Interpretation of distant focal accumulations revealed by bone scintigraphy using Tc-99m HMDP in patients with oral malignant tumors
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Focal accumulations in the skeleton were analyzed in order evaluate the usefulness of bone scintigraphy in the detection of distant skeletal metatases originating from malignant oral tumors.
Of 350 patients who underwent bone scintigraphy, 62 patients who showed distant focal accumulations in the skeleton were selected. Observations were performed on 12 skeletal regions: the skull, facial bone, clavicle, rib, scapula, sternum, cervical spine, thoracic spine, lumbar spine, pelvis, upper, and lower extremities. Distant focal accumulations were classified into 3 degrees: very hot, moderately hot and warm. A diagnosis of metastatic focal accumulation was made with reference to the CT, MR, X-ray and Ga-67 images, clinical features, and laboratory data.
Four of the 350 cases showed skeletal metastases (1.1%). Sixty-two of the 350 patients showed 106 distant focal accumulations, with 10 accumulations proving to be skeletal metastases. The common sites of the skeletal metastases were the lumbar spine, rib, cervical spine, and sternum. Patients with skeletal metastases had a tendency to show distant focal accumulations of very hot images in some skeletal sites, and these focal accumulations were usually accompanied by severe pain. The most common cause of distant focal accumulations except metastasis was traumatic injury.
The results in the present study indicate that the distant focal accumulations accompanied by severe pain and simultaneously observed in more than one skeletal site can be interpreted as skeletal metastases.
Key WordsTc-99m-HMDP Focal accumulation Skeletal metastasis Oral cancer
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- 2).Susan, V. I. and Jasvir, S. K.: Negative scintigraphy with positive magnetic resonance imaging in bone metastasis.Skeletal Radiol. 19: 113–116, 1990Google Scholar
- 5).Osmond, J. D., Pendergrass, H. P. and Potsaid, M. S.: Accuracy of Tc-99m diphosphate bone scans and roentogenograms in the detection of prostate, breast and lung carcinoma metastases.AJR. 125: 972–977, 1975Google Scholar
- 7).Ozaki, Y., Amemiya, K., Shirakata, A., Tamamoto, F., Sumi, K. and Ishikawa, K.: Focal accumulation pattern on the bone scintigram in cancer patients.Jpn. J. Clin. Radiol. 36: 241–246, 1991 (in Japanese)Google Scholar
- 10).Galasko, C. S. B.: The pathological basis for skeletal scintigraphy.J. Bone. Joint. Surg. 57-B: 353–359, 1975Google Scholar
- 11).Crile, G. W.: Excision of cancer of the head and neck—with special reference to the plan of dissection based on 132 operations.JAMA. 47: 1780–1786, 1906Google Scholar
- 12).Maeyama, I., Sato, S. and Goto, S.: Carcinomas metastatic to bone at the National Cancer Center Hospital in Tokyo.Jpn. J. Orthop. Assoc. 40: 221–229, 1966 (in Japanese)Google Scholar
- 13).Chain, A.: Secondary malignant disease of bone.Br. J. Cancer. 19: 15–29, 1965Google Scholar
- 14).Turner, J. W. and Jaffe, H. L.: Metastatic neoplasms—A clinical and roentgenological study of involvement of skeleton and lungs.AJR. 40: 479–492, 1940Google Scholar
- 15).Yung, T. M. and Funl, F. J.: Incidence of tumor metastasis to the lumbar spine-A comparison study of roentgenographic changes and gross lesions.J. Bone. Joint. Surg. 35: 55–64, 1953Google Scholar
- 16).Katayama, Y., Hata, T., Hosoda, K., Kowaka, S., Takemura, H., Takada, H., Sasaki, K., Kawakami, K. and Fukuda, M.: Evaluation of skeletal metastases in patients with oral cancer.Jpn. J. Bone. Metastasis. 9: 51–55, 1993 (in Japanese)Google Scholar
- 17).Berrettoni, B. A., Carter, J. R. and Ohio, C.: Current concepts review-Mechanism of cancer metastasis to bone.J. Bone. Joint. Surg. 68-A: 308–312, 1986Google Scholar
- 18).Baston, O. V.: The role of the vertebral vein in metastatic processes.Ann. Intern. Med. 16: 38–45, 1942Google Scholar
- 19).Ono, Y., Asakura, K., Tanohata, K., Nakamori, A., Ujiie, M., Matsui, K., Tanaka, T., Noda, J. and Yamamoto, Y.: Scintigraphic evaluation of the Normal sternum—The study of cancer patients without skeletal metastasis.Jpn. J. Nucl. Med. 17: 199–204, 1980 (in Japanese)Google Scholar
- 23).Imaeda, T., Iinuma, G., Hirota, K., Inoue, A., Sone, Y., Seki, M., Suzuki, M. and Doi, H.: Local bone pain and osseous scintigraphic findings in patients with metastatic bone tumor.Jpn. J. Nucl. Med. 25: 1319–1326, 1988 (in Japanese)Google Scholar