Accurate characterization of 99mTc-MDP uptake in extraosseous neoplasm mimicking bone metastasis on whole-body bone scan: contribution of SPECT/CT
Abstract Background 99mTc-labelled methylene diphosphonate (99mTc-MDP) uptake can occasionally be identified in extraosseous neoplasms on whole-body scans (WBSs) and may be misinterpreted as bone metastasis. The purpose of our study was to investigate the frequency of 99mTc-MDP uptake in extraosseou...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | BMC Medical Imaging |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12880-019-0345-1 |
| _version_ | 1819050177907916800 |
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| author | Linqi Zhang Qiao He Tao Zhou Bing Zhang Wei Li Hao Peng Xi Zhong Liwu Ma Rusen Zhang |
| author_facet | Linqi Zhang Qiao He Tao Zhou Bing Zhang Wei Li Hao Peng Xi Zhong Liwu Ma Rusen Zhang |
| author_sort | Linqi Zhang |
| collection | DOAJ |
| description | Abstract Background 99mTc-labelled methylene diphosphonate (99mTc-MDP) uptake can occasionally be identified in extraosseous neoplasms on whole-body scans (WBSs) and may be misinterpreted as bone metastasis. The purpose of our study was to investigate the frequency of 99mTc-MDP uptake in extraosseous neoplasms and to assess the additional value of SPECT/CT for the localization and characterization of this unusual uptake. Methods Data from 7308 patients (SPECT/CT was performed in 2147 patients) with known cancer who underwent WBSs for metastatic work-up between May 2015 and July 2018 were retrospectively reviewed. The locations, numbers, and intensities of extraosseous 99mTc-MDP uptake were evaluated by WBS, and the intratumoural calcification was evaluated by SPECT/CT. The diagnostic accuracy of SPECT/CT in locating 99mTc-MDP uptake in extraosseous neoplasms was compared to that of WBS. Results A total of 41 patients showed 99mTc-MDP uptake in extraosseous neoplasms. Of these patients, 23 patients had uncertain lesions by WBS, and further SPECT/CT was performed. The incidence of 99mTc-MDP uptake in extraosseous neoplasms was observed to be 0.6% by WBS and 1.1% (by) SPECT/CT. During imaging analysis, WBS had an accuracy of only 35% (14/40), whereas SPECT/CT correctly located and diagnosed all 40 lesion sites in the 23 patients. Twenty-three lesion sites (57.5%, 23/40) showed moderate or high intensity of extraosseous 99mTc-MDP uptake. Of the 23 patients, 17 patients (73.9%, 18/23) with 31 lesion sites (77.5%, 31/40) presented with intratumoural calcification. Conclusions 99mTc-MDP uptake in extraosseous neoplasms can be observed as 0.6% on WBS and is usually localized to the breast, liver, and lung. Nuclear physicians should be familiar with such extraosseous uptake when interpreting WBSs. SPECT/CT offers better accuracy than WBS alone for locating the majority of lesions present with intratumoural calcification. |
| first_indexed | 2024-12-21T11:43:54Z |
| format | Article |
| id | doaj.art-cdb2bc504e0247d1b88c80e4457d294c |
| institution | Directory Open Access Journal |
| issn | 1471-2342 |
| language | English |
| last_indexed | 2024-12-21T11:43:54Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Imaging |
| spelling | doaj.art-cdb2bc504e0247d1b88c80e4457d294c2022-12-21T19:05:14ZengBMCBMC Medical Imaging1471-23422019-05-011911910.1186/s12880-019-0345-1Accurate characterization of 99mTc-MDP uptake in extraosseous neoplasm mimicking bone metastasis on whole-body bone scan: contribution of SPECT/CTLinqi Zhang0Qiao He1Tao Zhou2Bing Zhang3Wei Li4Hao Peng5Xi Zhong6Liwu Ma7Rusen Zhang8Department of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical UniversityDepartment of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical UniversityDepartment of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical UniversityDepartment of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical UniversityDepartment of Radiology, Affiliated Cancer Hospital & Institute of Guangzhou Medical UniversityDepartment of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical UniversityDepartment of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical UniversityAbstract Background 99mTc-labelled methylene diphosphonate (99mTc-MDP) uptake can occasionally be identified in extraosseous neoplasms on whole-body scans (WBSs) and may be misinterpreted as bone metastasis. The purpose of our study was to investigate the frequency of 99mTc-MDP uptake in extraosseous neoplasms and to assess the additional value of SPECT/CT for the localization and characterization of this unusual uptake. Methods Data from 7308 patients (SPECT/CT was performed in 2147 patients) with known cancer who underwent WBSs for metastatic work-up between May 2015 and July 2018 were retrospectively reviewed. The locations, numbers, and intensities of extraosseous 99mTc-MDP uptake were evaluated by WBS, and the intratumoural calcification was evaluated by SPECT/CT. The diagnostic accuracy of SPECT/CT in locating 99mTc-MDP uptake in extraosseous neoplasms was compared to that of WBS. Results A total of 41 patients showed 99mTc-MDP uptake in extraosseous neoplasms. Of these patients, 23 patients had uncertain lesions by WBS, and further SPECT/CT was performed. The incidence of 99mTc-MDP uptake in extraosseous neoplasms was observed to be 0.6% by WBS and 1.1% (by) SPECT/CT. During imaging analysis, WBS had an accuracy of only 35% (14/40), whereas SPECT/CT correctly located and diagnosed all 40 lesion sites in the 23 patients. Twenty-three lesion sites (57.5%, 23/40) showed moderate or high intensity of extraosseous 99mTc-MDP uptake. Of the 23 patients, 17 patients (73.9%, 18/23) with 31 lesion sites (77.5%, 31/40) presented with intratumoural calcification. Conclusions 99mTc-MDP uptake in extraosseous neoplasms can be observed as 0.6% on WBS and is usually localized to the breast, liver, and lung. Nuclear physicians should be familiar with such extraosseous uptake when interpreting WBSs. SPECT/CT offers better accuracy than WBS alone for locating the majority of lesions present with intratumoural calcification.http://link.springer.com/article/10.1186/s12880-019-0345-1Extraosseous uptake99mTc-MDPSPECT/CTWhole-body bone scanCalcification |
| spellingShingle | Linqi Zhang Qiao He Tao Zhou Bing Zhang Wei Li Hao Peng Xi Zhong Liwu Ma Rusen Zhang Accurate characterization of 99mTc-MDP uptake in extraosseous neoplasm mimicking bone metastasis on whole-body bone scan: contribution of SPECT/CT BMC Medical Imaging Extraosseous uptake 99mTc-MDP SPECT/CT Whole-body bone scan Calcification |
| title | Accurate characterization of 99mTc-MDP uptake in extraosseous neoplasm mimicking bone metastasis on whole-body bone scan: contribution of SPECT/CT |
| title_full | Accurate characterization of 99mTc-MDP uptake in extraosseous neoplasm mimicking bone metastasis on whole-body bone scan: contribution of SPECT/CT |
| title_fullStr | Accurate characterization of 99mTc-MDP uptake in extraosseous neoplasm mimicking bone metastasis on whole-body bone scan: contribution of SPECT/CT |
| title_full_unstemmed | Accurate characterization of 99mTc-MDP uptake in extraosseous neoplasm mimicking bone metastasis on whole-body bone scan: contribution of SPECT/CT |
| title_short | Accurate characterization of 99mTc-MDP uptake in extraosseous neoplasm mimicking bone metastasis on whole-body bone scan: contribution of SPECT/CT |
| title_sort | accurate characterization of 99mtc mdp uptake in extraosseous neoplasm mimicking bone metastasis on whole body bone scan contribution of spect ct |
| topic | Extraosseous uptake 99mTc-MDP SPECT/CT Whole-body bone scan Calcification |
| url | http://link.springer.com/article/10.1186/s12880-019-0345-1 |
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