PDF herunterladen
Nuklearmedizin 1993; 32(05): 231-235
DOI: 10.1055/s-0038-1632284
Originalarbeiten
Schattauer GmbH

Quantitative Bone Scintigraphy in Prostatic Carcinoma - Long-Term Response to Treatment

Gunilla M. G. Sundkvist
1   From the Departments of Clinical Physiology, Malmö, Sweden
,
L. Ahlgren
2   Radiation Physics, Lund University, Malmö Allmänna Sjukhus, Malmö, Sweden
,
B. Lilja
1   From the Departments of Clinical Physiology, Malmö, Sweden
,
S. Mattsson
2   Radiation Physics, Lund University, Malmö Allmänna Sjukhus, Malmö, Sweden
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Received: 16. Februar 1993

in revised form: 19. April 1993

Publikationsdatum:
04. Februar 2018 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Summary

Quantitative bone scintigraphy was performed in 24 patients with prostatic carcinoma before orchiectomy and up to one to four years after operation. The gamma camera count rate was recorded over the lower thoracic and all lumbar vertebrae 4 h after injection of 99mTc-MDP. Twelve patients had normal bone scintigrams throughout the study. They showed from two years after operation a slight increase in count rate values compared with the preoperative values, probably due to hormonal changes after orchiectomy and to age-related alterations in skeletal metabolism. Twelve patients had abnormal bone scintigrams. They showed as a response to treatment the flare phenomenon with an increase in count rate over the abnormal vertebrae when measured two weeks after operation followed by a decrease after two months. The lowest count rate values were obtained between six months and one year after operation. Thereafter the count rate seemed to remain on the same level. An increase in count rate was connected to progression of disease and the patients died of prostatic carcinoma within one year thereafter.

Zusammenfassung

Die quantitative Skelettszintigraphie wurde bei 24 Patienten mit Prostatakarzinom vor Orchiektomie und ein bis fünf Jahre danach durchgeführt. Mit der Gammakamera wurden Zählraten über der unteren Brustwirbelsäule und über allen Lendenwirbelkörpern 4 h nach der Injektion von 99mTc-MDP gemessen. Im Verlauf zeigten zwölf Patienten unauffällige Skelettszintigramme. Bei diesen fand sich ab zwei Jahren nach der Operation ein geringer Anstieg der Zählraten im Vergleich zu den präoperativen Werten. Dafür verantwortlich waren vermutlich hormonale Veränderungen nach der Orchiektomie und altersbedingte Veränderungen des Skelettstoffwechsels. Zwölf Patienten hatten pathologische Skelettszintigramme. Sie zeigten als Antwort auf die Behandlung das Flare-Phänomen mit einer Erhöhung der Zählrate in den veränderten Wirbelkörpern, beginnend zwei Wochen nach der Operation mit anschließendem Abfall in den nächsten zwei Monaten. Die niedrigsten Zählraten wurden zwischen sechs Monaten und einem Jahr nach der Operation gemessen; anschließend blieben die Zählraten relativ konstant. Eine Zunahme der Zählraten war mit einer Progression der Erkrankung verbunden; die Patienten starben am Prostatakarzinom innerhalb des folgenden Jahres.

Key words

Prostatic neoplasms - bone neoplasms - orchiectomy - radionuclide imaging

Schlüsselwörter

Prostatakarzinom - Knochenmetastasen - Orchiektomie - Skelettszintigraphie
 

  • REFERENCES

  • 1 Badalament RA, Drago JR. Prostate cancer. Promising advances that may alter survival rates. Postgrad Med 1990; 87: 65-72.
    Suche in Google Scholar
  • 2 Berná L, Germá JR, Estorch M. et al. Bone marrow regeneration after hormonal therapy in patients with bone metastases from prostate carcinoma. J Nucl Med 1991; 32: 2295-8.
    PubMedSuche in Google Scholar
  • 3 Bishop MC, Hardy JG, Taylor MC, Wastie ML, Lemberger RJ. Bone imaging and serum phosphatases in prostatic carcinoma. Br J Urol 1985; 57: 317-24.
    CrossrefPubMedSuche in Google Scholar
  • 4 Chambers TJ. The pathobiology of the osteoclast. J Clin Pathol 1985; 38: 241-52.
    CrossrefPubMedSuche in Google Scholar
  • 5 Charkes ND. Skeletal blood flow: Implications for bone-scan interpretation. J Nucl Med 1980; 21: 91-8.
    PubMedSuche in Google Scholar
  • 6 Corrie D, Timmons JH, Bauman JM, Thompson IM. Efficacy of follow-up bone scans in carcinoma of the prostate. Cancer 1988; 61: 2453-4.
    CrossrefPubMedSuche in Google Scholar
  • 7 Crawford Hormonal therapy of prostatic carcinoma. Defining the challenge. Cancer 1990; 66: 1035-8.
    CrossrefPubMedSuche in Google Scholar
  • 8 Fogelman I, Bessent R. Age-related alterations in skeletal metabolism - 24-hr whole- body retention of diphosphonate in 250 normal subjects. J Nucl Med 1982; 23: 296-300.
    PubMedSuche in Google Scholar
  • 9 Folkman J, Klagsbrun M. Angiogenic factors. Science 1987; 235: 442-7.
    CrossrefPubMedSuche in Google Scholar
  • 10 Jacobs SC. Spread of prostatic cancer to bone. Urology 1983; 21: 337-44.
    CrossrefPubMedSuche in Google Scholar
  • 11 Merrick MV. Bone scintigraphy - an update. Clin Radiol 1989; 40: 231-2.
    CrossrefPubMedSuche in Google Scholar
  • 12 Merrick MV, Ding CL, Chisholm GD, Elton RA. Prognostic significance of alkaline and acid phosphatase and skeletal scintigraphy in carcinoma of the prostate. Br J Urol 1985; 57: 715-20.
    CrossrefPubMedSuche in Google Scholar
  • 13 Pollen JJ, Gerber K, Ashburn WL, Schmidt JD. Nuclear bone imaging in metastatic cancer of the prostate. Cancer 1981; 47: 2585-94.
    CrossrefPubMedSuche in Google Scholar
  • 14 Pollen JJ, Shlaer WJ. Osteoblastic response to successful treatment of metastatic cancer of the prostate. Am J Radiol 1979; 132: 927-31.
    Suche in Google Scholar
  • 15 Pollen JJ, Witztum KF, Ashburn WL. The flare phenomenon on radionuclide bone scan in metastatic prostate cancer. Am J Radiol 1984; 142: 773-6.
    Suche in Google Scholar
  • 16 Reiner WG, Scott WW, Eggleston JC, Walsh PC. Long-term survival after hormonal therapy for stage D prostatic cancer. J Urol 1979; 122: 183-4.
    PubMedSuche in Google Scholar
  • 17 Schiimichen C, Mundriziewski L, Tischler E, Hoffmann G. Relationship between blood flow and radiostrontium uptake in the healing bone fracture. Eur J Nucl Med 1979; 04: 413-7.
    CrossrefPubMedSuche in Google Scholar
  • 18 Smith PH, Bono A, Calais Fda Silva. et al. Some limitations of the radioisotope bone scan in patients with metastatic prostatic cancer. Cancer 1990; 66: 1009-16.
    CrossrefPubMedSuche in Google Scholar
  • 19 Snedecor GW, Cochran WG. Statistical methods. 7th ed.. Ames, Iowa: Iowa State University Press; 1980
    Suche in Google Scholar
  • 20 Soloway MS, Hardeman SW, Hickey D. et al. Stratification of patients with metastatic prostate cancer based on extent of disease on initial bone scan. Cancer 1988; 61: 195-202.
    CrossrefPubMedSuche in Google Scholar
  • 21 Soloway MS, Hopkins SC. Prostate cancer: Criteria of objective response to treatment. In: Carter SK, Marberger M. eds. Proc 13th Internat Congr Chemotherapy, Vienna, 1983;242/6-10..
  • 22 Stepan JJ, Lachman M, Zverina J, Pacovsky V, Baylink DJ. Castrated men exhibit bone loss: Effect of calcitonin treatment on biochemical indices of bone remodeling. J Clin Endocrinol Metab 1989; 69: 523-7.
    CrossrefPubMedSuche in Google Scholar
  • 23 Sundkvist GMG, Ahlgren L, Lilja B. et al. Repeated quantitative bone scintigraphy in patients with prostatic carcinoma treated with orchiectomy. Eur J Nucl Med 1988; 14: 203-6.
    PubMedSuche in Google Scholar
  • 24 Sundkvist GMG, Ahlgren L, Lilja B, Mattsson S, Abrahamsson PA. Dynamic quantitative bone scintigraphy in patients with prostatic carcinoma treated by orchiectomy. Eur J Nucl Med 1990; 16: 671-6.
    CrossrefPubMedSuche in Google Scholar
  • 25 Sundkvist GMG, Ahlgren L, Lilja B, Mattsson S. Additional information from quantitative 24-hour 99mTc-MDP bone scintigraphy in patients with prostatic carcinoma. Acta Oncol 1991; 30: 635-9.
    CrossrefPubMedSuche in Google Scholar
  • 26 Sundkvist GMG, Ahlgren L, Lilja B, Mattsson S. Quantitative bone scintigraphy and 24-hour whole-body counting of 99mTc-rnethylene diphosphonate in patients with prostatic carcinoma. Nucl Med 1992; 31: 178-81.
    Suche in Google Scholar
  • 27 Teitelbaum SL, Bullough PG. The pathophysiology of bone and joint disease. Am J Pathol 1979; 96: 283-354.
    Suche in Google Scholar
  • 28 Zorn-Bopp E, Büll U, Münzing W, Lang P, Moser EA. Die Ganzkörperretention von 99mTc-Methylen-Diphosphonat bei Skeletterkrankungen. Nucl Med 1983; 22: 24-30.
    Suche in Google Scholar