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The distribution of bone metastases on 146 whole body scans

Author(s): Davood Beiki | Babak Fallahi | Mohammad Bagher Khodaparast | Mohammad Eftekhari | Armaghan Fard-Esfahani | Mohsen Saghari | Alireza Emami Ardakani

Journal: Iranian Journal of Nuclear Medicine
ISSN 1681-2824

Volume: 18;
Issue: Suppl 1;
Start page: 118;
Date: 2010;
Original page

Keywords: Bone Scan | Malignancy | Scintigraphy pattern

Introduction: Bone scan as an appropriate procedure with high sensitivity and moderate specificity is currently accepted by many clinicians for early detection of metastasis; however, characterizing scintigraphic patterns of bone metastases in each type of cancer may still help physicians to improve their skills for more accurate and faultless judgment about the scan findings. Methods: A cross-sectional study was conducted to explore the specific patterns of bone metastases in 146 patients with different types of cancers using a multitude of imaging modalities including bone scan. Results: The most common locations of bone metastases on scan images of patients with prostate cancer (71 cases) were pelvis, thoracic vertebrae, proximal femur, ribs and lumbar vertebrae, respectively, which in most cases were not accompanied with significant localized pain. Very intense uptake was noted in about 95% of cases with metastases to the thoracic vertebrae and 50% of cases with metastatic lesions in the common sites of metastasis, i.e. lumbar spine and proximal femoral bone. The most common sites of bone metastases in 61 patients with breast cancer were pelvis and hip, lumbar vertebrae, thoracic vertebrae, ribs, sternum and cervical spine. As well, an intensely higher uptake was observed in most of metastases to the sternum (86%), hip (79%), lumbar and thoracic vertebrae (75-78%); however in contrary to the prostate cancer, in most cases of breast cancer, the skeletal metastasis accompanied by significant localized pain. The most common sites of bone metastasis due to gastrointestinal (GI) cancers were cervical (100%), lumbar (100%), thoracic (84%) vertebrae and sternum (50%) with more intense uptake in all cervical spine and sternal metastases. Localized pain was detected in almost all cases with metastases to the lumbar spine and sternum while the other metastatic lesions were associated with localized symptom in more than 50% of cases with GI cancer. Conclusion: The pattern of metastases (common sites, association with localized symptoms and intensity of uptake) are important factors for better characterization of lesions on bone scan as to whether this lesion is truly metastatic or represents a benign lesion
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