Differentiation of malignant and degenerative bone lesions using dexamethasone interventional 3- and 24-hour bone scintigraphy.
Seventy-seven adult patients with suspected skeletal metastases were divided into two groups. In group A (n = 30), following intravenous administration of 20 mCi (740 MBq) of technetium-99m methylene diphosphonate (99mTc-MDP), 3- and 24-h scintigraphy of bone lesions was performed. The 24/3 h lesion to bone background radiouptake ratio (RUR) was calculated for each lesion. In group B (n = 47), the same procedure was followed with dexamethasone intervention (10 mg in 24 h) following the 3-h acquisition. In group A, after determination of the critical point, malignant and degenerative bone lesions could be separated with a sensitivity, specificity and accuracy of 0.76, 0.72 and 0.73, respectively. The mean RUR of the malignant lesions was 1.20 +/- 0.23, and that of the benign lesions, 0.95 +/- 0.15. In group B cases, significantly increased sensitivity, specificity and accuracy of 0.87, 0.94 and 0.92, respectively, were found (P < 0.001). The mean RUR of the malignant lesions was 1.48 +/- 0.34, and that of degenerative lesions, 0.88 +/- 0.19. Dexamethasone interventional bone scintigraphy seems to be a new cost-effective method for differentiating malignant from degenerative bone lesions using the RUR.
Bhatnagar
A
A
Department of Nuclear Medicine, Institute of Nuclear Medicine and Allied Sciences, Delhi, India.
Mondal
A
A
Kashyap
R
R
Sharma
R K
RK
Sharma
R
R
Chakravarty
S K
SK
Bihari
V
V
Sawroop
K
K
Chopra
M K
MK
Soni
N L
NL
D001847:Bone Diseases / Q000000981:diagnostic imaging*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D003907:Dexamethasone / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate; D013997:Time Factors
D003907:Dexamethasone; D013669:Technetium Tc 99m Medronate