Bone: From planar imaging to SPECT & PET/CT

Jasna Mihailović, Leonard M. Freeman

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Since its introduction into clinical medicine 50 years ago, the radionuclide bone scan has played a key role in diagnosing a variety of osseous disorders; particularly metastatic disease. Using small diagnostic doses of Strontium-85 in the 1960's, it was rapidly established that the study was much more sensitive than skeletal radiographs. The introduction of Technetium-99m phosphate agents in the early 1970's, offered greatly improved resolution. Whole body imaging became the standard procedure. Interestingly, the positron-emitter, Fluorine 18-sodium fluoride was used by some investigators with the rectilinear scanner. Very recently, this radiotracer has been re-introduced and is witnessing considerable growth using modern PET/CT instrumentation. The cortical bone tracers, 99mTc-MDP and 18F-Fluoride assess osteoblastic response to the invading lesion. In the study of metastatic disease, it is superb for sclerotic blastic lesions. Although it detects most lytic lesions, many can be missed. This is due to a lack of osteoblastic response. The tumor may be slow growing, such as myeloma or conversely very rapidly growing and destructive, such as lung or kidney metastases. In these lesions, 18F-FDG is superior because it is concentrating in the tumor cells and does not depend on osteoblastic response to the tumor. In their early cause, many lytic lesions may be confined to the medullary portion of bone and not yet involve the cortex. Comparative studies of PET and CT have clearly shown the superior sensitivity of FDG in detecting metastatic bone lesions.

Original languageEnglish (US)
Pages (from-to)117-120
Number of pages4
JournalArchive of Oncology
Volume20
Issue number3-4
DOIs
StatePublished - Dec 2012

Fingerprint

Single-Photon Emission-Computed Tomography
Bone and Bones
Technetium Tc 99m Medronate
Whole Body Imaging
Neoplasms
Sodium Fluoride
Strontium
Fluorine
Clinical Medicine
Technetium
Fluorodeoxyglucose F18
Fluorides
Radioisotopes
Phosphates
Research Personnel
Electrons
Neoplasm Metastasis
Kidney
Lung
Growth

Keywords

  • Bone neoplasms
  • Diagnostic imaging
  • Emission-computed
  • Fluorodeoxyglucose F18
  • Neoplasm metastasis
  • Positron-emission tomography and computed tomography
  • Single-photon
  • Tomography

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Bone : From planar imaging to SPECT & PET/CT. / Mihailović, Jasna; Freeman, Leonard M.

In: Archive of Oncology, Vol. 20, No. 3-4, 12.2012, p. 117-120.

Research output: Contribution to journalArticle

Mihailović, Jasna ; Freeman, Leonard M. / Bone : From planar imaging to SPECT & PET/CT. In: Archive of Oncology. 2012 ; Vol. 20, No. 3-4. pp. 117-120.
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