Nuclear medicine studies in the differential diagnosis of diseases with spinal involvement

Plain X-rays computed tomographic and magnetic resonance images all yield information on the pathophysiology of diseases with spinal involvement. Descriptions of the following nuclear medicine methods are presented: Bone scanning with 99 m-technetium labeled phosphonate complexes used for the evaluation of skeletal metastases, primary bone tumors, traumatic, degenerative, and postoperative changes as well as in inflammatory conditions. Specific radionuclides used for the localization of inflammatory conditions are radioactive labeled leucocytes. Iodine total body scans used to detect spinal metastases of follicular and papillary thyroid carcinoma. 201-thalliumchloride is used as a tumor-marker with high affinity and sensitivity in malignant thyroid tumors. 131- or 123-iodine-meta-iodobenzylguanidine scans used in the detection of metastases of pheochromocytoma and neuroblastoma. Immunoscintigraphy with radioactive labeled anti-CEA antibodies used for the specific labelling of metastases of gastrointestinal tract tumors, melanoma, breast, and ovarian carcinoma. The value of the various nuclear medicine methods in the diagnostic schedule is illustrated in case reports.