Bone scintigraphy in nasopharyngeal carcinoma

Staging computed tomography of the thorax for nasopharyngeal carcinoma

“…The skeletal system, the thorax, and the liver have been recognized to be the most frequent sites of distant metastatic spread in NPC. [2][3][4][5][6][7][8] Previous studies had shown that the positive rates of staging bone scintigraphy and abdominal ultrasonography were related to advanced N stage disease, [9][10][11][12] , but the role of CT of the thorax has hitherto not been determined. This study shows that CT of the thorax has a very low yield as a staging investigation in NPC, in contrast to staging bone scintigraphy with a yield of 20% (9 of 44 patients) in this cohort of patients and a yield of 1.8% to 23% reported in the literature.…”

“…This study shows that CT of the thorax has a very low yield as a staging investigation in NPC, in contrast to staging bone scintigraphy with a yield of 20% (9 of 44 patients) in this cohort of patients and a yield of 1.8% to 23% reported in the literature. [9][10][11] . Although cost was not measured in this study, the inferred costeffectiveness of staging CT of the thorax would be low.…”

“…6 The thorax, after the skeletal system, is one of the most common sites of distant metastatic spread in NPC. 2,4,8 Although it is known that a subset of patients with advanced nodal disease would have distant metastases demonstrable by bone scintigraphy [9][10][11] and abdominal ultrasonography 12 at pretherapy staging, the role of staging CT of the thorax has not been evaluated before. It had also been observed that intrathoracic metastases that developed after treatment of localregional disease were frequently associated with mediastinal and hilar lymphadenopathy, 13 a feature that was uncommon for most other head and neck cancers.…”

Orthopedic Nuclear Medicine

“…Palestro reported an improvement in specificity from 12 -94 % with the addition of sulfur colloid bone marrow scanning, while Seabald showed specificity improved from 59 % to 92 % [40,182]. A study is considered to be positive for infection when the indium-111 leukocyte uptake exceeds Tc-99m colloid activity on bone marrow scanning in extent and/or focal intensity (discordant pattern).…”

“…The routine use of bone scanning in detecting metastases is controversial although as many as 23 % of newly diagnosed cases showed bone metastases [182]. SPECT bone scanning was found in a small series of patients to be more sensitive that CT scanning in assessing the skull base involvement by nasopharyngeal carcinoma [183].…”