Technetium-99m-labeled antigranulocyte antibody bone marrow scintigraphy.
Although bone scintigraphy is a sensitive method for detecting skeletal metastases, it is often equivocal for metastases due to poor specificity. This study evaluates 99mTc-antigranulocyte antibody (AGA) bone marrow scintigraphy in differentiating malignant from benign lesions, in 42 patients with skeletal tumors who had equivocal bone scans.


METHODS
AGA scans performed approximately 1 wk after 99mTc-MDP bone imaging were visually assessed for the presence of concordant marrow defects. Final diagnoses were made from radiological results, follow-up bone scans or clinical evaluation for 12 mo or longer.


RESULTS
The final diagnoses were: skeletal metastasis (19 patients), no metastasis (20 patients) and unconfirmed (3 patients). AGA scans could not determine the presence of a concordant defect in three patients because of overlying liver activity or previous irradiation of the region. Seventeen patients had bone marrow defects concordant with bone scan lesions, whereas 15/19 patients without metastasis had normal AGA scans. The sensitivity and specificity of AGA for detecting skeletal metastases were 100% and 79%, respectively.


CONCLUSIONS
AGA scans had a low incidence of skeletal metastases in patients who had equivocal bone scans. Although a concordant marrow defect increases the possibility of metastasis, further radiological investigation to exclude benign disease is warranted.
Lee
K H
KH
Department of Nuclear Medicine, Seoul National University Hospital, Korea.
Chung
J K
JK
Choi
C W
CW
Jeong
J M
JM
Lee
D S
DS
Bang
Y J
YJ
Lee
M C
MC
Kim
N K
NK
Koh
C S
CS
D000911:Antibodies, Monoclonal; D000951:Antigens, Neoplasm / Q000276:immunology; D001853:Bone Marrow / Q000000981:diagnostic imaging*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D015815:Cell Adhesion Molecules; D005260:Female; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins / Q000276:immunology; D008875:Middle Aged; D011237:Predictive Value of Tests; D016719:Radioimmunodetection; D012680:Sensitivity and Specificity; D013667:Technetium; D013669:Technetium Tc 99m Medronate
D000911:Antibodies, Monoclonal; D000951:Antigens, Neoplasm; D015815:Cell Adhesion Molecules; D008562:Membrane Glycoproteins; D013667:Technetium; D013669:Technetium Tc 99m Medronate