title: Tc-99m MIBI uptake in traumatic vertebral fractures and metastatic vertebral lesions: comparison with Tc-99m MDP.
abstract: This study compared technetium-99m-hexakis-2-methoxyisobutyl-isonitrile (Tc-99m MIBI) with technetium-99m methylene iphosphonate (Tc-99m MDP) to determine whether Tc-99m MIBI could distinguish vertebral metastases from traumatic vertebral fractures. Twenty patients with traumatic vertebral fracture (and no malignant disease) and 14 patients with metastatic vertebral lesions were evaluated. Three to 4 hours after intravenous injection of Tc-99m MDP, images of the vertebrae in all patients were obtained. Corresponding Tc-99m MIBI images were acquired within 4 days after the Tc-99m MDP bone images were obtained. Computed tomography and magnetic resonance imaging demonstrated 24 vertebral traumatic fractures and 44 vertebral metastases. On conventional bone scans, Tc-99m MDP activity was increased in 92% of vertebral fractures and in 100% of vertebral metastases. However, on MIBI scans, no abnormal findings were observed in the vertebrae with fracture, although increased activity was seen in 73% of vertebral metastases. In this study, traumatic vertebral fractures tended to display no pathologic increases in Tc-99m MIBI uptake, whereas bone metastases usually appeared with high uptake. In light of the excellent specificity of Tc-99m MIBI scans compared with Tc-99m MDP bone scans, imaging studies that use Tc-99m MIBI scans may play an important complementary role in differentiating vertebral metastases from traumatic vertebral fractures.
authors.affiliation: Department of Nuclear Medicine, Cukurova Unversity, Faculty of Medicine, Adana, Turkey.
authors.forename: Gulgun
authors.initials: G
authors.lastname: Buyukdereli
authors.forename: Tahsin
authors.initials: T
authors.lastname: Ermin
authors.forename: Oguz
authors.initials: O
authors.lastname: Kara
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kibar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D013669:Technetium Tc 99m Medronate; D017256:Technetium Tc 99m Sestamibi; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D014055:Tomography, Emission-Computed
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013669:Technetium Tc 99m Medronate