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Dynamic quantitative bone scintigraphy in patients with prostatic carcinoma treated by orchiectomy
G M Sundkvist1, L Ahlgren, B Lilja
1Department of Clinical Physiology, Lund University, Malmö General Hospital, Sweden.
European Journal of Nuclear Medicine
|January 1, 1990
Summary
Dynamic quantitative bone scintigraphy using technetium methylene diphosphonate Tc 99m (99mTc-MDP) effectively detects skeletal metastases in prostate cancer patients. Post-orchiectomy, abnormal bone uptake initially flares then decreases, indicating treatment response.
Area of Science:
- Nuclear Medicine
- Oncology
- Radiopharmacology
Background:
- Prostate carcinoma often metastasizes to bone, necessitating effective monitoring.
- Dynamic quantitative bone scintigraphy provides functional information about bone metabolism.
Purpose of the Study:
- To evaluate the utility of dynamic quantitative bone scintigraphy with 99mTc-MDP in assessing skeletal metastases in prostate cancer patients.
- To monitor changes in bone uptake following orchiectomy.
Main Methods:
- 31 men with prostatic carcinoma underwent dynamic quantitative bone scintigraphy with 99mTc-MDP.
- Scintigraphy was performed pre-orchiectomy and at 2 weeks, 2 months, and 6 months postoperatively.
- Count rates over thoracic and lumbar vertebrae were analyzed from 1 to 240 minutes post-injection.
Main Results:
- 18 of 31 patients had skeletal metastases.
- Abnormal bone uptake was detectable as early as 6 minutes post-injection in metastatic vertebrae.
- A "flare phenomenon" (increased uptake) was observed 2 weeks post-orchiectomy, followed by decreased uptake at 2 and 6 months.
Conclusions:
- Dynamic quantitative bone scintigraphy is a sensitive tool for detecting bone metastases in prostate cancer.
- The observed flare phenomenon and subsequent decrease in uptake reflect treatment response to orchiectomy.
- Even normal-appearing vertebrae in patients with metastases showed a tendency towards the flare phenomenon.