Recognition of the superscan in prostatic bone scintigraphy

Constable, A. R.; Cranage, R. W.

doi:10.1259/0007-1285-54-638-122

Cited by 59 publications

(27 citation statements)

References 7 publications

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“…En oncologie, la scintigraphie osseuse représente, de par sa haute sensibilité [1][2][3][4], un outil précieux pour le bilan initial et dans la surveillance des cancers ostéophiles [15][16][17]. Malheureusement, la spécificité de cet examen est moins élevée, se pose souvent le problème du diagnostic différentiel entre les métastases et les pathologies bénignes qui entraînent un remaniement osseux, et ce surtout lorsque les foyers d'hyperfixation ostéoblastiques sont uniques et/ou situés au niveau de régions anatomiques particulières (par exemple à proximité des articulations) [18][19][20][21][22][23].…”

Section: Discussion : Rôle De La Scintigraphie Osseuse Dans Le Bilan unclassified

Radiopharmaceuticals and bone metastases: Which molecules for which patients and which indications?

et al. 2015

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Le principe des explorations scintigraphiques est de déterminer, et le plus souvent de représenter sous forme d'images, la biodistribution d'un radiopharmaceutique au sein de l'organisme. L'imagerie hybride, anatomique et fonctionnelle, augmente la sensibilité et la spécificité des examens scintigraphiques, et ce notamment dans les cas difficiles où l'analyse séparée des deux examens ne permet de trancher avec certitude quant à la nature et la signification des anomalies. La scintigraphie osseuse aux diphosphonates technétiés est l'examen radio-isotopique classique dans l'étude de la pathologie osseuse. Dans certains cas néan-moins, la tomographie par émission de positons (TEP) au FDG est plus sensible dans la détection de métastases ostéo-lytiques. La radiothérapie métabolique consiste en l'administration d'un radioélément en source non scellée, dont les rayonnements vont détruire les cellules qui ont accumulé sélectivement ce produit. La prise en charge de la douleur osseuse constitue un problème majeur, notamment en cas de cancer mammaire ou prostatique où la présence de méta-stases peut demeurer compatible avec une survie de longue durée. Dans ce cadre, la radiothérapie métabolique permet de diminuer les douleurs secondaires aux métastases osseuses, en association ou non à des médicaments antalgiques.Mots clés Scintigraphie osseuse · TEP/TDM au FDG · Radiothérapie métabolique · Métastases osseuses hyperalgiques · Palliation antalgique osseuse Abstract Nuclear medicine investigations are able to represent the biodistribution of a radiopharmaceutical within the body as images. The hybrid, anatomical and functional imaging increases the sensitivity and specificity of scintigraphic examinations, particularly in difficult cases where two separate analyses do not allow to decide the nature and significance of the abnormalities. Bone scintigraphy with technetium diphosphonates is the classic radioisotope examination in the study of bone pathology. In some cases, however, FDG-PET is more sensitive in detecting osteolytic metastases. The administration of a radionuclide in unsealed source whose radiation will destroy cells that have selectively accumulated product is called radiometabolic therapy. The management of bone pain is a major problem, particularly in cases of breast or prostate cancer where the presence of metastases can remain compatible with long-term survival of cancer patients. In this context, the radiometabolic therapy reduces the pain secondary to bone metastases, in association or not with analgesics.

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Section: Discussion : Rôle De La Scintigraphie Osseuse Dans Le Bilan unclassified

Radiopharmaceuticals and bone metastases: Which molecules for which patients and which indications?

et al. 2015

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“…1,2 Superscans have been described mostly in metastatic and metabolic bone diseases, and less commonly in myeloproliferative disorders and miscellaneous conditions. [3][4][5] The patterns of uptake between the metastatic and metabolic superscans are different. A metastatic superscan often demonstrates diffuse heterogeneous uptake in the axial skeleton and visualized tracer accumulation in the urinary bladder in spite of absent renal activity, but increased uptake on a metabolic superscan affects both axial and appendicular bones as well as the skull, mandible, and sternum uniformly.…”

Section: Figure 1 Amentioning

confidence: 99%

Super-Superscan on a Bone Scintigraphy

Liu

2011

Clinical Nuclear Medicine

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Superscans on bone scintigraphy have been described mostly in metastatic and metabolic bone diseases, with different patterns and appearances of radiotracer uptake. This is a report of bone scintigraphy demonstrating superimposed metastatic and metabolic superscan in a patient with prostate cancer, who subsequently developed renal osteodystrophy. Two years after the first bone scintigraphy showing multiple metastases, the patient developed renal insufficiency, hyperphosphoremia, and hypocalcemia. Repeat bone scintigraphy demonstrates significantly different appearance from that of the first study. Caution should be exercised when interpreting a bone scintigraphy in patients with known malignancy and coexisting renal failure or metabolic bone disease. Superimposed appearances of metastatic and metabolic superscan may obscure recognition of osseous metastases.

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“…This is the so-called 'super bone scan' described by Osmond et al [2]. Recognition of a superscan based solely on the absence of renal activity is not definitive as abnormal renal function and drainage may affect their appearance [3]. Accumulated bladder activity is frequently much less than normally seen, but is not an entirely reliable indicator for or against the presence of a superscan.…”

Section: Introductionmentioning

confidence: 99%

“…In this study, the underlying cause of superscan was metastatic carcinoma of prostate and no further qualitative evaluation of the scan pattern was made. Constable and Cranage [3] presented one of the first attempts to quantify the uptake in the superscan category of patients. Using the 12th thoracic vertebra to soft tissue ratio they were able to distinguish superscan patients from other groups.…”

Section: Introductionmentioning

confidence: 99%