Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0153690 (bone metastases)
 6,382 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prostate cancer (PCa) is the most commonly diagnosed cancer in American men with a subset inevitably presenting with metastatic disease to the bone. A well-recognized limitation in evaluating new treatments for metastatic PCa is the inability to use imaging to objectively assess response therapy. In this study, we evaluated the feasibility of clinically translating the functional diffusion map (fDM) imaging biomarker for quantifying the spatiotemporal effects of bone tumor response in a patient treated for metastatic PCa with bone metastases. A patient beginning therapy was scanned using MRI before treatment and again at 2 and 8 weeks post-treatment initiation to quantify changes in tumor diffusion values. Three metastatic lesions were identified for fDM analysis, all of which all demonstrated an early increase in diffusion values at 2 weeks, which increased further at 8 weeks post-treatment initiation. This finding correlated with a decrease in the patient's prostate-specific antigen (PSA) levels suggestive of patient response. CT, bone scans, and anatomic MRI images obtained posttreatment were found to be uninformative for the assessment of treatment effectiveness. This study presents the feasibility of fDM-measurements in osseous lesions over time and shows that changes in fDM values were consistent with therapeutic response. Thus, the fDM imaging biomarker may provide a quantifiable therapeutic endpoint to assess response in patients with metastatic bone cancer.
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PMID:A feasibility study evaluating the functional diffusion map as a predictive imaging biomarker for detection of treatment response in a patient with metastatic prostate cancer to the bone. 1808 7

According to the recently published BoneEVA study, 7.8 million Germans (6.5 million women) are affected by osteoporosis. Of them, 4.3% experienced at least one clinical fracture. Only 21.7% were treated with an anti-osteoporotic drug, whereby only 10% received a bisphosphonate and 17% given calcium and vitamin D. On the other hand, as osteoporosis may be associated with severe pain in 90% of patients, analgesics are prescribed. The total direct costs attributable to osteoporosis amounted to Euro 5.4 billion in 2003. One out of three postmenopausal women and one out of five men over the age of 50 years will experience osteoporotic fractures unless preventive measures are undertaken. According to the German guidelines for diagnosis and treatment of osteoporosis, bone densitometry using dual energy x-ray absorptiometry (DXA) together with other clinical risk factors (previous low trauma fracture, use of nicotine, low body weight [BMI<20 kg/m2], immobilisation, and more than two falls during the last six months) are recommended for diagnosis. Using typical cases out of clinical practice, this article delineates frequent mistakes in the interpretation of DXA measurements. Furthermore, the present paper clarifies the role of classical x-rays, which still represent the predominant procedure for the identification of fractures and especially vertebral fractures. In comparison to x-rays, CT or MRI are more important in differential diagnosis of malignant disease and bone metastases. Essentially a reduction of vertebral height without evidence of central endplate fracture in postmenopausal women may be unrelated to osteoporosis. Quantitative morphometry should not be used alone for the assessment of vertebral fracture in clinical decision-making. Therefore, we recommend differential diagnosis of morphometric vertebral deformities by an expert reader to rule out deformities related to degenerative disease and norm variants of which we will present several examples to train the view of the reader.
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PMID:[Use of imaging procedures in the diagnostics of osteoporosis interpretation of x-rays and bone density measurements]. 1820 60

MRI is very sensitive to detect bone metastases. To improve specificity, a clever use of sequences, spin echo, gradient echo in or opposed phase, contrast medium and diffusion is needed.
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PMID:MRI of bone metastases: the choice of the sequence. 1821 60

The patient was a 66-year-old man. Total gastrectomy was performed due to Borrmann V type moderately differentiated adenocarcinoma of the middle part of the stomach. The final diagnosis was UM 7x6 cm, sT3, sN1, sH0, sP0, sM0, sCY0, sStage IIIA, PM (-), DM (-), D2+alpha, Cur B, ly2, v2. Because CEA had increased slowly from ten months after the operation, it was judged a possibly partial relapse. Twice-administered CDDP 80 mg/body and S-1 80 mg on the eighth day served to decrease CEA. He was hospitalized again due to fracture of the spine, though he left the hospital once. The patient was diagnosed by MRI inspection of the vertebrae thoracicae and the lumbar vertebra as multiple spinal bone metastases. After CDDP 60 mg/body of day 8 was administered twice at S-1 80 mg/day, CEA became normal. Osteolytic changes of the spinal bone disappeared. The 24 months from February 2004 to January 2006 passed without additional treatment. His CEA value tended to rise within the normal range in February 2006. After that, the CEA level increased with a 4-week cycle of 2 weeks of S-1 40-80 mg alternating with a two-week rest.
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PMID:[A patient with gastric cancer complicated with multiple spinal bone metastases showing a complete remission to combination of S-1 and CDDP]. 1828 72

We performed a retrospective analysis of 71 subjects with metastatic pheochromocytoma and paraganglioma (30 subjects with mutation of succinate dehydrogenase enzyme subunit B (SDHB) gene and 41 subjects without SDHB mutation). Sixty-nine percent presented with bone metastases (SDHB +/-: 77% vs 63%), 39% with liver metastases (SDHB +/-: 27% vs 47%), and 32% with lung metastases (SDHB +/-: 37% vs 29%). The most common sites of bone involvement were thoracic spine (80%; SDHB+/-: 83% vs 77%), lumbar spine (78%; SDHB +/-: 78% vs 75%), and pelvic and sacral bones (78%; SDHB +/-: 91% vs 65%, P=0.04). Subjects with SDHB mutation also showed significantly higher involvement of long bones (SDHB +/-: 78% vs 30%, P=0.007) than those without the mutation. The best overall sensitivity in detecting bone metastases demonstrated positron emission tomography (PET) with 6-[(18)F]-fluorodopamine ([(18)F]-FDA; 90%), followed by bone scintigraphy (82%), computed tomography or magnetic resonance imaging (CT/MRI; 78%), 2-[(18)F]-fluoro-2-deoxy-d-glucose ([(18)F]-FDG) PET (76%), and scintigraphy with [(123/131)I]-metaiodobenzylguanidine (71%). In subjects with SDHB mutation, imaging modalities with best sensitivities for detecting bone metastases were CT/MRI (96%), bone scintigraphy (95%), and [(18)F]-FDG PET (92%). In subjects without SDHB mutations, the modality with the best sensitivity for bone metastases was [(18)F]-FDA PET (100%). In conclusion, bone scintigraphy should be used in the staging of patients with malignant pheochromocytoma and paraganglioma, particularly in patients with SDHB mutations. As for PET imaging, [(18)F]-FDG PET is highly recommended in SDHB mutation patients, whereas [(18)F]-FDA PET is recommended in patients without the mutation.
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PMID:Role of positron emission tomography and bone scintigraphy in the evaluation of bone involvement in metastatic pheochromocytoma and paraganglioma: specific implications for succinate dehydrogenase enzyme subunit B gene mutations. 1831 Feb 97

Sellar paragangliomas are very rare lesions with only 11 previous cases described in the literature. We present a further case of sellar paraganglioma. The patient is a 17-year-old man who developed headache, visual blurring, and diplopia. MRI showed a sellar lesion. Trans-nasal trans-sphenoid biopsy showed features of paraganglioma. He was treated by Stereotactic radiotherapy. Four months after treatment he developed bone metastases which was palliated by radiation, zoledronic acid, and chemotherapy. This is the first case of sellar paraganglioma showing metastases to bone.
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PMID:A rare case of paraganglioma of the sella with bone metastases. 1832 Mar 26

We report a case of metastatic breast cancer with leptomeninges and multiple bone metastases that showed an excellent response to the combination of trastuzumab and capecitabine; therapeutic effect was evaluated by MRI at follow-up. A 44-year-old woman underwent modified radical mastectomy in February 1997. In April 2003, a tumor at the right basis cerebri and multiple bone metastases were noted, and in October 2003, she underwent enucleation of the tumor. Histopathologically, the tumor was consistent with a basal skull metastasis from breast cancer. In March 2004, the patient began to experience pain, weakness, and paresthesia of both legs. She was diagnosed, with leptomeningeal metastasis (LM) from breast cancer using MRI. In December 2005, the combination of trastuzumab and capecitabine administered as sixth-line treatment was very effective for LM. Although it is generally very difficult to diagnose LM and assess the therapeutic effect with MRI, in this case, it was possible. To our knowledge, there has been no report in the literature describing the combination of trastuzumab and capecitabine for LM from breast cancer. Although the mechanism underlying the efficacy of this combination is still unknown, the treatment would be worth trying because of its few side effects in extensively treated patients with LM from breast cancer. To confirm the antitumor efficacy of trastuzumab and capecitabine, however, further investigations are required.
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PMID:Successful treatment of leptomeningeal metastases from breast cancer using the combination of trastuzumab and capecitabine: a case report. 1847 15

Bone metastases of solid tumors are common, and about 80% of them occur in patients with breast, lung or prostate cancer. Bone metastases can be suspected clinically and by laboratory tests; however, a final diagnosis relies on radiographic evidence. Bone metastases of prostate cancer usually have osteoblastic characteristics, manifested by pathological bone resorption and formation. Conventional bone scans (e.g. with (99m)Tc-labeled methylene diphosphonate) are preferred to plain-film radiography for surveillance of the entire skeleton. Radiologic diagnosis of bone metastases, particularly in patients with low burden of disease, is difficult because noncancerous bone lesions that mimic cancer are common. Conventional bone scans are limited by their low sensitivity and high false-negative rate (up to 40%) compared with advanced bone-imaging modalities such as PET, PET-CT and MRI, which might assist or replace conventional scanning methods. The correct diagnosis of bone involvement in prostate cancer is crucial to assess the effects of therapy on the primary tumor, the patient's prognosis, and the efficacy of bone-specific treatments that can reduce future bone-associated morbidity. In addition, predictive tools such as nomograms enable the identification of patients at risk of bone involvement during the course of their disease. Such tools may limit treatment costs by avoidance of unnecessary tests and might reduce both short-term and long-term complication rates.
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PMID:Bone imaging in prostate cancer. 1868 19

As current classification systems for the assessment of treatment response in bone metastasis do not meet the needs of oncologists, new imaging biomarkers are desirable. Therefore, the diagnostic impact of dynamic contrast enhanced (DCE)-volumetric computed tomography (VCT) (descriptive analysis), DCE-MRI (two-compartment model) and diffusion weighted imaging (DWI) for monitoring anti-angiogenic therapy effects of the VEGF antibody bevacizumab in breast cancer bone metastases in rats was studied. Nude rats (n=8 animals treated with bevacizumab and n=9 untreated control rats) with site-specific osteolytic bone metastasis of the hind leg were imaged with a 1.5T clinical MRI-scanner in an animal coil as well as in a volumetric CT-scanner at days 30, 40, 50 and 60 after inoculation of MDA-MB-231 human breast cancer cells. From these data, osteolytic lesion size (OLS), peak enhancement (PE), area under the curve (AUC), amplitude (A), exchange rate constant (k(ep)) and apparent diffusion coefficient (ADC) were determined in bone metastases. Prior to changes in OLS (p< or =0.05 at days 50 and 60) there was already a significant decrease in PE, AUC and A (p< or =0.05 at days 40-60) in treated animals compared to controls. However, for k(ep) and ADC there were no significant differences between the groups at any time point (p>0.05 at days 40-60). In conclusion, anti-angiogenic treatment response in osteolytic breast cancer bone metastases can be assessed early with surrogate markers of vascularization, while DWI appears to be insensitive.
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PMID:Imaging anti-angiogenic treatment response with DCE-VCT, DCE-MRI and DWI in an animal model of breast cancer bone metastasis. 1907 Apr 45

We present a case of a 58-year-old woman with papillary carcinoma of the thyroid and elevated thyroglobulin. Whole body 123I scan with SPECT images demonstrated focal uptake in the thoracic spine, reported as bone metastases. Subsequent (18)FDG PET and (99m)Tc HDP bone were normal. MRI and CT scans confirmed the presence of vertebral haemangiomas corresponding to the uptake seen on the (123)I scan. False-positive uptake of (123)I in benign vertebral haemangiomas should be considered in the differential diagnosis of focal vertebral uptake.
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PMID:Iodine-123 uptake in vertebral haemangiomas in a patient with papillary thyroid carcinoma. 1917 86


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