Radionuclides for Patients With Painful Skeletal Metastases
Radionuclides for Patients With Painful Skeletal Metastases
The diagnosis of bone metastases can be made using several diagnostic imaging techniques. The most utilized technique is the Tc nuclear medicine bone scan; the radionuclide tracer, attached to an organophosphate (methylene diphosphonate), is specifically incorporated into the skeleton in areas of significant osteoblast activity, preferentially binding to hydroxyapatite within the bone matrix. Although this type of bone scan is useful for osteoblastic metastases (such as from prostate, lung, or breast tumors), primarily osteolytic lesions (myeloma, thyroid, renal cell), generally exhibit poor uptake. Plain films and computed tomography (CT) scans are sensitive for observing the destructive characteristics of such osteolytic metastases. Other imaging modalities, such as magnetic resonance imaging (MRI) and F sodium fluoride (NaF) positron emission tomography (PET), may also have utility in select patients.
Diagnosis of Bone Metastases
The diagnosis of bone metastases can be made using several diagnostic imaging techniques. The most utilized technique is the Tc nuclear medicine bone scan; the radionuclide tracer, attached to an organophosphate (methylene diphosphonate), is specifically incorporated into the skeleton in areas of significant osteoblast activity, preferentially binding to hydroxyapatite within the bone matrix. Although this type of bone scan is useful for osteoblastic metastases (such as from prostate, lung, or breast tumors), primarily osteolytic lesions (myeloma, thyroid, renal cell), generally exhibit poor uptake. Plain films and computed tomography (CT) scans are sensitive for observing the destructive characteristics of such osteolytic metastases. Other imaging modalities, such as magnetic resonance imaging (MRI) and F sodium fluoride (NaF) positron emission tomography (PET), may also have utility in select patients.
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