Japanese
Title高齢者の骨シンチグラム (3) 前立腺癌の17症例の骨シンチグラムとX線像の比較および検討
Subtitle原著
Authors入倉英雄*,**, 千葉一夫*, 松井謙吾*, 山田英夫*, 大石幸彦*,**, 飯尾正宏*, 南武**, 町田豊平**
Authors(kana)
Organization*東京都養育院付属病院核医学放射線部, **慈恵会医科大学泌尿器科
Journal核医学
Volume11
Number2
Page97-109
Year/Month1974/4
Article原著
Publisher日本核医学会
Abstract「はじめに」前立腺癌は男性老人にみられる重要な泌尿器疾患の一つである. 本疾患は臨床症状の発現が遅く, 自覚症状の発現により来院した時には, すでに病巣の周囲への波及, 遠隔転移の例が多い. しかも多くの悪性腫瘍の中でも, 最も骨転移を起こしやすい特徴をもっている. したがって本症における骨転移巣の発見のために幾多の努力がなされてきた. 従来から用いられてきた骨転移巣発見の手段としてX線診断法によるBone surveyがある. しかしこの方法では骨のカルシウム含有量の30〜50%の減少があってはじめて検出可能となるといわれ, 早期に転移巣を診断することは困難であった. 近年ラジオアイソ・トープ (以下RIと略す) による骨診断法が開発され比較的早期に骨転移巣などの骨疾患の変化が診断可能となった. 前立腺癌の骨転移についても85Sr, 89mSr, 18FをBone seeker とする骨スキャンによる検討がなされてきた.
Practice臨床医学：一般
Keywords
English
TitleComparison of Bone Scanning and Radiography for Detecting Bony Metastases of Prostate Cancer
SubtitleOriginal
AuthorsHideo IRIKURA*, Kazuo CHIBA*, Kengo MATSUI*, Hideo YAMADA*, Yukihiko OHISHI*, Masahiro IIo*, Takeshi MINAMI**, Toyohei MACHIDA**
Authors(kana)
Organization*Department of Nuclear Medicine and Radiological Science, Tokyo Metropolitan Geriatric Hospital, **Department of Urology, Tokyo Jikei University, School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume11
Number2
Page97-109
Year/Month1974/4
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractBony metastasis of 17 cases with prostate cancer, being proved histologically, was studied by both bone scanning and radiography. The bone scanning was performed 3 hours after injection of 10 mCi of Tc-99m labeled pyrophosphate using minified whole body scanner and life size rectilenear scanner in the interesting regions. Age of the patients studied was ranged from 66 years old to 83, with a mean age of 73 years old. Cases examined were classified into five groups according to the spread of metastases ; Stage 0 stands for no metastasis proved, stage I for metastases to the pelvis and/or lumbar spine, stage II for thoracic spine and/or thoracic cage other than stage I, stage III for cranial region or lower extremities beyond stage II, and stage IV means metastases to the bones through-out the body. Four cases showed no metastasis, 3 cases were grouped in stage I, one case in stage II, 7 cases in stage III and 2 cases in stage IV by bone scanning. Three out of 4 cases in stage 0 showed abnormal finding neither in bone scan nor in radiography. One case with normal bone scan showed abnormal radiographic silhouette in the 3rd lumbar vertebra, which is thought benign osteosclerosis after 7 months of follow-up. One case with bone metastasis observed in the scan resulted in no abnormal finding with x-ray study. Other twelve cases indicated abnormal lesions both in bone scan and in radiography. In 4 cases among them abnormal findings were observed in the identical sites on the scan and x-ray films. However, in 8 cases the sites of ab-normal accumulation of radioactivity were observed in the same regions of bones on radiography plus the other sites where no abnormal shadow was found in x-ray study. These results indicate that bone scanning is more superior for the detection of metastases to x-ray study. This suggests bone scan is suitable for early detection as well as screening of bone metastases of prostate cancer. Six (67%) mong 9 cases grouped into stage III or IV by bone scanning showed a highly significant increase of both serum alkaline and acid phosphatases. Usually kidney images were obtained with Tc-99m pyrophosphate scanning, indicating a part of injected radioactivity was excreted into urine as a chelate. However, in seven cases with widely spread metastases (2 cases of stage IV and 5 out of 7 cases of stage III), neither kidney nor urinary bladder was visualized. This finding suggests that most of Tc-99m pyrophosphate is incorporated into bone and metastatic region of the bone in these patients. No visualization of kidney and urinary system with Tc-99m pyrophosphate scan indicates that metastatic bone lesions are widely spread out.
PracticeClinical medicine
Keywords

【全文PDF】