphonates is one of the most frequently performed of all radionuclide procedures. Radionuclide bone imaging is not specific, but its excellent sensitivity makes it useful in screening for many pathologic conditions. Moreover, some conditions that are not clearly depicted on anatomic images can be diagnosed with bone scintigraphy. Bone metastases usually appear as multiple foci of increased activity, although they occasionally manifest as areas of decreased uptake. Traumatic processes can often be detected, even when radiographic findings are negative. Most fractures are scintigraphically detectable within 24 hours, although in elderly patients with osteopenia, further imaging at a later time is sometimes indicated. Athletic individuals are prone to musculoskeletal trauma, and radionuclide bone imaging is useful for identifying pathologic conditions such as plantar fasciitis, stress fractures, "shin splints," and spondylolysis, for which radiographs may be nondiagnostic. A combination of focal hyperperfusion, focal hyperemia, and focally increased bone uptake is virtually diagnostic for osteomyelitis in patients with nonviolated bone. Bone scintigraphy is also useful for evaluating disease extent in Paget disease and for localizing avascular necrosis in patients with negative radiographs. Radionuclide bone imaging will likely remain a popular and important imaging modality for years to come.

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Section: Metastatic Diseasementioning

confidence: 99%

Section: Metastatic Diseasementioning

confidence: 99%

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Radionuclide Bone Imaging: An Illustrative Review

Love¹,

Din²,

Tomas³

et al. 2003

RadioGraphics

362

191

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“…The flare phenomenon, occurring in the first few months after the start of therapy, has been prospectively documented by Coleman et al [175] in patients with advanced breast cancer receiving chemotherapy or endocrine treatment. Recently, we have observed increased uptake in the axial skeleton and/or juxta-articular areas in addition to the flare response of metastases on bone scintigraphy in six patients receiving granulocyte colony stimulating factor (CSF) in combination with chemotherapy [176]. Recently, we have observed increased uptake in the axial skeleton and/or juxta-articular areas in addition to the flare response of metastases on bone scintigraphy in six patients receiving granulocyte colony stimulating factor (CSF) in combination with chemotherapy [176].…”

Section: Iatrogenic Bone Changes Due To Chemotherapymentioning

confidence: 99%

Nuclear medicine in the monitoring of organ function and the detection of injury related to cancer therapy

1993

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This article emphasizes the role of nuclear medicine in the monitoring of function to prevent or limit injury in organs in which toxicity related to cancer therapy may have implications for the survival and/or the quality of life of the patient. After a brief discussion of the advantages of nuclear medicine techniques in detecting organ injury, the effect of radiation therapy and chemotherapy on normal tissue is discussed, underlining the need to characterize adverse effects of cancer therapy in long-term survivors. The use of radionuclides to document organ injury and effects from cancer therapy in heart, digestive tract, kidneys, lungs, major salivary glands, skeleton and brain is then reviewed. In a short section the potential applicability of positron emission tomography in documenting organ toxicity during cancer therapy is discussed. Thanks to the various available radiopharmaceuticals, the ability of the tracers to document specific functional aspects, the improved methods for visualization and quantitation of organ injury and the possibilities of physiological or pharmacological intervention, nuclear medicine gives the clinician potent tools for the monitoring of organ function at risk during cancer therapy. The trend to intensify cancer treatment by combining various treatment modalities and the increasing chances of prolonged survival in a large number of patients call for effective integration of nuclear medicine methods into the recommended guidelines for grading organ injury in clinical oncology.

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“…There may be many metabolic, hormonal, or therapy-induced conditions inducing focal or diffuse bone uptake. Carcinoma polyarthritis, hypertrophic pulmonary osteoarthropathy, flare phenomenon (which is the enhanced uptake in metastases due to hormonal treatment, chemotherapy, or radiotherapy), colony-stimulating factor causing increased uptake in axial skeleton and juxta-articular areas, osteonecrosis due to radiotherapy, or corticosteroid use may all interfere with correct evaluation (Stokkel et al, 1993). Primary benign or malignant bone tumors, sports medicine injuries, fractures, stress injuries, skeletal trauma, osteomyelitis, postprosthesis infection and loosening, septic arthritis, avascular necrosis, reflex sympathetic dystrophy syndrome, enthesopathies and biomechanical stress lesions, inflammatory arthropathies, Paget disease, other metabolic bone diseases, costochondritis, and miscellaneous bone conditions also create increased uptake in the bones (Fig.…”

mentioning

confidence: 99%