Clinical study on bone metastases from bronchogenic carcinoma by bone scintigraphy with sup(99m)Tc-phosphorous compounds, 2

With the advance of sup(99m)Tc-phosphorous compounds and whole-body imaging procedure the bone scintigraphy has become one of the most useful technique for the detection of bone metastases. Bone scintigraphy has a higher sensitivity for the detection of bone metastases and their distribution than roentgenography. But disadvantages of this technique are also noted. These imply accumulations in areas of some benign conditions of the bone, even in areas of some soft part lesions, and also physiological accumulations. These facts together with false negative as well as photon deficient (cold) lesions should be taken into consideration in establishing the diagnosis in daily practices. In this study, 129 scintigraphies with sup(99m)Tc-phosphorous compounds were performed on 90 patients with bronchogenic carcinoma. Of 90 intial bone scintigraphies, 36 (40%) were positive for metastatic bone disease and 15 (17%) were undetermined or benign cases. Of 36 bone metastases, 8 (22%) were solitary, 10 (28%) were localized and 18 (50%) were multiple. The distribution of bone metastases were seen in ribs (44%), thoracic vertebra (39%), and lumbar vertebra and pelvis (36%). Of 36 bone metastases, 4 (11%) cold lesions were observed. The incidence was seemed to be relatively high. The sensitivity of the bone scintigraphy was 100% in solitary and localized lesions and 89% in multiple bone lesions. False-negative bone scintigraphies were obtained in only two patients (6%) with positive roentgenography which showed osteolytic rib metastases. Of 13 followup scintigraphies, 8 (62%) showed either the appearance of new lesions, or the progression of previously noted lesion. None showed regression. (author)