Multiple Metastasis-Like Bone Lesions in Scintigraphic Imaging

Abstract

Multiple benign osteolytic lesions are very hard to differentiate from disseminated bone metastasis. Whole-body bone scintigraphy (WBBS) with technetium-99m methylene diphosphonate (Tc-99m MDP) demonstrates multiple lesions with increased uptake in any bone involved. Even combined with medical history and multiple imaging results, such as MRI and CT, the clinical diagnosis of metastasis lesion remains as a challenge. These clinical characteristics are similar to multiple malignant bone metastases and therefore affect the following treatment procedures. In this paper, we analyzed multiple benign osteolytic lesions, like eosinophilic granuloma (EG), multiple myeloma (MM), disseminated tuberculosis, fibrous dysplasia, or enchondroma, occurring in our daily clinical work and concluded that additional attention should be paid before giving the diagnosis of multiple bone metastases.

Imaging of bone metastasis: An update

“…Skeletal scintigraphy has some notable limitations. For example, bone scintigraphy is non-specific and multiple benign osseous lesions, such as eosinophilic granuloma fibrous dysplasia and enchondroma, can lead to a false positive diagnosis of bone metastasis [14] . Interpreting focal accumulation of radiotracer in the spine can be particularly problematic as degenerative disease may be indistinguishable from bone metastases.…”

Distal appendicular skeletal involvement of diffuse large B-cell lymphoma on technetium-99m methylenediphosphonate bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography: a case report

“…Bone scan is widely available and commonly used to detect bone metastases from cancers because it is inexpensive and sensitive and is able to capture a whole-body image [7]. Notably, PET/CT also provides whole-body images with an overall assessment of disease extent, and so can reveal lesions that are hidden on other conventional images.…”

Psoriatic Arthritis Under a Proteomic Spotlight: Application of Novel Technologies to Advance Diagnosis and Management

“…As a targeted peptide-centric approach, MRM has been used for multiple biomarker studies in the past few years to detect and quantify biomarkers in a range of diseases (Table 1) [112][113][114][115][116][117][118][119][120][121][122][123]. MRM assays can be multiplexed to support the measurement and quantification of 100 s of important candidate biomarker proteins simultaneously in several hundreds of patient tissue or serum samples.…”

“…The analysis of labelled or label-free shotgun data can be analysed with numerous softwares including MaxQuant, Mass Profiler Professional (MPP), Peaks, Perseus, Progenesis LC-MS and A series of tutorials for MRM method development and data analysis using skyline can be found online https://skyline.gs.washington.edu/labkey/wiki/home/software/Skyline /page.vie?name=tutorials This group developed an MRM assay for the detection of C-reactive protein (CRP). Implementing this assay, they were able to distinguish progressive arthritic patients from non progressive patients based on differential levels of CRP Kuhn et al [118] An MRM assay was developed to detect amyloid beta in cerebrospinal fluid. This assay was utilised to distinguish patients with Alzheimer's from non-diseased controls Ackermann et al [126] An MRM assay was developed to measure 18 plasma proteins in patients with colorectal cancer receiving chemotherapy.…”

“…Recently, however, two interesting studies have emerged. Using an LC-MS/MS approach, Ademowo et al assessed the protein expression profile in the synovial tissue (ST) of PsA receiving biological therapy with adalimumab [118]. It was found that 107 proteins were differentially expressed between patients that responded well as compared to those who responded poorly to therapy.…”