medigraphic.com
ISSN 1561-3100 (Print)

2012, Number 2

<< Back

Revista Cubana de Ortopedia y Traumatología 2012; 26 (2)

Use of nuclear medicine and imaging techniques in disorders of the bone system

Hernández FD, Marrero RLO, Ledea LOE

Language: Spanish
References: 90
Page: 190-212
PDF size: 371.00 Kb.


ABSTRACT

Nuclear medicine is the medical specialty that deals with clinical diagnosis, treatment and research through the use of isotopes as open sources. Bone diseases such as osteoporosis, primary bone cancer, bone metastases, arthrosis and arthritis are common among the population. The objective of this review was to present international and national statistics, and evaluate the incidence of these disorders. Additionally, a review was conducted of various clinical studies to identify the radiopharmaceuticals most frequently used to diagnose and treat bone disease, and their combination with the most common imaging techniques. A presentation was made of the usefulness of bone gammagraphy and the confirmation of the disorders studied. Reference was also made to the use of new techniques such as single photon emission tomography or positron emission tomography. It was found that the radioisotope most commonly used to diagnose diseases of the bone system was 99mTc, due to its physical and chemical characteristics, whereas 186Re, 188Re, 153Sm, 177Lu, 32P, 89Sr, 85Sr, 117mSn are used for therapeutic purposes, depending on the type, location and magnitude of the lesions and the availability of the radioisotope. At present, radiopharmaceutical development centers on combining these radioisotopes with various biomolecules to improve their properties and broaden their field of application.


REFERENCES

  1. Degrossi E, Gariti M, Kavasima M. Nomenclador de Medicina Nuclear. Curso Anual de Auditoria Médica [citado 19 Sep 2012]. Disponible en: http://auditoriamedicahoy.net/biblioteca/Nomenclador_de_Medicina_Nuclear

  2. Kanterewicz E. Anamnesis. Exploración física. Estudio analítico. En: Arboleya L, Pérez L, editores. Manual de enfermedades óseas. 2da ed. Sociedad Española de Reumatología. Madrid: Editorial Médica Panamericana; 2010. p. 6570. .

  3. Muñoz Torres M, Varsavsky M, Avilés Pérez MD. Osteoporosis. Definición. Epidemiologia. Rev Osteoporos Metab Miner. 2010;2(3):5-75.

  4. González Macías J, Rozman C, Farreras Valentí P. Osteoporosis. Principios de Medicina Interna. Vol. I. 14º ed. Nueva York: Editorial Harcourt; 2000: p.1233-42.

  5. Krane SM, Michael FH. Enfermedades óseas metabólicas. En: Harrison J. Principios de Medicina Interna. Vol. II. 14º ed. Madrid: Editorial Mc Graw-Hill Interamericana; 1998. p. 2557-63.

  6. Guerra García MM, Rodríguez Fernández JB, Puga Sarmiento E, Charle Crespo MA, Gómez Carvalho CS, Prejigueiro Santás lA. Incidencia de la fractura de cadera osteoporótica en Galicia en relación con la dispensación de medicamentos con indicación en su prevención y tratamiento. Aten Primaria. 2010. doi:10.1016/j.aprim.2010.04.010.

  7. Hobecker O, Guayán VA, Mango Vorrath NP, Giménez SL. Impacto de la osteoporosis sobre la población. Rev Posgrado Cátedra Med. 2005;12(144):24-7.

  8. Gajardo H. La Osteoporosis: huesos frágiles en nuestro futuro. Revista Creces; 1990(10).

  9. Ochoa Torres F, Pereira Costa R. Encuesta sobre osteoporosis en un área de salud. Rev Cubana Endocrinol. 1997;8(2):135-41.

  10. Van den Beuken-van EM, de Rijke JM, Kessels AG, Schouten HC, Van Kleef M, Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 2007;18(9):1437-49.

  11. Nelson OS, Munro AJ, Tannock IF. Bone metastatic: pathophysiology and management policy. J Clin Oncol. 1991;9(3):509-24.

  12. Colemana RE, Lipton A, Roodman GD, Guise TA, Boyce BF, Brufsky AM, et al. Metastasis and bone loss: Advancing treatment and prevention. Cancer Treat Rev. 2010;36(8):615-20.

  13. Bodei Lam M, Chiesa C, Flux G, Brans B, Chiti A, Giammarile F. EANM procedure guideline for treatment of refractory metastatic bone pain. Eur J Nucl Med Mol Imaging. 2008;35(10):1934-40.

  14. Mundy GR, Chen D, Zhao M, Dallas S, Xu C, Harris S. Growth regulatory factors and bone. Rev Endocr Metab Disord. 2001;2(1):105-15.

  15. Guise TA, Mundy GR. Cancer and bone. Endocrinol Rev. 1998;19(1):18-54.

  16. Roodman GD. Mechanisms of bone metastasis. N Engl J Med. 2004;350(16):1655-64.

  17. Lietman SA, Joyce MJ. Bone sarcomas: Overview of management, with a focus on surgical treatment considerations. Cleveland Clin J Med. 2010;77(1):8-12.

  18. Malawer MM, Helman LJ, O´Sullivan B. Sarcomas of bone. In: DeVita VT, Hellman S, Rosenberg SA, editors. Cancer: Principles and Practice of Oncology. 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2004.

  19. Simon MA, Springfi DS. Surgery for bone and soft-tissue tumors. Philadelphia: Editorial Lippincott-Raven; 1998.

  20. Pizzo P. Principles and Practice of Pediatric Oncology. 4th ed. Philadelphia: Lippincot, Williams and Wilkins; 2002.

  21. Tamayo Figueroa A, Chao Carrasco L, Cárdenas Centeno O, Escandón León F, Reyes Álvarez J. Experiencia en tumores malignos en el Complejo Científico Ortopédico Internacional "Frank País". Rev Cubana Ortop Traumatol. 2003;17(1-2):53-6.

  22. Anuario Estadístico de Salud 2010. Dirección Nacional de Registros Médicos y Estadísticas de Salud. La Habana: Ministerio de Salud Pública de Cuba; 2011.

  23. Merchant TE, Kushner BH, Sheldon JM, LaQuaglia M, Healey JH. Effect of low-dose radiation therapy when combined with surgical resection for Ewing sarcoma. Med Pediatr Oncol. 1999;33(2):65-70.

  24. Goldsby R, Burke C, Nagarajan R, Zhou T, Chen Z, Marina N, et al. Second solid malignancies among children, adolescents, and young adults diagnosed with malignant bone tumors after 1976: follow-up of a Children's Oncology Group cohort. Cancer. 2008;113(9):2597-604.

  25. Mankin HJ, Lange TA, Spanier SS. The hazards of biopsy in patients with malignant primary bone and soft-tissue tumors. J Bone Joint Surg Am. 1982;64(8):1121-7.

  26. Lawrence JS, Bremmer JM, Bier F. Osteo-arthrosis: prevalence in the population and relationship between symptoms and x-ray changes. Ann Rheum Dis. 1966;25(1):1-24.

  27. Ministerio de Salud. Guía Clínica Tratamiento Médico en personas de 55 años y más con artrosis de cadera y/o rodilla, leve o moderada. Santiago: Minsal; 2009. p. 7.

  28. Acosta Hernández RR. ¿Artritis o artrosis? Rev Cubana Med Gen Integr [revista en la Internet]. 2008 Sep [citado 2012 Mar 29];24(3): Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21252008000300001&lng=es

  29. Sweeney SE, Firestein GS. Rheumatoid arthritis: regulation of synovial inflammation. Intern J Biochem Cell Biol. 2004;36(3):372-8.

  30. Del Cura JL, Pedraza S, Gayete A. Radiología Esencial. t. I. Madrid: Ed. Médica Panamericana SA; 2009.

  31. Carril JM, Banzo JI. Manual práctico de osteoporosis y enfermedades del metabolismo mineral. Sección II. Madrid: Jarpyo editores SA; 2004. p. 93-8.

  32. Hill JW, Kolb DK. Química para el nuevo milenio. 8va ed. México: Prentice Hall Hispanoamericana SA; 1999. 704 p.

  33. González P, Massardo T, Canessa J, Humeres P, Jofré MJ. Aplicaciones clínicas del PET. Rev méd. 2002;130(5):569-579. ISSN 0034-9887

  34. Humeres P. Medicina nuclear: Aplicación en patología osteoarticular. Rev Chilena Radiol. 2002;8(2):77-83.

  35. Strobel K, Burger C, Seifert B, Husarik DB, Soyka JD, Hany TF. Characterization of focal bone lesions in the axial skeleton: Performance of planar bone scintigraphy compared with SPECT and SPECT fused with CT. American Roentgen Ray Society AJR. 2007;188(5):467-74.

  36. Even Sapir E, Flusser G, Lerman H, Lievshitz G, Metser U. SPECT/Multislice low-dose CT: a clinically relevant constituent in the imaging algorithm of nononcologic patients referred for Bone Scintigraphy. J Nucl Med. 2007;48(2):319-24.

  37. Cortés Blanco A, Martínez Lázaro R. Condiciones autorizadas de uso humano en la práctica clínica de los generadores de molibdeno-99/tecnecio-99m (99Mo/99mTc) comercializados en España. Seguridad Nuclear. 2006;39(II trimestre):13-20.

  38. Moore AE, Blake GM, Fogelman I. Quantitative measurements of bone remodeling using 99mTc-methylene diphosphonate bone scans and blood sampling. J Nucl Med. 2008;49(3):375-82.

  39. Torres Martin de Rosales R, Finucane C, Mather SJ, Blower PJ. Bifunctional bisphosphonate complexes for the diagnosis and therapy of bone metastases. Chem Commun (Camb). 2009;(32):4847-9. PubMed. DOI: 10.1039/b908652h.

  40. Fernández H, Patrício JP, Oliveira P, Oliveira A, Faria T, Pereira J, et al. Calcificação metastática detectada em cintigrafia óssea. Acta Med Port. 2010;23(4):731-4.

  41. Turpin S, Lambert R. Role of scintigraphy in musculoskeletal and spinal infections. Radiol Clin North Am. 2001Mar;39(2):169-89.

  42. Rohlina M, Larsson A, Hammarstrom L. Distribution of «Tc»-Labelled Phosphorus Compounds, 45Ca and 85Sr in Diphosphonate-treated Rats. Acta Radiol Therapy Physics Biol. 1977;16(4):513-24.

  43. Drake MT, Clarke BL, Khosla S. Bisphosphonates: mechanism of action and role in clinical practice. Clin Proc. 2008;83(9):1032-45.

  44. Lenora J, Norrgren K, Thorsson O, Wollmer P, Obrant KJ, Ivaska KK. Bone turnover markers are correlated with total skeletal uptake of 99mTc-methylene diphosphonate (99mTc-MDP). BMC Medical Physics. 2009;9:3. ISSN 1756-6649

  45. Montoya Molina CE, Sepúlpeda Méndez J, Arteaga de Murphy C, Menéndez Alafort L, Rolas Bautista JC, López Alvarenga JC. El 99mTc-alendronato como nueva opción en la gammagrafía ósea. Rev Invest Clin. 1997;49(5):373-7.

  46. Álvarez Rodríguez E. Optimización del tratamiento con alendronato en osteoporosis [Tesis doctoral]. Madrid: Facultad de Medicina, Universidad Complutense de Madrid; 2008.

  47. Ogawa K, Mukai T, Arano Y, Otaka A, Ueda M, Uehara T, et al. Rhemium-186-monoaminemonoamidedithiol-conjugated bisphosphonate derivatives for bone pain palliation. Nucl Med Biol. 2006;33(4):513-20.

  48. Ogawa K, Mukai T, Inoue Y, Ono M, Saji H. Development of a Novel 99mTc-chelate-conjugated bisphosphonate with high affinityfor bone as a bone scintigraphic Agent J Nucl Med. 2006;47(12):2042-7.

  49. Marrero Riverón LO, Álvarez Cambras R, Hernández Cairo A, Batista Cuellar JF, Guerra Ordoñez CA, Perera Pintado A. Valor de la gammagrafía con 99mTc-ciprofloxacina cubana en la detección de las prótesis de cadera infectadas. Rev Cubana Ortop Traumatol [revista en la Internet]. 2006 Jun [citado 2012 Mar 30];20(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-215X2006000100002&lng=

  50. Sonmezoglu K, Sonmezoglu M, Halac M, Akgün I, Türkmen C, Önsel C, et al. Usefulness of 99mTc-Ciprofloxacin (Infecton) scan in diagnosis of chronic orthopedic infections: comparative study with 99mTc-HMPAO leukocyte scintigraphy. J Nucl Med. 2001;42(4):567-74.

  51. Fonti R, Salvatore B, Quarantelli M, Sirignano C, Segreto S, Petruzziello F, et al. 18F-FDG PET/CT, 99mTc-MIBI, and MRI in evaluation of patients with Multiple Myeloma. J Nucl Med. 2008;49(2):195-200.

  52. Marrero Riverón LO, Álvarez Cambras R, Cárdenas Centeno OM de, Tamayo Figueroa A, Perera Pintado A, Quintana Rodríguez FJ. Captación de 99mTc-MIBI en los tumores óseos. Estudio comparativo con el 99mTc-MDP. Rev Cubana Ortop Traumatol. 1999;13(1-2):6-18.

  53. Meller J, Köster G, Liersch T, Siefker U, Lehmann K, Meyer I, et al. Chronic bacterial osteomyelitis: prospective comparison of 18F-FDG imaging with a dual-head coincidence camera and 111In-labelled autologous leucocyte scintigraphy. European J Nucl Med Molecular Imaging. 2002;29(1):53-60.

  54. Palestro CJ, Kipper SL, Weiland FL, Love C, Tomas MB. Osteomyelitis: Diagnosis with 99mTc-labeled antigranulocyte antibodies compared with diagnosis with 111In-labeled leukocytes-initial experience. Radiology. 2002;223(3):758-64.

  55. Shalom RB, Yefremov N, Guralnik L, Keidar Z, Engel A, Nitecki S, et al. SPECT/CT using 67Ga and 111In-labeled leukocyte scintigraphy for diagnosis of infection. J Nucl Med. 2006;47(4):6-10.

  56. Subramanian G, McAfee JG, Rosenstreich M, Coco M. Indium-113m-Labeled polyfunctional phosphonates as bone-imaging agents. J Nucl Med. 1975;16(11):1080-4.

  57. Seabold JE, Forstrom LA, Schauwecker DS, Brown ML, Datz FL, McAfee JG. Procedure guideline for indium-111-leukocyte scintigraphy for suspected infection/ inflammation. J Nucl Med. 1997;38(6):997-1001.

  58. Meller J, Sahlmann CO, Scheel AK. 18F-FDG PET and PET/CT in fever of unknown origin. J Nucl Med. 2007;48(1):35-42.

  59. Chiacchio S, Borso E, AlSharif AA, Boni G, Mariani G. Radiofármacos para el tratamiento paliativo del dolor en pacientes con metástasis óseas y su posible integración con la quimioterapia. Alasbimn J. 2010;13(50):1-5.

  60. Mertens WC, Filipczack LA, Ben-Josef Edgar, Davis LP, Portes AT. Systemic bone-seeking Radionuclides for palliation of painful osseousmetastases: Current Concepts. CA Cancer J Clin. 1998(6);48:361-74.

  61. Loblaw DA, Wu JS, Kirkbride P, Panzarella T, Smith K, Aslanidis J, et al. Pain flare in patients with bone metastases after palliative radiotherapy a nested randomized control trial. Support Care Cancer. 2007;15(4):451-5.

  62. Chow E, Ling A, Davis L, Panzarella T, Danjoux C. Pain flare following external beam radiotherapy and meaningful change in pain scores in the treatment of bone metastases. Radiother Oncol. 2005;75(1):64-9.

  63. Serafini AN, Houston SJ, Resche I, Quick DP, Grund FM, Ell PJ, et al. Palliation of pain associated with metastatic bone cancer using samarium-153 lexidronam: A double-blind placebo-controlled clinical trial. J Clin Oncol. 1998;16(4):1574-81.

  64. Sartor O, Reid RH, Bushnell DL, Quick DP, Ell PJ. Safety and efficacy of repeat administration of samarium Sm-153 lexidronam to patients with metastatic bone pain. Cancer. 2007;109(3):637-43.

  65. De la Calle AB, González González G, Fornés C, Martínez Calderón F. 153SM-EDTMP (Samario) como tratamiento del dolor óseo de origen metastático. Rev Soc Esp Dolor. 2006;13(3):159-63. ISSN 1134-8046.

  66. Serafini AN. Therapy of metastatic bone pain. J Nucl Med. 2001;42(6):895-906.

  67. Blake GM, Zivanovic MA, Blaquiere RM, Fine DR, McEwan AJ, Ackery DM. Strontium-89 therapy: measurement of absorbed dose to skeletal metastases. J Nucl Med. 1988;29(4):549-57.

  68. Lewington VJ, McEwan AJ, Ackery DM, Bayly RJ, Keeling DH, Macleod PM, et al. A prospective randomized double-blind crossover study to examine the efficacy of strontium-89 in pain palliation in patients with advanced prostate cancer metastatic to bone. European J Cancer. 1991;27(8):954-8.

  69. Porter AT, McEwan AJ. Strontium-89 as an adjuvant to external beam radiation improves pain relief and delays disease progression in advanced prostate cancer: results of a randomized controlled trial. Seminars in Oncology. 1993;20(3 Suppl 2):38-43.

  70. Buchali K, Correns HJ, Schuerer M, Schnorr D, Lips H, Sydow K. Results of a double blind study of 89-strontium therapy of skeletal metastases of prostatic carcinoma. European J Nucl Med. 1988;14(7-8):349-51.

  71. Robinson RG, Blake GM, Preston DF. Stromtium-89: treatment results and kinetics in patients with painful metastatic prostate and breast cancer in bone. Radiographics. 1989;9(2):271.

  72. Giammarile F, Mognetti T, Blondet C, Desuzinges C, Chauvot P. Bone pain palliation with 85Sr therapy. J NucI Med. 1999;40(4):585-90.

  73. Breen SL, Powet JE, Porter AT. Dose estimation in strontium-89 radiotherapy of metastatic prostatic carcinoma. J Nucl Med. 1992;33(7):1316-23.

  74. Charkes ND. Some differences between bone scans made with 87mSr and 85Sr. J Nucl Med. 1968;10(7):491-4.

  75. Meeuse JJ, Van der Linden YM, Van Tienhoven G, Gans ROB, Leer JW, Reyners AKL, et al. Efficacy of radiotherapy for painful bone metastases during the last 12 weeks of life. Cancer. 2010;116(11):2716-25.

  76. Rutty Sola GA, Arguelles MG, Bottazzini DL, Furnari JC, Gómez Parada I, Rojo A, et al. Lutetium-177-EDTMP for bone pain palliation. Preparation, biodistribution and pre-clinical studies. Radiochimi Acta. 2000;88(3-4):157.

  77. Chakraborty S, Das T, Banerjee S, Balogh L, Chaudhari PR, Sarma HD, et al. 177Lu-EDTMP: a viable bone pain palliative in skeletal metastasis. Cancer Biother Radiopharm. 2008;23(2):202-13.

  78. Chang Y, Jeong J, Lee YS, Kim Y, Lee D, Chung JK, et al. Comparison of potential bone pain palliation agents Lu-177-EDTMP and Lu-177-DOTMP. J Nucl Med. 2008;49(1):93.

  79. Puerta Yepes N, Pérez J, Nevares N, Zapata A, López Bularte A, Rojo A et al. 177LU-EDTMP: Estudio biocinético y dosimétrico de un kit de producción local de 177Lu-EDTMP para su uso como agente paliativo del dolor. Alasbimn J. 2001;53(13). ISSN: 0717-4055. Disponible en: http://www.alasbimnjournal.net/a/52

  80. Vuèina J, Lukiæ D. Radionuclidic generators for the production of Technetium-99m and Rhenium-188 UDC 539.1. Physics, Chemistry Technology. 2002;2(4):235-43.

  81. Savio E, Gaudiano J, Robles A, Balter H, Paolino A, López A, et al. 188Re-HEDP: Pharmacokinetics characterization, clinical and dosimetric evaluation in osseous metastatic patients with two levels of radiopharmaceutical dose. BMC Nuclear Med. 2001;1:2. Disponible en: http://www.biomedcentral.com/1471-2385/1/2

  82. Torres Martin de Rosales R, Finucane C, Foster J, Mather SJ, Blower PJ. 188 Re (CO)3-dipicolylaminealendronate: a new bisphosphonate conjugate for the radiotherapy of bone metastases. Bioconjug Chem. 2000;21(5):811-5.

  83. Palmedo H, Guhlke S, Bender H, Sartor J, Schoeneich G, Risse J et al. Dose escalation study with rhenium-188 hydroxyethylidene diphosphonate in prostate cancer patients with osseous metastases. Eur J Nucl Med. 2000;27(2):123-30.

  84. Maxon HR, Schroder LE. Rhenium-186 (Sn) HEDP for Treatment of Painful Osseous Metastases: Results of a Double-blind Crossover Comparison with Placebo. J Nucl Med. 1991;32(10):1077-881.

  85. Liepe K, Franke WG, Kropp J, Koch R, Runge R, Hliscs R. Comparison of rhenium-188, rhenium-186-HEDP and strontium-89 in palliation of painful bone metastases. Nuklearmedizin. 2000;39(6):146-51.

  86. Torres L, Coca M, Batista J, Casaco A, López G, García I, et al. Biodistribution and internal dosimetry of the 188Re-labelled humanized monoclonal antibody anti-epidemal growth factor receptor, nimotuzumab, in the locoregional treatment of malignant gliomas. Nucl Med Comm. 2008;29(1):66-75.

  87. Nair N. Relative efficacy of 32P and 89Sr in palliation in skeletal metastases. J Nucl Med. 1999;40(2):256-61.

  88. Ziessman HA, O´Malley JP, Thrall JH. Medicina nuclear: los requisitos en radiología. 3ra ed. Madrid: Ed. Elsevier; 2007. p. 296-8.

  89. Cruz Arencibia J, García Rodríguez E, Sagarra Veranes M, Morín Zorrilla J. Radiofármacos en radiosinoviortesis. Nucleus. 2010;47. ISSN 0864-084X.

  90. Bishayee A, Rao DV, Srivastava SC. Marrow-spaing effects of 117mSn (4+) diethylenetriaminepentaacetic acid for radionuclide therapy of bone cancer. J Nucl Med. 2000;41(12):2043-50.




2020     |     www.medigraphic.com