The one-in-all diagnostic value of 99mTc-MDP bone scan combining with single-photon emission tomography (SPECT)/CT imaging in spinal osteoblastoma

Risk factors for rib metastases of lung cancer patients with high-uptake rib foci on 99Tcm-MDP SPECT/CT

BACKGROUND

99Tcm-MDP SPECT/CT is widely used to diagnose early bone metastasis. Ribs are high-risk bone metastasis sites, while few study is related to ribs. The study is to investigate the risk factors of rib metastases in lung cancer patients.

METHODS

We retrospectively analyzed the patients' clinical characteristics and SPECT/CT imaging features. The patients were divided into a rib metastasis group (108 cases) and a non-rib metastasis group (103 cases).

RESULTS

In 211 patients, rib metastases were closely related to tumor markers, T stage, N stage, clinical staging, lymph node (LN) involvement, number of rib foci, localization on rib and foci type (P<0.05). In 93 patients with pure rib foci, rib metastases were affected by clinical staging, LN involvement, localization on the rib and primary lung cancer localization (P<0.001, 0.038,<0.001, 0.034, respectively). In 100 patients with a solitary rib focus, rib metastases were associated with clinical staging, localization on the rib, and LN involvement (P<0.001, 0.001, and 0.014, respectively). In all 633 rib foci, localization on the rib was an effective risk factor for rib metastases (P<0.001).

CONCLUSIONS

Patients with increased tumor markers, stage IV lung adenocarcinoma and multiple rib foci located ipsilaterally with the primary lung tumor, or rib foci accompanied other bone foci are more likely to develop rib metastasis. Patients with pure rib foci or a solitary rib focus, especially in the anterior rib with negative LN involvement, have a low probability of rib metastasis.

Imaging signs and the qualitative diagnosis of solitary rib lesions using 99mtechnetium-methylene diphosphonate whole-body bone imaging in patients with a malignant tumor

Background

The aim of this study was to summarize the valuable information for qualitative diagnosis by investigating the imaging signs from the whole-body bone imaging of solitary rib lesions.

Methods

A retrospective analysis was conducted of the data from 313 patients with malignant tumors and solitary rib lesions identified using whole-body bone imaging in Department of Nuclear Medicine of Central South University Xiangya School Affiliated Haikou Hospital between January 2015 and December 2017. Based on the final comprehensive diagnosis of the rib lesions, the patients were divided into a bone metastasis group, fracture group, other benign lesions group, and an uncertain group, and the characteristic imaging changes in rib lesions in each group were explored.

Results

(I) Significant differences were identified among the 4 groups (P<0.001) in the distribution of lesions in the anterior, posterior, and lateral ribs and proximal costal cartilage. The fracture group had the highest proportion of lesions in the anterior ribs (99/121, 81.8%) and proximal costal cartilage (74.4%, 90/121). (II) Significant differences were detected in morphology, concentration, boundaries, and radioactivity distribution among the 4 groups of patients (P<0.001). The bone metastasis group had the highest proportion of lesions appearing as stripes (35/67, 52.2%), and the fracture group had the highest proportion of lesions appearing as spots (94.2%, 114/121) and the lowest proportion appearing as stripes (3/121, 2.5%). (III) Significant differences were found in the longitudinal diameter, transverse diameter, aspect ratio, and tumor-to-normal tissue ratio between the 4 groups (P<0.001). The longitudinal diameter (27.8±16.0 mm) and aspect ratio (1.9±1.0) of the bone metastasis group were the highest, whereas the longitudinal diameter (15.2±3.9 mm) and aspect ratio (1.0±0.2) of the fracture group were the smallest.

Conclusions

This study revealed that different types of solitary rib lesions had relatively characteristic imaging signs in whole-body bone imaging.

Multimodal Imaging Evaluation and Clinical Progress of Spinal Osteoblastoma: A Comprehensive Review

Spinal osteoblastoma is rare clinically, with insidious onset, atypical symptoms, and various imaging manifestations, which can easily lead to misdiagnosis and delayed diagnosis. It can cause severe neurological dysfunction in patients with intermediate to advanced stages and may easily recur after surgery. Imaging examinations such as radiography, computed tomography, magnetic resonance imaging, and positron emission tomography have different value for the diagnosis of spinal osteoblastoma, but they lack specificity. The preferred treatment is surgical resection, which is technically difficult, and in some cases, osteoblastoma cannot be completely removed. New clinical approaches such as radiofrequency ablation, radiotherapy, targeted chemotherapy, and other comprehensive treatments have emerged and are progressing rapidly, but no unified norms have yet been developed. This manuscript provides a systematic review of the literature and provides an extensive and comprehensive review of this rare tumor in terms of multimodality imaging manifestations and clinical progress.

Osteoblastoma of the Lumbar Spine: Findings in SPECT/CT

ABSTRACT

Osteoblastoma is an uncommon benign osteoid tissue-forming bone tumor. We present the case of a 16-year-old adolescent boy with lower back pain that radiated down the right thigh. Lumbar MRI and CT findings were consistent with a long-standing osteoid osteoma located in the right laminae and pedicle of L3. SPECT/CT with 99mTc-DPD showed a highly increased osteogenic activity within the lesion, especially in the core region, also suggesting an osteoid osteoma. Surgical en bloc resection was performed with a final histological diagnosis of osteoblastoma.

Imaging Review of Pediatric Benign Osteocytic Tumors and Latest Updates on Management

Pediatric benign osteocytic tumors include osteoma, enostosis, osteoid osteoma, and osteoblastoma. In pediatric populations, benign bone tumors are more common than malignancies. Benign osteocytic tumors may have a unique clinical presentation that helps narrow the differential diagnosis. A systemic imaging approach should be utilized to reach the diagnosis and guide clinicians in management. Radiographs are the most prevalent and cost-effective imaging modality. Cross-sectional imaging can be utilized for tissue characterization and for evaluation of lesions involving complex anatomical areas such as the pelvis and spine. Computed Tomography (CT) is the modality of choice for diagnosis of osteoid osteoma. CT scan can also be utilized to guide radiofrequency ablation, which has been found to be highly effective in treating osteoid osteoma and osteoblastoma. Enostosis is a no-touch lesion. Osteoma is commonly located in the paranasal sinuses. Osteoma needs an excision if it causes complications due to a mass effect.