Discordant findings of skeletal metastasis between tc 99M MDP bone scans and F18 FDG PET/CT imaging for advanced breast and lung cancers--two case reports and literature review

The Kaohsiung Journal of Medical Sciences
Yu-Wen ChenChih-Liang Lin

Abstract

Traditionally, Tc 99m methyl diphosphate (MDP) bone scintigraphy provides high-sensitivity detection of skeletal metastasis from breast and lung cancers in regular follow-up. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), based on the glucose metabolism of malignant cells, plays a role in describing tumor growth, proliferation of neoplasm and the extent of metastasis. In general, concordant findings of skeletal metastasis are seen on both types of image, especially in cases of breast and lung cancer. However, there were extremely discordant findings of skeletal metastasis between bone scans and F 18 FDG PET/CT imaging in two cases among 300 consecutive F 18 FDG PET/CT follow-up exams of patients with malignancies, during the past year, in our center. Both cases, one of breast cancer and one of lung cancer, had negative bone scintigraphic findings, but a diffusely high grade of F 18 FDG avid marrow infiltration in the axial spine, leading to the diagnosis of stage IV disease in both cases. Owing to variant genetic aberrance of malignance, F 18 FDG PET/CT reveals direct evidence of diffuse, rapid neoplasm metabolism in the bone marrow of the spine, but not of secondary osteoblastic reactions i...Continue Reading

References

Jan 1, 1987·British Journal of Cancer·R E Coleman, R D Rubens
May 9, 1998·Proceedings of the National Academy of Sciences of the United States of America·H YasudaT Suda
Sep 2, 1998·European Journal of Endocrinology·L C Hofbauer, A E Heufelder
Jul 31, 1999·Experimental Hematology·G D Roodman
Apr 16, 2004·The New England Journal of Medicine·G David Roodman

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Citations

Apr 12, 2011·Molecular Imaging and Biology : MIB : the Official Publication of the Academy of Molecular Imaging·Andrei IagaruSanjiv Sam Gambhir
Aug 19, 2015·Seminars in Nuclear Medicine·Kanhaiyalal AgrawalIgnac Fogelman
Jan 1, 2012·BoneKEy Reports·Floor M LambersRalph Müller

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