Limits...
Prevalence of exclusive lower extremity metastases at (18)F-NaF PET/CT.

Ordones MB, Valadares AA, Duarte PS, Sado HN, Lima MS, Carvalho G, Sapienza MT, Buchpiguel CA - Radiol Bras (2015 May-Jun)

Bottom Line: One thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement.The prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: MD, Resident, Center of Nuclear Medicine, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HCFMUSP), São Paulo, SP, Brazil.

ABSTRACT

Objective: To evaluate the prevalence of exclusive lower extremity metastases, specifically in the femur and below the knee, observed at (18)F-NaF PET/CT.

Materials and methods: One thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement. The presumptive diagnoses based on such uptakes were subsequently obtained by evaluation of other imaging studies.

Results: No exclusive uptake suggestive of metastasis below the femur was observed in the present series. Exclusive uptake was observed in the proximal femur with a presumptive diagnosis of metastasis in two patients.

Conclusion: The prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases.

No MeSH data available.


Related in: MedlinePlus

Coronal fusion PET/CT (A) and PET (B) with18F-NaF show osteogenic reaction at right femoral head and neck,suspicious for bone involvement secondary to the underlying disease. Pelvic MRIcoronal section T1-weighted image with fat suppression after intravenousgadolinium injection (C) shows expansile lesion infiltrating the bonemarrow of the right femoral head and neck, suggestive of secondary finding. Also amedullary lesion is observed in the femoral diaphysis suspicious for secondaryinvolvement.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4492565&req=5

f02: Coronal fusion PET/CT (A) and PET (B) with18F-NaF show osteogenic reaction at right femoral head and neck,suspicious for bone involvement secondary to the underlying disease. Pelvic MRIcoronal section T1-weighted image with fat suppression after intravenousgadolinium injection (C) shows expansile lesion infiltrating the bonemarrow of the right femoral head and neck, suggestive of secondary finding. Also amedullary lesion is observed in the femoral diaphysis suspicious for secondaryinvolvement.

Mentions: Twenty-six patients presented exclusive lower extremity uptake. In two patients, suchuptakes were initially classified as metastases, in 13, as undefined, and in 11, aspoorly suggestive of metastasis. Later, one of the cases of exclusive uptakes classifiedas metastasis in the major trochanter of the right femur (Figure 1A) was classified as probably benign, because pelvic CT imageacquired after 15 months demonstrated an area of possible heterotopic calcification inthis region (Figure 1B); in the other caseclassified as metastasis, malignancy located in the right femoral neck was confirmed bymagnetic resonance imaging (MRI) (Figure 2) - thepatients presented with a lung neoplasm. Amongst the 13 patients with exclusive lowerlimb uptake classified as undefined, two cases were classified as probably malignant inthe images reanalysis and in the evaluation of other studies. In one of such cases, theuptake was located in the left intertrochanteric region and was considered as suggestiveof secondary compromise at MRI (Figure 3) - thepatient presented with breast cancer with metastases in the liver and lung. In the othercase, the uptake was located in the distal region of the right femur and the malignancywas confirmed by the PET/CT computed tomography image itself, characterizing boneinfiltration by metastasis from melanoma in adjacent soft tissue (Figure 4) - the patient presented with multiple nodular areas insoft tissues compatible with involvement by the underlying disease. The other cases ofundefined uptake were classified as probably benign by the reanalysis of PET/CT imagesor by further imaging studies. The 11 cases of uptake originally classified as poorlysuggestive of metastasis were classified as benign as follow-up and images reanlysis.Thus, only two out 1,000 patients presented exclusive lower extremity bone uptakesuggesting bone metastasis, both in the proximal third of the femora, and a thirdpatient presented multiple metastases from melanoma in soft tissues, with one of suchmetastases infiltrating the distal region of the left femur.


Prevalence of exclusive lower extremity metastases at (18)F-NaF PET/CT.

Ordones MB, Valadares AA, Duarte PS, Sado HN, Lima MS, Carvalho G, Sapienza MT, Buchpiguel CA - Radiol Bras (2015 May-Jun)

Coronal fusion PET/CT (A) and PET (B) with18F-NaF show osteogenic reaction at right femoral head and neck,suspicious for bone involvement secondary to the underlying disease. Pelvic MRIcoronal section T1-weighted image with fat suppression after intravenousgadolinium injection (C) shows expansile lesion infiltrating the bonemarrow of the right femoral head and neck, suggestive of secondary finding. Also amedullary lesion is observed in the femoral diaphysis suspicious for secondaryinvolvement.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492565&req=5

f02: Coronal fusion PET/CT (A) and PET (B) with18F-NaF show osteogenic reaction at right femoral head and neck,suspicious for bone involvement secondary to the underlying disease. Pelvic MRIcoronal section T1-weighted image with fat suppression after intravenousgadolinium injection (C) shows expansile lesion infiltrating the bonemarrow of the right femoral head and neck, suggestive of secondary finding. Also amedullary lesion is observed in the femoral diaphysis suspicious for secondaryinvolvement.
Mentions: Twenty-six patients presented exclusive lower extremity uptake. In two patients, suchuptakes were initially classified as metastases, in 13, as undefined, and in 11, aspoorly suggestive of metastasis. Later, one of the cases of exclusive uptakes classifiedas metastasis in the major trochanter of the right femur (Figure 1A) was classified as probably benign, because pelvic CT imageacquired after 15 months demonstrated an area of possible heterotopic calcification inthis region (Figure 1B); in the other caseclassified as metastasis, malignancy located in the right femoral neck was confirmed bymagnetic resonance imaging (MRI) (Figure 2) - thepatients presented with a lung neoplasm. Amongst the 13 patients with exclusive lowerlimb uptake classified as undefined, two cases were classified as probably malignant inthe images reanalysis and in the evaluation of other studies. In one of such cases, theuptake was located in the left intertrochanteric region and was considered as suggestiveof secondary compromise at MRI (Figure 3) - thepatient presented with breast cancer with metastases in the liver and lung. In the othercase, the uptake was located in the distal region of the right femur and the malignancywas confirmed by the PET/CT computed tomography image itself, characterizing boneinfiltration by metastasis from melanoma in adjacent soft tissue (Figure 4) - the patient presented with multiple nodular areas insoft tissues compatible with involvement by the underlying disease. The other cases ofundefined uptake were classified as probably benign by the reanalysis of PET/CT imagesor by further imaging studies. The 11 cases of uptake originally classified as poorlysuggestive of metastasis were classified as benign as follow-up and images reanlysis.Thus, only two out 1,000 patients presented exclusive lower extremity bone uptakesuggesting bone metastasis, both in the proximal third of the femora, and a thirdpatient presented multiple metastases from melanoma in soft tissues, with one of suchmetastases infiltrating the distal region of the left femur.

Bottom Line: One thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement.The prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: MD, Resident, Center of Nuclear Medicine, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HCFMUSP), São Paulo, SP, Brazil.

ABSTRACT

Objective: To evaluate the prevalence of exclusive lower extremity metastases, specifically in the femur and below the knee, observed at (18)F-NaF PET/CT.

Materials and methods: One thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement. The presumptive diagnoses based on such uptakes were subsequently obtained by evaluation of other imaging studies.

Results: No exclusive uptake suggestive of metastasis below the femur was observed in the present series. Exclusive uptake was observed in the proximal femur with a presumptive diagnosis of metastasis in two patients.

Conclusion: The prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases.

No MeSH data available.


Related in: MedlinePlus