Article Figures & Data
Figures
- FIGURE 1.
Classification of 99mTc-MIBI activity patterns. (A) No detectable activity in patient with breast cancer was confirmed by lack of abnormal MRI findings. (B) Homogeneous mild activity in patient with lung cancer was confirmed by lack of abnormal MRI findings. (C) Clearly visualized focal activity in patient with malignant lymphoma (non-Hodgkin’s) was confirmed by abnormal MRI findings and bone marrow cytology from puncture sites on each anterior iliac crest. Clearly visualized activity of 99mTc-MIBI was interpreted as abnormal.
- FIGURE 2.
Normal 99mTc-MIBI skeletal images of woman with hypertension with no evidence of cancer. Homogeneous mild activity was found in thoracic spine, ribs, and lumbar spine; no detectable activity was evident in femur.
- FIGURE 3.
Patient with breast cancer. (A) Initial 99mTc-HMDP scans show no bone metastases. (B) 99mTc-MIBI scans show multiple lesions in thoracic spine, bilateral proximal femur, and right pubic bone. Findings were confirmed 1 mo later by MRI. (C) Multiple intense accumulations of 99mTc-HMDP appeared 4 mo later on whole-body scans. (D) Further 99mTc-MIBI scans (second set) show increased accumulations in thoracic spine, bilateral proximal femur, and left lung metastatic lesion. 99mTc-HMDP accumulations in more extensive sites, including bilateral proximal femur, appeared 2 mo after obtaining second set of 99mTc-HMDP scans.
- FIGURE 4.
Patient with lung cancer. (A) 99mTc-HMDP scans show no definite bone metastases, although anterior pelvis image could not be obtained. (B) 99mTc-MIBI scans show increased uptake in multiple regions of ribs, in thoracic and lumbar spine, and in right lung tumor and also show irregular-shaped uptake in bilateral proximal femur in anterior pelvis image. MRI showed multiple metastases in thoracic spine, and bone marrow cytology from puncture sites on sternum showed many lung cancer cells.
- FIGURE 5.
Patient with colon cancer. (A) 99mTc-HMDP scans show no metastases in thoracic spine. (B) Corresponding 99mTc-MIBI scans reveal diffuse intense uptake in thoracic spine. Bone marrow cytology from puncture sites on each anterior iliac crest indicated positive findings.
- FIGURE 6.
Patient with prostate cancer. (A) 99mTc-HMDP scans show multiple intense accumulations in cervical spine, thoracic spine, lumbar spine, skull, and ribs. (B) In contrast, 99mTc-MIBI scans do not show any abnormalities.
Tables
- TABLE 1
Comparison of Detectability of Bone Metastases Between 99mTc-HMDP and 99mTc-MIBI Scans in Relation to Skeletal Sites
Site No. of metastases 99mTc-HMDP(+), 99mTc-MIBI(−) 99mTc-HMDP(−), 99mTc-MIBI(+) 99mTc-HMDP(+), 99mTc-MIBI(+) 99mTc-HMDP(+)* 99mTc-MIBI(+)* 99mTc-HMDP vs. 99mTc-MIBI Rib 57 15 12 30 45 (78.9) 42 (73.7) NS Thoracic spine 33 8 6 19 27 (81.8) 25 (75.8) NS Lumbar spine 23 9 4 10 19 (82.6) 14 (60.9) NS Sternum 18 0 4 14 14 (77.8) 18 (100) NS Pelvis 62 12 11 39 51 (82.3) 50 (80.6) NS Humerus 22 1 11 10 11 (50.0) 21 (95.5) P < 0.005 Femur 98 1 63 34 35 (35.7) 97 (99.0) P < 0.005 Other 21 4 5 12 16 (76.2) 17 (81.0) NS Total 334 50 116 168 218 (65.3) 284 (85.0) P < 0.005 ↵* Value in parentheses is percentage.
99mTc-HMDP(+) = 99mTc-HMDP positive; 99mTc-HMDP(−) = 99mTc-HMDP negative; 99mTc-MIBI(+) = 99mTc-MIBI positive; 99mTc-MIBI(−) = 99mTc-MIBI negative; NS = not significant.
- TABLE 2
Comparison of Detectability of Bone Metastases Between 99mTc-HMDP and 99mTc-MIBI Scans in Relation to Underlying Primary Malignancy
Primary malignancy No. of metastases 99mTc-HMDP(+), 99mTc-MIBI(−) 99mTc-HMDP(−), 99mTc-MIBI(+) 99mTc-HMDP(+), 99mTc-MIBI(+) 99mTc-HMDP(+)* 99mTc-MIBI(+)* 99mTc-HMDP vs. 99mTc-MIBI Breast cancer 69 10 27 32 42 (60.9) 59 (85.5) P < 0.005 Lung cancer 68 17 20 31 48 (70.6) 51 (75.0) NS Prostate cancer 38 9 4 25 34 (89.5) 29 (76.3) NS Myeloma 30 0 13 17 17 (56.7) 30 (100) P < 0.005 Hepatoma 21 0 11 10 10 (47.6) 21 (100) P < 0.005 Gastric cancer 21 4 3 14 18 (85.7) 17 (81.0) NS Bladder cancer 17 0 2 15 15 (88.2) 17 (100) NS Renal cancer 11 4 4 3 7 (63.6) 7 (63.6) NS Colon cancer 11 2 3 6 8 (72.7) 9 (81.8) NS ↵* Value in parentheses is percentage.
99mTc-HMDP(+) = 99mTc-HMDP positive; 99mTc-HMDP(−) = 99mTc-HMDP negative; 99mTc-MIBI(+) = 99mTc-MIBI positive; 99mTc-MIBI(−) = 99mTc-MIBI negative; NS = not significant.
- TABLE 3
Comparison of Detectability of Bone Metastases Between 99mTc-HMDP and 99mTc-MIBI Scans in Regions of Femur and Humerus
Primary malignancy No. of metastases 99mTc-HMDP(+), 99mTc-MIBI(−) 99mTc-HMDP(−), 99mTc-MIBI(+) 99mTc-HMDP(+), 99mTc-MIBI(+) 99mTc-HMDP(+)* 99mTc-MIBI(+)* 99mTc-HMDP vs. 99mTc-MIBI Breast cancer 21 0 14 7 7 (33.3) 21 (100) P < 0.005 Lung cancer 29 2 9 18 20 (69.0) 27 (93.1) P < 0.05 Prostate cancer 11 0 3 8 8 (72.7) 11 (100) NS Myeloma 11 0 5 6 6 (54.5) 11 (100) P < 0.05 Hepatoma 12 0 10 2 2 (16.7) 12 (100) P < 0.005 Gastric cancer 4 0 3 1 1 (25.0) 4 (100) NS Bladder cancer 2 0 0 2 2 (100) 2 (100) NS Renal cancer 5 0 4 1 1 (20.0) 5 (100) NS Colon cancer 3 0 3 0 0 3 (100) NS ↵* Value in parentheses is percentage.
99mTc-HMDP(+) = 99mTc-HMDP positive; 99mTc-HMDP(−) = 99mTc-HMDP negative; 99mTc-MIBI(+) = 99mTc-MIBI positive; 99mTc-MIBI(−) = 99mTc-MIBI negative; NS = not significant.
- TABLE 4
Comparison of Detectability of Bone Metastases Between 99mTc-HMDP and 99mTc-MIBI Scans in Regions Other Than Femur and Humerus
Primary malignancy No. of metastases 99mTc-HMDP(+), 99mTc-MIBI(−) 99mTc-HMDP(−), 99mTc-MIBI(+) 99mTc-HMDP(+), 99mTc-MIBI(+) 99mTc-HMDP(+)* 99mTc-MIBI(+)* 99mTc-HMDP vs. 99mTc-MIBI Breast cancer 48 10 13 25 35 (72.9) 38 (79.2) NS Lung cancer 39 13 9 17 30 (76.9) 26 (66.7) NS Prostate cancer 27 9 1 17 26 (96.3) 18 (66.7) P < 0.025 Myeloma 19 0 7 12 12 (63.2) 19 (100) P < 0.025 Hepatoma 9 0 1 8 8 (88.9) 9 (100) NS Gastric cancer 17 4 0 13 17 (100) 13 (76.5) NS Bladder cancer 15 0 2 13 13 (86.7) 15 (100) NS Renal cancer 6 4 0 2 6 (100) 2 (33.3) NS Colon cancer 8 2 0 6 8 (100) 6 (75.0) NS ↵* Value in parentheses is percentage.
99mTc-HMDP(+) = 99mTc-HMDP positive; 99mTc-HMDP(−) = 99mTc-HMDP negative; 99mTc-MIBI(+) = 99mTc-MIBI positive; 99mTc-MIBI(−) = 99mTc-MIBI negative; NS = not significant.
