Evaluation of new sclerotic bone metastases in breast cancer patients during treatment.
OBJECTIVE
According to the World Health Organization (WHO) criteria for response of bone metastases to therapy, new lesions indicate progressive disease. We intended to prove that a new sclerotic lesion on conventional radiography may also be a sign of a positive therapeutic response in a previously undetectable lytic metastasis.


METHODS
In a previous placebo-controlled clinical trial of clodronate (Ostac) therapy, 139 breast cancer patients with bone metastases underwent both conventional radiography and bone scan every 6 months for 2 years with 99mTc before and during clodronate treatment. WHO criteria were applied for therapy response evaluation.


RESULTS
In 24 patients, 52 new sclerotic lesions observed during therapy were selected for re-evaluation of conventional radiographs and bone scans. In 8 of the 24 patients, 17 of 52 new sclerotic lesions (33%) had showed positive uptake on previous bone scans. These lesions were possibly misinterpreted as new when applying WHO criteria.


CONCLUSIONS
For better assessment of new sclerotic lesions during treatment, more sensitive techniques, e.g. bone scan, are needed as a complement to conventional radiography.
Ciray
I
I
Department of Diagnostic Radiology, University Hospital, Uppsala, Sweden.
Aström
G
G
Andréasson
I
I
Edekling
T
T
Hansen
J
J
Bergh
J
J
Ahlström
H
H
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D004002:Clodronic Acid / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D010026:Osteosclerosis / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging
D004002:Clodronic Acid