Oral Radiology

, Volume 16, Issue 1, pp 23–34 | Cite as

Interpretation of distant focal accumulations revealed by bone scintigraphy using Tc-99m HMDP in patients with oral malignant tumors

  • Tsuyoshi Sato
  • Yasuhiko Morita
  • Youichirou Iwashita
  • Yoshihiro Kawabata
  • Takenori Noikura
Original Article



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.

Study design

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 Words

Tc-99m-HMDP Focal accumulation Skeletal metastasis Oral cancer 


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Copyright information

© Japanese Society for Oral and Maxillofacial Radiology 2000

Authors and Affiliations

  • Tsuyoshi Sato
    • 1
  • Yasuhiko Morita
    • 1
  • Youichirou Iwashita
    • 1
  • Yoshihiro Kawabata
    • 1
  • Takenori Noikura
    • 1
  1. 1.Department of Dental RadiologyKagoshima University Dental SchoolKagoshimaJapan

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