Meme kanserli bir hastada 18-Floro-de-oksi-Glukoz pozitron emisyon tomografisinde multiple kemik metastazları: Olgu sunumu ve literatürün gözden geçirilmesi [Multiple bone metastases detected on 2-[18F]-fluoro-2-deoxy-d-glucose PET]

Yıl 2012, Cilt: 3 Sayı: 3, 426 - 429, 01.09.2012

Zeki Dostbil Buğra Kaya Oktay Sarı Erhan Varoğlu Murat İsmailoğlu

https://doi.org/10.5799/ahinjs.01.2012.03.0195

Öz

Bone scintigraphy has been widely used to assess skeletal metastasis in patients with breast cancer. 18F-FDG-PET/CT is another imaging modality that has gained previously wide use to determine metastasis based on increased glucose metabolism in malignant cells. Generally, these two modalities give similar results in evaluation of bone metastasis of breast cancer. In this breast cancer case, 99mTc-MDP bone scintigraphy showed normal findings in regards to skeletal metastasis while 18F-FDG-PET/CT, contrast-enhanced CT and MRI revealed multiple metastatic focuses.

Anahtar Kelimeler

18F-fluorodeoxyglucose, bone metastasis, bone scintigraphy, positron emission tomography

Meme kanserli bir hastada 18-Floro-de-oksi-Glukoz pozitron emisyon tomografisinde multiple kemik metastazları: Olgu sunumu ve literatürün gözden geçirilmesi

Öz

Kemik sintigrafisi, meme kanserli hastaların iskelet sistemi metastazlarının değerlendirilmesinde halen yaygın olarak kullanılmaktadır. 18F-FDG-PET/BT, malign hücrelerde artmış glukoz metabolizmasının görüntülenmesi prensibine dayanarak metastazları tespit etmede son yıllarda yaygın kullanım alanı kazanmış diğer bir görüntüleme yöntemidir. Genel olarak, meme kanserinin kemik metastazlarının tespitinde bu iki yöntem benzer sonuçlar vermektedir. Meme kanserli bu olguda 99mTc-MDP kemik sintigrafisi kemik metastazı yönünden normal bulgular göstermesine karşın 18F-FDG-PET/BT, kontrastlı BT ve MR\'da iskelet sisteminde birçok odakta kemik metastazları tespit edilmiştir.

Anahtar Kelimeler

18F-florodeoksiglikoz, kemik metastazı, kemik sintigrafisi, pozitron emisyon tomografisi

Kaynakça

• Ohta M, Tokuda Y, Suzuki Y, et al. Whole body PET for the evaluation of bony metastases in patients with breast cancer: comparison with 99Tcm-MDP bone scintigraphy. Nucl Med Commun 2001;22(8):875-9.
• Chen YW, Huang MY, Hsieh JS, Hou MF, Chou SH, Lin CL. Discordant findings of skeletal metastasis between tc 99M MDP bone scans and F18 FDG PET/CT imaging for advanced breast and lung cancers--two case reports and literature review. Kaohsiung J Med Sci 2007;23(12):639- 46.
• Coleman RE, Rubens RD. The clinical course of bone me- tastases from breast cancer. Br J Cancer 1987;55(1):61-6.
• Roodman GD. Mechanisms of bone metastasis. N Engl J Med 2004;350(16):1655-64.
• Liu T, Xu JY, Xu W, Bai YR, Yan WL, Yang HL. Fluorine-18 deoxyglucose positron emission tomography, magnetic resonance imaging and bone scintigraphy for the diag- nosis of bone metastases in patients with lung cancer: which one is the best?-a meta-analysis. Clin Oncol (R Coll Radiol) 2011;23(5):350-8.
• Schmidt GP, Reiser MF, Baur-Melnyk A. Whole-body imag- ing of the musculoskeletal system: the value of MR imag- ing. Skeletal Radiol 2007;36(12):1109-19.
• Ozülker T, Küçüköz AU, Ozülker F, Ozpaçacı T. Compari- son of (18)F-FDG-PET/CT with (99m)Tc-MDP bone scin- tigraphy for the detection of bone metastases in cancer patients. Nucl Med Commun 2010;31(6):597-603.
• Taube T, Elomaa I, Blomqvist C, Beneton MN, Kanis JA. Histomorphometric evidence for osteoclast-mediated bone resorption in metastatic breast cancer. Bone 1994;15(2):161-6.
• Coleman RE. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 2001;27(3):165-76.
• Min JW, Um SW, Yim JJ, et al. The role of whole-body FDG PET/CT, Tc 99m MDP bone scintigraphy, and serum alkaline phosphatase in detecting bone metastasis in pa- tients with newly diagnosed lung cancer. J Korean Med Sci 2009;24(2):275-80.
• Gallowitsch HJ, Kresnik E, Gasser J, et al. F-18 fluorode- oxyglucose positron-emission tomography in the diagno- sis of tumor recurrence and metastases in the follow-up of patients with breast carcinoma: a comparison to con- ventional imaging. Invest Radiol 2003;38(5):250-6.
• Nakamoto Y, Cohade C, Tatsumi M, Hammoud D, Wahl RL. CT appearance of bone metastases detected with FDG PET as part of the same PET/CT examination. Ra- diology 2005;237(2):627-34.
• Kao CH, Hsieh JF, Tsai SC, Ho YJ, Yen RF. Comparison and discrepancy of 18F-2-deoxyglucose positron emis- sion tomography and tc-99m MDP bone scan to detect bone metastases. Anticancer Res 2000;20(3B):2189-92.
• Tombal B, Lecouvet F. Modern detection of prostate can- cer’s bone metastasis: Is the bone scan era over? Adv Urol 2012;2012(7):893-9.
• Groves AM, Beadsmoore CJ, Cheow HK, et al. Can 16-detector multislice CT exclude skeletal lesions during tumour staging? Implications for the cancer patient. Eur Radiol 2006;16(5):1066-73.
• Kitajima K, Suzuki K, Nakamoto Y, et al. Low-dose non- enhanced CT versus full-dose contrast-enhanced CT in integrated PET/CT studies for the diagnosis of uter- ine cancer recurrence. Eur J Nucl Med Mol Imaging 2010;37(8):1490-8.
• Even-Sapir E, Metser U, Mishani E, Lievshitz G, Lerman H, Leibovitch I. The detection of bone metastases in pa- tients with highrisk prostate cancer: 99mTc-MDP planar bone scintigraphy, singleand multi-field-of-view SPECT, 18F-Fluoride PET, and 18F-Fluoride PET/CT. J Nucl Med 2006;47(2):287-97.
• Schirrmeister H, Glatting G, Hetzel J, et al. Prospective evaluation of the clinical value of planar bone scans, SPECT, and (18)F-labeled NaF PET in newly diagnosed lung cancer. J Nucl Med 2001;42(12):1800-4.