PATTERN OF METASTATIC DEPOSIT IN BONES

Abstract

To detect the pattern of bony involvement of various malignant diseases by planar bone scanning.

Methods : 99m Tc-MDP was injected four and three phases bone scan performed in some circumstances. After 2 hrs static acquisition done. After four injection, sequential images were taken for 30 seconds, blood pool images at | minute, static views were taken after 2 hours. Diagnosis was made in all cases histologically.

Results : In the years of 1999-2000, only 76 patients, where as in the year of 2001-2002, 236 patients were referred to NMC, Rangpur for bone scan to detect metastatic deposition in bones. Among these (236), 81 patients with Ca (Ca-Carcinoma) breast, metastatic deposit found in 31 patients (38.27%), metastatic deposit found in Ca prostate patients 66.66%, in Ca-lung, secondaries found in bone 58.33%, metastatic deposit in renal Ca 60% and in Urinary Bladder malignancy 33.33%. In Hodgkin’s lymphoma (HL) and Non-Hodgkin’s lymphoma (NHL) bony metastasis found 33.33% and 40% respectively. Clinically most of the referred patients were of suspected bone metastasis.

Conclusion : Accurate bone scan diagnosis depends on high quality image. Specific advantages of SPECT in identifying and localizing skeleal pathology have already been established. But planar scintigraphy in diagnostic application for skeletal oncology not laagging behind. SPECT supplements but does not replace planar bone scanning.However, programme should be taken to aware the referring physician to detect bony involvement earlier by isotope scan than radiograph which will help to palliate or, cure the patients.