Early Diagnosis Of Bone Metastases Research Articles

Deep learning algorithm-based multimodal MRI radiomics and pathomics data improve prediction of bone metastases in primary prostate cancer

PurposeBone metastasis is a significant contributor to morbidity and mortality in advanced prostate cancer, and early diagnosis is challenging due to its insidious onset. The use of machine learning to obtain prognostic information from pathological images has been highlighted. However, there is a limited understanding of the potential of early prediction of bone metastasis through the feature combination method from various sources. This study presents a method of integrating multimodal data to enhance the feasibility of early diagnosis of bone metastasis in prostate cancer.Methods and materialsOverall, 211 patients diagnosed with prostate cancer (PCa) at Gansu Provincial Hospital between January 2017 and February 2023 were included in this study. The patients were randomized (8:2) into a training group (n = 169) and a validation group (n = 42). The region of interest (ROI) were segmented from the three magnetic resonance imaging (MRI) sequences (T2WI, DWI, and ADC), and pathological features were extracted from tissue sections (hematoxylin and eosin [H&E] staining, 10 × 20). A deep learning (DL) model using ResNet 50 was employed to extract deep transfer learning (DTL) features. The least absolute shrinkage and selection operator (LASSO) regression method was utilized for feature selection, feature construction, and reducing feature dimensions. Different machine learning classifiers were used to build predictive models. The performance of the models was evaluated using receiver operating characteristic curves. The net clinical benefit was assessed using decision curve analysis (DCA). The goodness of fit was evaluated using calibration curves. A joint model nomogram was eventually developed by combining clinically independent risk factors.ResultsThe best prediction models based on DTL and pathomics features showed area under the curve (AUC) values of 0.89 (95% confidence interval [CI], 0.799–0.989) and 0.85 (95% CI, 0.714–0.989), respectively. The AUC for the best prediction model based on radiomics features and combining radiomics features, DTL features, and pathomics features were 0.86 (95% CI, 0.735–0.979) and 0.93 (95% CI, 0.854–1.000), respectively. Based on DCA and calibration curves, the model demonstrated good net clinical benefit and fit.ConclusionMultimodal radiomics and pathomics serve as valuable predictors of the risk of bone metastases in patients with primary PCa.

Potential biomarkers for the early detection of bone metastases.

The clinical manifestations of bone metastases are diversified while many sites remain asymptomatic at early stage. As the early diagnosis method is not perfect and the early symptoms of tumor bone metastasis are not typical, bone metastasis is not easy to be detected. Therefore, the search for bone metastasis-related markers is effective for timely detection of tumor bone metastases and the development of drugs to inhibit bone metastases. As a result, bone metastases can only be diagnosed when symptoms are found, increasing the risk of developing skeletal-related event (SREs), which significantly impairs the patient's quality of life. Therefore, the early diagnosis of bone metastases is of great importance for the treatment and prognosis of cancer patients. Changes of bone metabolism indexes appear earlier in bone metastases, but the traditional biochemical indexes of bone metabolism lack of specificity and could be interfered by many factors, which limits their application in the study of bone metastases. Some new biomarkers of bone metastases have good diagnostic value, such as proteins, ncRNAs, circulating tumor cells (CTCs). Therefore, this study mainly reviewed the initial diagnostic biomarkers of bone metastases which were expected to provide references for the early detection of bone metastases.

Diagnostic value of whole -body diffusion weighted imaging added to bone scan in early diagnosis of bone metastases in breast cancer patients

BackgroundMetastases to the bones are a frequent location of metastasis in advanced breast cancer and are responsible for substantial morbidity and healthcare expenses. Imaging has been crucial in directing patient therapy for decades, contributing to the staging and response evaluation of the skeleton. This research aimed to assess the diagnostic value of whole-body magnetic resonance imaging with diffusion-weighted imaging added to radionuclide bone scans for early diagnosis of bone metastases in breast cancer patients.ResultsThe study was a prospective observational cohort study performed on 20 patients with breast cancer and suspected bone metastases. The patients were evaluated first by obtaining a detailed personal history. Laboratory tests, including CBC, liver, and kidney function tests were assessed. All patients were examined by diffusion-weighted whole-body MRI (DWIBS; diffusion-weighted imaging with background body signal suppression) images and bone scintigraphy after intravenous injection of 20 mci of technetium-99m (99mTc) methylene diphosphonate using a dual head gamma camera. The total number of lesions detected by bone scan was 74, and 75 lesions were seen by DWIBS. Twenty-four lesions were missed by bone scan and detected by DWIBS. Fourteen lesions were detected by bone scan and found free by DWIBS examination in the spine and pelvic bones.ConclusionsWhole body DWIBS seems to be a promising method of imaging in detecting bone metastases from breast cancer that could be used complementary to the traditional bone scan for more accurate diagnosis and staging of the tumor, helping to determine the most appropriate protocol of management.

Diagnosis of SPECT/CT bone imaging combined with two serum examinations in patients with bone metastases from pulmonary cancer.

To study the clinical diagnostic value of SPECT/CT bone imaging combined with two serum examinations in patients with bone metastases from pulmonary cancer. The clinical data of 120 patients consistent with pulmonary cancer admitted to the First Affiliated Hospitalof Hebei North University from March 2019 to December 2019 were selected for retrospective analysis, and they were divided into the bone metastasis group (n = 58) and non-bone metastasis group (n = 62) according to comprehensive evaluation result of X-ray, CT, MRI and clinical follow-up. The CT values of patients were obtained by SPECT/CT bone imaging to compare serum levels of ALP (alkaline phosphatase belongs to phosphoric monoester hydrolases, as a specific phosphatase, mainly in body tissues and body fluid) and BAP (bone alkaline phosphatase is formed by different modification and processing of alkaline phosphatase, and is mainly released by osteoblasts) and CT values of patients in both groups, using receiver operating characteristic (ROC) curve to evaluate the diagnostic efficacy of single detection and combined detection. SPECT/CT bone imaging in patients with bone metastasis from pulmonary cancer showed abnormal radioactive accumulation in spine, pelvis and bilateral ribs. Serum ALP, BAP and CT values in bone metastasis group were overtly higher than the non-bone metastasis group (P < 0.001). Logistic regression analysis showed that serum ALP, BAP and CT value were independent risk factors for bone metastasis from pulmonary cancer. The AUC value and Youden index of combined diagnosis were higher than those of single diagnosis. SPECT/CT bone imaging combined with serum detection of ALP and BAP in patients with pulmonary cancer is helpful for early diagnosis of bone metastasis, which provides more basis for the formulation and selection of clinical treatment options.

Computer-Aided Detection of Bone Metastasis using Bone Scintigraphy Scans

Abstract: When cancer cells spread from their original site to the bone then it is known as ‘Bone Metastasis’. Patients with solid tumors such as lung, breast, kidney, prostate etc. oftentimes develop bone metastasis. Cancer cells that spread to the bone mostly affect limbs, pelvis, spine, skull and ribs. Once tumors have metastasized to the bone, patients usually undergo skeletal complications collectively known as skeletal-related events (SRE) like skeletal remodelling, fractures, spinal cord compression, pain or anaemia and bowel incontinence. Therefore, early diagnosis of bone metastasis is crucial for increasing survivability as it has a major impact on treatment decision and at the same time it is a decisive factor in the evolution of the disease and the quality of life. ‘Bone Scintigraphy’ is accepted to be an efficient diagnostic tool for whole-body examination of bone metastasis. Computer-Aided Detection method is used to avoid mistakes which might be caused by human interference &amp; experimental sources. CAD system provides faster and more precise results that facilitates in the early detection of bone metastasis, hence increasing the patient’s chance of survival. To reduce the dependency of the system on source of the input image &amp; for making the system robust we have explored various done image enhancement techniques.

Progress in diagnosis of bone metastasis of prostate cancer.

The diagnosis of bone metastasis of prostate cancer (PC) is of great significance to the treatment and prognosis of patients with PC.Bone scan is the most commonly used in the early diagnosis of bone metastasis, but its specificity is low and there is a high false positive.In recent years, with the in-depth study of the application of CT, MRI, emission computed tomography (ECT), positron emission computed tomography/computed tomography (PET/CT) and deep learning algorithm-convolutional neural networks (CNN) in the diagnosis of bone metastasis, the combined application of various auxiliary parameters in the diagnosis of bone metastasis has significantly been improved. The therapeutic effect of PC patients with bone metastasis can also be evaluated, which is expected to achieve the treatment of bone metastasis as well as diagnosis. By systematically expounding the research progress of the above-mentioned techniques in the diagnosis of bone metastasis, it can provide clinicians with new methods for the diagnosis of bone metastasis and improve the diagnostic efficiency for bone metastasis.

A predictive biomarker panel for bone metastases: Liquid biopsy approach

Bone metastases is one of the common metastatic site and leading cause of cancer-related mortality in progressive cancer patients. The purpose of the present study is to establish a liquid biopsy based multi-gene classifier and associated signalling pathways for early diagnosis of bone metastases. We used publically available microarray datasets and analysed them in a platform/chip-specific manner using GeneSpring software. Analyses of gene expression datasets identified 15 consistently over-expressed genes with statistical significance. Further, expression profile of same set of 15 genes were compared in breast and lung cancer exosome derived mRNA with (n = 10) and without (n = 10) bone metastases against healthy controls. ROC curve analysis performed individually for all the 15 genes shortlisted the 4 most relevant genes (HSP90AA1, SPP1, IL3, and PTK2) with higher sensitivity and specificity in both cancers. This liquid biopsy-based bone metastases predictor using multi-gene panel is a unique approach with potential clinical applications for effective management of aggressive cancers.

Metástase óssea rara de carcinoma mamário em cadela: relato de caso

Mammary gland tumors are the most frequent neoplasm in dogs and are mostly malignant. Metastases ordinarily occur firstly at the pulmonary level, and subsequently in the lymph nodes, liver and kidneys. Less frequently, they appear at the bone. Therefore, the present study report a case of bone metastasis in a seven-year-old female boxer dog, consisting of poorly differentiated carcinoma that probably originated from mammary carcinoma. For the diagnosis, the bone biopsy was performed and the tissue fragmentsobtained were sent for histopathological examination. The positive immunohistochemical stain for cytokeratin 7 performed later reinforced the hypothesis that mammary carcinoma was the primary site of metastasis. The occurrences of bone metastases arising from the mammary gland are rare among dogs, possibly because metastasis is underdiagnosed and the animals do not reach the final stage of the disease. Thereby, there is a need to investigate the entire skeleton more accurately, in order to make an early diagnosis of bone metastasis and increase these animals’ survival.

Serum ProGRP as a novel biomarker of bone metastasis in prostate cancer

BackgroundThe prognosis of prostate cancer (PCa) is related to tumor metastasis, among which 80% were bone metastasis. In this study, we investigated the correlation between diverse clinical factors and bone metastasis in PCa patients and identified potential biomarkers of bone metastasis in PCa patients. MethodsThe clinical data of 150 PCa patients were reviewed consecutively from January 2015 to March 2020 in this study. The relationships between clinical characteristics, serum biomarkers and bone metastasis in PCa patients were analyzed, respectively. Multivariate logistic regression analysis was applied to identify potential markers of bone metastasis in prostate cancer. Receiver operating characteristic (ROC) curve was used to explore the diagnostic values of potential biomarkers. ResultsCompared with the PCa patients without bone metastasis, the serum levels of CA-125, T-PSA, F-PSA, CYFRA21-1 and ProGRP were significantly elevated in PCa patients with bone metastasis. Multivariate logistic regression analysis showed that T-PSA (OR 1.014, P = 0.021), F-PSA (OR 1.124, P = 0.016) and Pro-gastrin-releasing peptide (ProGRP) (OR 1.057, P = 0.026) were significantly associated with the bone metastasis of PCa patients. ROC curves indicated that T-PSA, F-PSA and ProGRP could effectively discriminate bone metastasis from non-bone metastasis PCa patients, and the AUCs (area under the curves) were 0.885, 0.919 and 0.752, respectively. According to the Youden index, the cut-off values of T-PSA, F-PSA and ProGRP were defined as 56.50 ng/ml, 6.96 ng/ml and 31.60 pg/ml, respectively. T-PSA, F-PSA and ProGRP produced a sensitivity of 78.30%, 81.70% and 61.70%, a specificity of 93.30%, 88.90% and 82.20%, respectively. The AUC for the combination of T-PSA, F-PSA with ProGRP was 0.941 with 90.00% sensitivity, much better than that of any single biomarker or two biomarkers combinate. ConclusionsSerum ProGRP might be a potential tumor marker of bone metastasis in prostate cancer, which may contribute to the early diagnosis of bone metastasis when used alone or in combination with other commonly used biomarkers.

Establishment of a serological molecular model for the early diagnosis and progression monitoring of bone metastasis in lung cancer

BackgroundThe prognosis is very poor for lung cancer patients with bone metastasis. Unfortunately, a suitable method has yet to become available for the early diagnosis of bone metastasis in lung cancer patients. The present work describes an attempt to develop a novel model for the early identification of lung cancer patients with bone metastasis risk.MethodsAs the test group, 205 primary lung cancer patients were recruited, of which 127 patients had bone metastasis; the other 78 patients without bone metastasis were set as the negative control. Additionally, 106 healthy volunteers were enrolled as the normal control. Serum levels of several cytokines in the bone microenvironment (CaN, OPG, PTHrP, and IL-6) and bone turnover markers (tP1NP, β-CTx) were detected in all samples by ECLIA or ELISA assay. Receiver operating characteristic (ROC) curves and multivariate analyses were performed to evaluate diagnostic abilities and to assess the attributable risk of bone metastasis for each of these indicators; the diagnostic model was established via logistic regression analysis. The prospective validation group consisted of 44 patients with stage IV primary lung cancer on whom a follow-up of at least 2 years was conducted, during which serum bone biochemical marker concentrations were monitored.ResultsThe serological molecular model for the diagnosis of bone metastasis was logit (p). ROC analysis showed that when logit (p) > 0.452, the area under curve of the model was 0.939 (sensitivity: 85.8%, specificity: 89.7%). Model validation demonstrated accuracy with a high degree of consistency (specificity: 85.7%, specificity: 87.5%, Kappa: 0.770). The average predictive time for bone metastasis occurrence of the model was 9.46 months earlier than that of the bone scan diagnosis. Serum OPG, PTHrP, tP1NP, β-CTx, and the diagnostic model logit (p) were all positively correlated with bone metastasis progression (P < 0.05).ConclusionsThis diagnostic model has the potential to be a simple, non-invasive, and sensitive tool for diagnosing the occurrence and monitoring the progression of bone metastasis in patients with lung cancer.

Preparation, Characterization, and Radiolabeling of [68Ga]Ga-NODAGA-Pamidronic Acid: A Potential PET Bone Imaging Agent.

Early diagnosis of bone metastases is crucial to prevent skeletal-related events, and for that, the non-invasive techniques to diagnose bone metastases that make use of image-guided radiopharmaceuticals are being employed as an alternative to traditional biopsies. Hence, in the present work, we tested the efficacy of a gallium-68 (68Ga)-based compound as a radiopharmaceutical agent towards the bone imaging in positron emitting tomography (PET). For that, we prepared, thoroughly characterized, and radiolabeled [68Ga]Ga-NODAGA-pamidronic acid radiopharmaceutical, a 68Ga precursor for PET bone cancer imaging applications. The preparation of NODAGA-pamidronic acid was performed via the N-Hydroxysuccinimide (NHS) ester strategy and was characterized using liquid chromatography-mass spectrometry (LC-MS) and tandem mass spectrometry (MSn). The unreacted NODAGA chelator was separated using the ion-suppression reverse phase-high performance liquid chromatography (RP-HPLC) method, and the freeze-dried NODAGA-pamidronic acid was radiolabeled with 68Ga. The radiolabeling condition was found to be most optimum at a pH ranging from 4 to 4.5 and a temperature of above 60 °C. From previous work, we found that the pamidronic acid itself has a good bone binding affinity. Moreover, from the analysis of the results, the ionic structure of radiolabeled [68Ga]Ga-NODAGA-pamidronic acid has the ability to improve the blood clearance and may exert good renal excretion, enhance the bone-to-background ratio, and consequently the final image quality. This was reflected by both the in vitro bone binding assay and in vivo animal biodistribution presented in this research.

Symptoms Related to Moderate Skeletal-Related Events as Clues for the Diagnosis of Bone Metastasis.

Early diagnosis of bone metastasis is difficult. The aim of the present study was to determine whether symptoms related to skeletal-related events (SREs) can be used for the diagnosis of bone metastasis in the absence of screening tests. We reviewed 81 patients with bone metastasis to evaluate their SREs at diagnosis. SREs were arbitrarily classified as moderate or severe. Moderate SREs included radiation to the bone before pathological fracture or paralysis, bone surgery before pathological fracture or paralysis, and hypercalcemia without dialysis. Severe SREs included pathological fracture, spinal cord compression, and hypercalcemia necessitating dialysis. The complication rates of SREs at the time the bone metastasis was diagnosed were 59.3% and 24.7% for severe and moderate SREs, respectively, and only 16.0% of cases were uncomplicated. The clinical factors that showed a significant relationship with the severity of SREs were age and history of malignancy. However, there was no significant relationship between the complication rate of total SREs and the presence or absence of a malignancy history (83.3% vs. 85.2%, respectively, p=0.83). The results of the present study suggest that symptoms related to SREs can be used to diagnose bone metastasis in the absence of a screening test. Bone metastasis should be diagnosed as often as possible based on symptoms related to moderate SREs and should be treated as soon as possible before patients develop severe SREs.

Diagnosis of Bone Metastasis in Patients Without a History of Cancer.

Diagnosing bone metastasis in patients without a history of cancer remains challenging. Diagnostic evaluation may be prolonged owing to difficulties in distinguishing between bone metastasis and common orthopedic diseases. We hypothesized that bone metastasis due to occult cancer would be more difficult to diagnose than bone metastasis in patients with a history of cancer. Few studies exist on the difficulty of diagnosing bone metastasis in patients without a history of cancer. Therefore, we reviewed the clinical course of patients with bone metastasis between January 2011 and December 2014. We reviewed patients with bone metastasis to determine the diagnostic rate at first visit, period from symptom-onset to first visit, period from first visit to diagnosis, and presence of severe skeletal-related events at diagnosis, and compared these between 27 patients without a history of cancer (Group A) and 54 patients with a history of cancer (Group B). The diagnostic rate at first visit was significantly lower (11.5% vs. 52.4%, p=0.00069), the period from first visit to diagnosis was significantly longer (median, 7 weeks vs. 3 weeks, p=0.018), and the presence of severe skeletal-related events at diagnosis was significantly higher (81.4% vs. 50.0%, p=0.05) in patients without a history of cancer compared with those with a history of cancer. The results of this study indicate that it is difficult to diagnose bone metastasis in patients without a history of cancer. This must be considered in the early diagnosis of bone metastasis to prevent severe skeletal-related events.

Diagnostic Value of Plain Radiography for Symptomatic Bone Metastasis at the First Visit.

To prevent and minimize skeletal-related diseases, early diagnosis of bone metastases is important. However, previous reports have shown that plain radiography has low sensitivity and fails to screen multiple asymptomatic lesions. Limited investigations have been reported on the value of plain radiography in the diagnosis of symptomatic bone metastases. Therefore, this study aimed to investigate the diagnostic utility of plain radiography for symptomatic bone metastasis. Two experienced orthopedic surgeons retrospectively evaluated the plain radiographs of 39 patients with symptoms during their first visit between 2011 and 2014 for bone metastases. Another 2 experienced orthopedic surgeons then reviewed the data using 2 reference standards, the clinical results and the retrospectively evaluated results, in a blinded manner. The data were then reviewed by 2 certified orthopedic surgeons and 7 orthopedic surgeons in training with differing years of experience in a blinded manner. The overall sensitivity of diagnosis of symptomatic bone metastasis using plain radiography at the clinic first visit was 71.4%. Upon blinded evaluation, the accuracy, sensitivity, and specificity were 55.8%, 54.3%, and 68.8% and 77.6%, 73.0%, and 85.7% for clinical results and results from 2 experienced orthopedic surgeons as a reference standard, retrospectively. There was a strong and significant correlation between the accuracy and observers' years of experience in orthopedic surgery among the orthopedic surgeons in training (R=0.942, p=0.0015). Plain radiography around the time of the first visit has a definitive role in the early diagnosis of symptomatic bone metastasis.

30 - The use of bone tRAP-5b for early diagnosis of bone metastases in patients with renal cell carcinoma

30 - The use of bone tRAP-5b for early diagnosis of bone metastases in patients with renal cell carcinoma

Development of imaging probes for bone cancer in animal models. A systematic review.

Bone is a dynamic tissue that is constantly remodeled throughout the lifetime to ensure the integrity of the skeleton. Primary cancer cells disseminate into circulation, often extravasating to bone, where they interact with the bone marrow to grow and proliferate, disrupting the bone homeostasis. Although primary bone tumors account for less than 0.2% of all cancers, bone is a common site for the development of metastases, as its microenvironment provides the necessary conditions for the growth and proliferation of cancer cells. Metastases to the skeletal system are observed in up to 70% of all cancer patients and the growth of disseminated tumor metastases is a major cause of mortality. As widely known, a non-invasive diagnosis of bone tumors at early stages is of great importance to provide insights that will help on the decision of therapy regimen, improving treatment outcomes. Early diagnosis of bone metastases is also an important step for establishing palliative care as they may cause serious endocrine, hematologic, neurologic and orthopedic complications as well as intolerable pain. Therefore, development of new imaging techniques, imaging moieties, and animal models to mimic these bone conditions, play an important role in improving the clinical outcome of this disease. In this review, we will briefly describe the advantages and disadvantages of the currently available imaging techniques that aim at identifying bone tumors. In addition, we will provide an update on the animal models applicable at mimicking bone tumor characteristics, as well as describe recent advances on the development of new imaging probes, in the preclinical settings including targeted nanoparticles and radiopharmaceuticals.

Bone turnover markers in women with early stage breast cancer who developed bone metastases. A prospective study with multivariate logistic regression analysis of accuracy

BackgroundThe skeleton is the most common site of metastasis for breast cancer and the periodic measurement of circulating bone turnover markers (BTMs) can be useful. The aim of this study was to prospectively evaluate the diagnostic accuracy of a panel of BTMs in the early detection of bone metastases (BMs). MethodsWe reviewed the medical records of 297 postmenopausal women with early stage luminal-type invasive ductal carcinoma (IDC). Twenty-six patients who developed isolated BMs during follow-up and 24 randomly selected controls were studied. The two groups were matched according to age, final disease staging, and follow-up. All patients underwent periodic measurement of total and bone-specific (BSAP) alkaline phosphatase, CTX, ICTP, osteocalcin, NTX, PINP, and TRACP5b. ResultsOnly BSAP, CTX, PINP, and TRACP5b were significantly (p<0.05) associated with the group, and the logistic regression analysis excluded CTX from the model. The AUC (ROC curve) for TRACP5b alone, which was the most accurate marker, and for the combination of BSAP+PINP+TRACP5b was 0.784 (95% CI: 0.651–0.916) and 0.889 (95% CI: 0.798–0.981), respectively. ConclusionAccording to our results, the measurement of these three markers together should be performed in all postmenopausal patients with luminal-type IDC, when an early diagnosis of BMs is required.

Expression of epidermal growth factor receptor, carbohydrateantigen 125, and carbohydrateantigen 199 in postoperative non-small cell lung cancer patients with bone metastasis

Objective To investigate the expression of epidermal growth factor receptor (EGFR) in the tissue of non-small cell lung cancer (NSCLC), and the expression of carbohydrateantigen 125 (CA125), and carbohydrateantigen 199 (CA199) in postoperative NSCLC patients with bone metastasis and without bone metastasis, and discuss the roles of EGFR, CA125 and CA199 in postoperative NSCLC patients with bone metastasis. Methods Sixteen cases of postoperative NSCLC with bone metastasis served as the experimental group, and 16 cases of postoperative NSCLC without bone metastasis as the control group. The expression of EGFR in the lung cancer, and the serum levels of CA125 and CA199 were determined. Results The strong positive rate of EGFR was 81.2% in the experimental group. The CA125 and CA199 positive rate in the experimental group was 56.3% and 43.8% respectively. Combined detection positive rate was 81.3%. The strong positive rate of EGFR was 6.2% in the control group. The CA125 and CA199 positive rate in the control group was 0. Combined detection positive rate was 0. The serum levels of CA125 and CA199 in the experimental group were (138.05±141.06) Ku/L and (78.06±112.86) U/ml, and those in the control group were (9.94±6.50) Ku/L and (9.40±4.66) U/ml respectively. Conclusion With the high expression of EGFR, combined detection of CA125 and CA199 has certain significance in the early diagnosis of bone metastasis in postoperative NSCLC patients. Key words: Non-small cell lung cancer; Bone metastasis; Epidermal growth factor receptor; Carbohydrateantigen 125; Carbohydrateantigen 199

DIAGNOSTICS OF BONE METABOLISM DISORDERS IN ONCOLOGICAL DISEASES

Osteoporosis is one of the most significant bone complications of cancer. About 1.5 million cancer patients worldwide have bone metastases. Patients with myeloma, breast cancer, prostate, thyroid, bladder and lung have very high risk of development of bone lesions and related complications. Currently, osteodensitometry is the gold standard for the diagnosis of osteoporosis. In recent years we frequently use the innovative imaging techniques for bone metastases, such as CT, MRI, PET/CT. Unfortunately, the diagnostic value of these methods is that it is not always possible to identify abnormalities of bone metabolism in cancer, especially in the early stages. This review shows the world experience of usage of biochemical markers of bone resorption (calcium, hydroxyproline, NTX, CTX, PYD, DPD, TRAP-5b, bone sialoprotein - BSP) and markers of bone synthesis (osteocalcin, CSF, ACF, Karlovy vary IFF), their advantages and disadvantages. The level of these markers is increased in most patients with osteoporosis and bone metastases, it is suggesting a potential role in early diagnosis of bone metastases.

Preparation and biodistribution assessment of 111In-BPAMD as a novel agent for bone SPECT imaging

Abstract An early diagnosis of bone metastases is very important for providing a profound decision on a subsequent therapy. In this study, a new agent for SPECT-imaging of bone metastases, 111In-(4-{[(bis(phosphonomethyl))carbamoyl]methyl}-7,10-bis(carboxymethyl)-1,4,7,10-tetraazacyclododec-1-yl) acetic acid (111In-BPAMD) complex has been developed with specific activity of 2.85 TBq/mmol. Radiochemical purity of the radiolabeled complex was checked by instant thin layer chromatography method indicated high radiochemical purity &gt; 95% at the optimal conditions. The complex demonstrated significant stability at room temperature and in human serum at least for 48 h. Hydroxyapatite (HA) binding assay showed high binding ability of the radiolabeled complex even at the low amounts of HA. Also, log P measurements highlighted the strong hydrophilic nature of the complex. Biodistribution studies as well as planar imaging after injection of the complex into the male Syrian mice showed major accumulation of the labelled compound in the bone tissue. Totally, the obtained results indicated that 111In-BPAMD has interesting characteristics as an agent for SPECT-imaging of the bone metastases.