Skip to main content
SpringerLink
Log in

Radionuclide Imaging of Bone Metastases

  • Chapter
Musculoskeletal Diseases 2009–2012

  • 1131 Accesses

Abstract

Skeletal imaging of oncologic patients is aimed at identifying early bone involvement, to determine the extent of the disease, and to monitor the response to therapy [1]. Detection of malignant bone involvement is either direct, by visualization of tumoral infiltration, or indirect, by detecting the reaction of bone to the presence of malignant cells. The vast majority of bone metastases initiate as bone marrow micrometastases. As the lesion enlarges within the marrow, the surrounding bone undergoes osteoclastic (resorptive) and osteoblastic (depositional) activity. Based on the balance between these two processes, metastasis can be lytic, sclerotic (blastic), or mixed [2, 3]. In nuclear medicine, 18F-fluordeoxyglucose (18F-FDG), a PET tracer, directly accumulates in tumor cells and may therefore identify malignant bone involvement even at early stages, when confined to the marrow, before cortical bone reaction has occurred, while increased accumulation of 99mTc-MDP-methylene diphosphonate (the tracer used for bone scintigraphy) or 18F-fluoride, a bone-seeking PET tracer, depends on the presence of secondary reactive osteoblastic changes [3, 4].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hamaoka T, Madewell JE, Podoloff DA et al (2004) Bone imaging in metastatic breast cancer. J Clin Oncol 22:2942–2953

    Article  PubMed  Google Scholar 

  2. Roodman GD (2004) Mechanisms of bone metastasis. N Engl J Med 350:1655–1664

    Article  CAS  PubMed  Google Scholar 

  3. Blake GM, Park-Holohan SJ, Cook GJ, Fogelman I (2001) Quantitative studies of bone with the use of 18F-fluoride and 99mTc-methylene diphosphonate. Semin Nucl Med 31:28–49

    Article  CAS  PubMed  Google Scholar 

  4. Even-Sapir E (2005) Imaging of malignant bone involvement by morphologic, scintigraphic, and hybrid modalities. J Nucl Med 46:1356–1367

    PubMed  Google Scholar 

  5. Smith TJ, Davidson NE, Schapira DV et al (1998) American Society of Clinical Oncology 1998. Update of recommended breast cancer surveillance guidelines. J Clin Oncol 17:1080–1082

    Google Scholar 

  6. Schoder H, Larson SM (2004) Positron emission tomography for prostate, bladder, and renal cancer. Semin Nucl Med 34:274–292

    Article  PubMed  Google Scholar 

  7. Gates GF (1998) SPECT bone scanning of the spine. Semin Nucl Med 28:78–94

    Article  CAS  PubMed  Google Scholar 

  8. Even-Sapir E, Metser U, Mishani E et al (2006) The detection of bone metastases in patients with high-risk prostate cancer: 99mTc-MDP planar bone scintigraphy, single-and multi-field-of-view SPECT, 18F-fluoride PET, and 18F-fluoride PET/CT. J Nucl Med 47:287–297

    PubMed  Google Scholar 

  9. Keidar Z, Israel O, Krausz Y (2003) SPECT/CT in tumor imaging: technical aspects and clinical applications. Semin Nucl Med 33:205–218

    Article  PubMed  Google Scholar 

  10. Cook GJ, Houston S, Rubens R et al (1998) Detection of bone metastases in breast cancer by 18FDG PET: differing metabolic activity in osteoblastic and osteolytic lesions. J Clin Oncol 16:3375–3379

    CAS  PubMed  Google Scholar 

  11. Abe K, Sasaki M, Kuwabara Y et al (2005) Comparison of 18FDG-PET with 99mTc-HMDP scintigraphy for the detection of bone metastases in patients with breast cancer. Ann Nucl Med 19:573–579

    Article  PubMed  Google Scholar 

  12. Port ER, Yeung H, Gonen M et al (2006) (18)F-2-fluoro-2-deoxy-d:-glucose positron emission tomography scanning affects surgical management in selected patients with high-risk, oper-able breast carcinoma. Ann Surg Oncol 13:677–684

    Article  PubMed  Google Scholar 

  13. Cheran SK, Herndon JE, Patz EF (2004) Comparison of whole-body FDG-PET to bone scan for detection of bone metastases in patients with a new diagnosis of lung cancer. Lung Cancer 44:317–325

    Article  PubMed  Google Scholar 

  14. Pakos EE, Fotopoulos AD, Ioannidis JP (2005) 18F-FDG PET for evaluation of bone marrow infiltration in staging of lym-phoma: a meta-analysis. J Nucl Med 6:958–963

    Google Scholar 

  15. Carr R, Barrington SF, Madan B et al (1998) Detecion of lym-phoma in bone marrow by whole-body positron emission tomography. Blood 91:3340–3346

    CAS  PubMed  Google Scholar 

  16. Even-Sapir E, Lievshitz G, Perry C et al (2006) Fluorine-18 Fluorodeoxyglucose PET/CT patterns of extranodal involvement in patients with non-Hodgkin Lymphoma and Hodgkin’s disease. PET Clinics 1:251–263

    Article  Google Scholar 

  17. Durie BGM, Waxman AD, D’Agnolo A, Williams CM (2002) Whole-body 18F-FDG PET identifies high-risk myeloma. J Nucl Med 43:1457–1463

    PubMed  Google Scholar 

  18. Schirrmeister H, Bommer M, Buck A et al (2002) Initial results in the assessment of multiple myeloma using F-18 FDG PET. Eur J Nucl Med Mol Imag 29:361–366

    Article  CAS  Google Scholar 

  19. Israel O, Goldberg A, Nachtigal A et al (2006) FDG-PET and CT patterns of bone metastases and their relationship to previously administered anti-cancer therapy. Eur J Nucl Med Mol Imaging 33:1280–1284

    Article  PubMed  Google Scholar 

  20. Clamp A, Danson S, Nguyen H et al (2004) Assessment of therapeutic response in patients with metastatic bone disease. Lancet Oncol 5:607–616

    Article  PubMed  Google Scholar 

  21. Kazama T, Faria SC, Varavithya V et al (2005) FDG PET in the evaluation of treatment for lymphoma: clinical usefulness and pitfalls. Radiographics 25:191–207

    Article  PubMed  Google Scholar 

  22. Cook GJ, Fogelman I (2001) The role of positron emission tomography in skeletal disease. Semin Nucl Med 31:50–61

    Article  CAS  PubMed  Google Scholar 

  23. Schirrmeister H, Kuhn T, Guhlmann A et al (2001) Fluorine-18 2-deoxy-2-fluoro-D-glucose PET in the preoperative staging of breast cancer: comparison with the standard staging procedures. Eur J Nucl Med 28:351–358

    Article  CAS  PubMed  Google Scholar 

  24. Even-Sapir E, Mishani E, Flusser G, Metser U (2007) 18F-Fluoride positron emission tomography and positron emission tomography/computed tomography. Semin Nucl Med 37:462–469

    Article  PubMed  Google Scholar 

  25. Even-Sapir E, Metser U, Flusser G et al (2004) Assessment of malignant skeletal disease: initial experience with 18F-fluoride PET/CT and comparison between 18F-fluoride PET and 18F-fluoride PET/CT. J Nucl Med 45:272–278

    PubMed  Google Scholar 

  26. Beheshti M, Vali R, Waldenberger P et al (2008) Detection of bone metastases in patients with prostate cancer by F-18 fluo-rocholine and F-18 fluoride PET-CT: a comparative study. Eur J Nucl Med Mol Imaging 35:1766–1774

    Article  PubMed  Google Scholar 

  27. Antoch G, Vogt FM, Freudenberg LS et al (2003) Whole-body dual-modality PET/CT and whole-body MRI for tumor stag-ing in oncology. JAMA 290:3199–3206

    Article  CAS  PubMed  Google Scholar 

  28. Strobel K, Exner UE, Stumpe KD et al (2008) The additional value of CT images interpretation in the differential diagnosis of benign vs. malignant primary bone lesions with 18F-FDG-PET/CT. Eur J Nucl Med Mol Imag 35:2000–2008

    Article  CAS  Google Scholar 

  29. Metser U, Lerman H, Blank A et al (2004) Malignant involvment of the spine: assessment by 18F-fluorodeoxyglucose PET/CT. J Nucl Med 45:279–284

    PubMed  Google Scholar 

  30. Ell PJ (2006) The contribution of PET/CT to improved patient management. Br J Radiol 79:32–36

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Einat Even-Sapir Weizer

Authors
  1. Einat Even-Sapir Weizer
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Radiology, Orthopedic University, Hospital Balgrist, Zurich, Switzerland

    J. Hodler

  2. Kilchberg, Switzerland

    Ch. L. Zollikofer

  3. Zurich, Switzerland

    Ch. L. Zollikofer

  4. Nuclear Medicine, University Hospital, Zurich, Switzerland

    G. K. Von Schulthess

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag Italia

About this chapter

Cite this chapter

Weizer, E.ES. (2009). Radionuclide Imaging of Bone Metastases. In: Hodler, J., Zollikofer, C.L., Von Schulthess, G.K. (eds) Musculoskeletal Diseases 2009–2012. Springer, Milano. https://doi.org/10.1007/978-88-470-1378-0_32

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-1378-0_32

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1377-3

  • Online ISBN: 978-88-470-1378-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation