Association of mannose-binding lectin 2 (mbl2) gene heterogeneity and its serum concentration with osteoporosis in postmenopausal women.

The aim of the study was to detect prevalence of MBL2 exon 1 (codons 52, 54 and 57) genetic polymorphism in postmenopausal women in Bosnia and Herzegovina and its possible role as genetic risk factor for susceptibility to occurrence of osteoporosis in this study group. Also, we investigated association between MBL serum concentrations and osteoporosis in postmenopausal women. Genetic codons' variations were determined by PCR-RFLP and MBL in serum was measured by ELISA method in 75 postmenopausal women (37 with osteoporosis and 38 apparently healthy, non-osteoporotic women serving as a control). Serum MBL levels were not significantly different between osteoporosis and control group (492 (37-565.1) and 522.6 (477-559.4) ng/mL respectively, p=0.206). Genotype frequencies were not significantly different (p=0.997) between the studied groups of postmenopausal women. Genotype frequencies A/A, A/0 and 0/0 in osteoporosis group were 0.576; 0.405; 0.018 and in control group 0.562; 0.412; 0.026, respectively. Frequencies of A and 0 allele were 0.78 and 0.22 in osteoporosis and 0.77 and 0.23 in control group. The results do not suggest association of functional polymorphism of MBL2 gene and MBL serum concentration with osteoporosis in postmenopausal females.

The utility of procollagen type 1 N-terminal propeptide for the bone status assessment in postmenopausal women.

The utility of procollagen type 1 N-terminal propeptide (P1NP) in the management of metabolic bone diseases remains a subject of debate since the reference ranges are not rigorously established and fail to account for many of the preanalytical variables. We aimed to establish reference intervals for P1NP level in healthy and osteoporotic postmenopausal females stratified by age, body mass index and menopausal duration. We also aimed to assess the relationship between P1NP and BMD. This cross-sectional study enrolled 183 postmenopausal females who were divided in osteoporosis group (N=93) and control group (N=90) with preserved bone mass based on BMD assessed by DXA. In the osteoporosis group median P1NP was significantly higher (51.7 ng / mL; 95%CI 43.2-53.7) compared to control group (38.9 ng/mL; 95%CI 34.2-43.9)(p<0.01). After controlling for age, BMI and years since menopause, there was significant inverse association between BMD and P1NP at the femoral neck (r=-0.18), total hip (r=-0.207) and lumbar spine (r=-0.236). There was no significant difference in P1NP concentration across quartiles of age in postmenopausal females. P1NP was significantly lower in obese postmenopausal females with preserved bone mass compared to normal weight and overweight females in control and in osteoporosis group. In conclusion, we showed that P1NP is inversely associated with BMD even after controlling for age, BMI and years since menopause. Although, P1NP is significantly higher in postmenopausal females with osteoporosis compared to postmenopausal females with preserved bone mass its low specificity does not warrant its utility is diagnosing osteoporosis.

Importance of measurement of thyroglobulin and anti-thyroglobulin antibodies in differentiated thyroid cancer.

Differentiated thyroid cancers include papillary and follicular carcinomas, both originating from follicular epithelium. Treatment of choice is usually total or near total thyroidectomy, followed by ablative radioiodine 131I treatment, and by the long-term administration of thyroid hormone. Despite its excellent prognosis, recurrent disease does occur in approximately 20-40% of patients. Guidelines for the follow-up management of differentiated thyroid cancer are commonly based on circulating thyrogobulin measurement in the complete absence of eutopic thyroid tissue. A retrospective review was conducted on 116 patients (66 papillary and 50 follicular carcinoma, mean age 51.2 years) who had undergone total or near total thyroidectomy and radioactive iodine remnant ablation. Serum thyroglobulin (Tg) and anti-thyroglobulin antibodies (TgAb) levels were measured preoperatively, 1 month after thyroidectomy (before 131I treatment) and 6 and 12 months after ablation therapy (Tg1, TgAb1 and Tg2, TgAb2, respectively). During one year of follow-up, in a total of 24 patients (21%) recurrent disease were confirmed by ultrasonography and whole-body-scanning, mostly. It was found significant correlation between serum Tg levels (measured preoperatively and postoperatively) and recurrent diseases (p < 0.05), while serum TgAb levels did not have any statistical significance. However, in multivariate regression analysis only Tg levels measured 12 months after the therapy (Tg2) remained a significant predictor of recurrent disease (p = 0.008). Although a high Tg level before surgery does not indicate that tumor is present, in the postoperative period and after ablative therapy Tg has proven predictive value because stimulated Tg levels above 10 ng/ml confirmed that indicate residual or recurrent cancer, and its periodically measurements is recommended.

The value of serum thyreoglobulin levels and whole body (I-131) scintigraphy in the follow-up of the thyroid cancer patients after thyroidectomy.

Serum thyreoglobulin (Tg) and whole body scintigraphy (I-131 WBS) have been used to detect recurrent and metastatic thyroid cancers postoperatively. However, discordant results of Tg measurement and 131I WBS have been reported. Negative 131I WBS and a positive Tg test are usually found, but less common occurrence of positive 131I WBS and a negative Tg test has also been demonstrated in a small but significant number of cases. Therefore, the aim of the study was to retrospectively analyse patients with positive 131I WBS after total thyreoidectomy and again 1 year after the radioactive iodine. There were 52 patients included in the study. Four weeks after surgery, during which thyroid hormone treatment was not introduced, each patient received an ablative dose of 131I. The evaluation of the WBS was qualitative and considered positive if thyroid remnant, lymphatic node or metastasis were detected. WBS and serum Tg was measured 12 months after 131I ablation with thyroid hormone suppression. We considered positive any Tg level above the sensitivity values and negative if lower than this level. Tg levels were related to the existence of a positive scan or a negative one. In our 52 WBS positive patients concordant positive Tg levels were observed in 42 patients while in 10 patients we found a negative Tg levels after the surgery. After 1-year follow-up, out of initially 42 concordant patients 8 patients showed remaining concordant positive Tg and WBS values. Discordant results were observed in 13 patients (4 patients were Tg- and WBS+ while 9 patients were Tg+ and WBS-). In the majority of patients (50%) remained with concordant results but changed from Tg+ and WBS+ to Tg- and WBS-. Diagnostic WBS is an additional valuable tool, besides Tg levels, in the follow up of patients after total thyreoidectomy.

Comparison of the diagnostic capabilities of noninvasive methods for early detection of coronary artery disease.

Early detection of coronary artery disease is one of the prerequisites for adequate and successful treatment of patients and because of that it is important to assess which diagnostic method in a certain time gives the most reliable data to define the optimal medical treatment. The study included 100 subjects. All subjects underwent the electrocardiogram, electrocardiographic stress test, ultrasound examination of the heart without a load, SPECT stress/rest myocardial perfusion scintigraphy and coronary angiography. Coronary angiography as an invasive method has been used as a gold standard with which are compared the results of conducted diagnostic noninvasive examinations, and determined their specificity and sensitivity. The results were statistically analyzed using the recipient operating curve-ROC. Discussed are the diagnostic features of each method and conclusions that brought complementary radiological and nuclear medical imaging can provide very important information about coronary heart disease before making a decision on coronary angiography.

Tomographic ventilation/perfusion lung scintigraphy in the monitoring of the effect of treatment in pulmonary embolism: serial follow-up over a 6-month period.

BACKGROUND: Pulmonary embolism (PE) is a severe condition with nonspecific symptoms. Diagnosis relies on medical imaging but follow-up is currently based on clinical symptoms and general risk factors. The duration of anticoagulant treatment after an acute episode of PE is still subject to debate and the best method of identifying the risk of recurrence in individual patients is undefined. Tomographic lung scintigraphy [ventilation/perfusion single photon emission computed tomography (V/P SPECT)] has improved the diagnostic accuracy with regard to PE but has not been evaluated for PE follow-up. AIM: The aim of this prospective study was to quantitatively follow the natural history of treated PE using V/P SPECT, which could prove helpful in defining an anticoagulant treatment regime for individual patients. METHODS: Of 83 consecutive patients with clinically suspected PE examined with V/P SPECT, 23 patients with confirmed PE were followed by serial V/P SPECT examinations over a 6-month period. All patients were also followed clinically. RESULTS: The mean relative decrease in PE extent compared with the time of diagnosis was 54±26% at 2 weeks, 79±30% at 3 months, and 82±30% at 6 months. Significant resolution of mismatched perfusion defects occurred between V/P SPECT controls within the first 3 months of anticoagulation (P<0.001) but not thereafter. V/P SPECT identified four patients with chronic PE, even though all patients were free from symptoms at 3-month follow-up. CONCLUSION: Follow-up of PE with V/P SPECT is feasible to evaluate treatment effectiveness in individual patients and to identify patients that develop chronic PE. This study also confirms that resolution of perfusion defects after PE occurs within the first 3 months of treatment. It is therefore recommended that V/P SPECT follow-up should be considered at 3 months after diagnosis.

Evaluation of bone remodelling parameters after one year treatment with alendronate in postmenopausal women with osteoporosis.

Antiresorptive agents are widely used to treat osteoporosis. Both reduction in bone turnover and increase in BMD may be necessary to decrease the fracture risk. The aim of the study was to evaluate the effects of aledronate on bone turnover markers and bone mineral density in postmenopausal women with osteoporosis. The study involved a group of 56 postmenopausal women with osteoporosis treated with alendronate (70 mg) weekly at the Institute of Nuclear Medicine Clinical Center University of Sarajevo during a 12-months period. Bone mineral density (BMD) at lumbar spine and proximal femur and bone turnover markers (serum ß-CrossLaps, urinary N-telopeptides of type I collagen (NTx), total serum alkaline phosphatase (AP) and serum osteocalcin) were measured at baseline and after 12 months of the treatment with aledronate. BMD values significantly increased both at lumbar spine by 13.46% and proximal femur by 21.96% during the study period (-3.12±0.24 vs. -2.7±0.19 and -2.55±0.2 vs. -1.99±0.19 respectively; p<0.001). Bone turnover markers significantly decreased during the study period; C-terminal telopeptides of type I collagen fragment (ß-CrossLaps) 49.0% (0.51±0.05 vs.0.26±0.028 ng/mL), NTX 33.4% (48.3±4.9 vs.32.15±3.25 nMBCE/mM Cr), AP 24.3% (81.1±5.2 to 61.43±5.2 IU/L) and serum osteocalcin by 29.7% (34.3±2.65 to 24.1±1.36 ng/mL)(p<0.001). Alendronate treatment increased BMD and reduced the level of bone turnover markers. Therefore, the treatment with aledronate during 12 months period can be recommended in postmenopausal women with osteoporosis.

Echocardiographic evaluation of cardiac function in female patients with thyroid disorders.

The aim of this study was to assess echocardiographic changes in female patients with untreated dysfunctional thyroid states and whether the therapy aimed to normalize the thyroid dysfunction could lead to improvement in cardiac systolic and diastolic function. The study included 90 female subjects who performed control of thyroid hormonal status at the Institute of Nuclear Medicine at the University of Sarajevo Clinics Centre and who previously were untreated for the thyroid functional disorders. The study sample was divided in three groups based on the thyroid hormones levels: a) hyperthyroid group (n= 30) b) hypothyroid group (n=30) and c) euthyroid (control). Echocardiography measurements were performed on commercially available Toshiba, SSH 140. Before the therapy no statistically significant differences in the peak early and late mitral inflow velocities (E/A) values between the study groups was observed, but the mean left ventricular ejection fraction (LVEF) in hypothyroid group was significantly lower (58.30+/-1.05) compared to control (64.96+/-0.71) and hyperthyroid group (64.69+/-1.31) (p<0.001). In hypothyroid group we found significant increase in mean LVEF (58.30+/-1.05 vs. 64.95+/-0.86, p<0.01) and E/A (1.06+/-0.07 vs. 1.17+/-0.08; p=0.01) values after the normalization of thyroid hormone status.Thyroid dysfunctional states were not associated with impaired diastolic function, probably due to the short duration of thyroid dysfunction and timely and successful conversion therapy. Systolic function however was significantly reduced in hypothyroid patients but subsequently improved after the adequate therapy. Early diagnostic approach in patients with thyroid dysfunctional states is important for avoidance of cardiac complications that accompany these disorders.

Efficiency and safety of radioactive iodine I-131 in treatment of thyroid disease.

Thyroid gland is the largest endocrine gland in the body. The thyroid gland produces hormones that regulate the metabolism rate, affect the growth and many functions of various organ systems. Nuclear medicine technique is very useful diagnostic tool in detecting thyroid disease. Thyroid scintigraphy can reveal functional and anatomic information of thyroid gland. A variety of radiopharmaceuticals and methodologies have been used over the years in nuclear medicine. Iodine-131 has been used to image the thyroid several decades. Radioactive Iodine I-131 is useful for the treatment of hyperthyroidism and thyroid cancer. There were 100 participants included in the study who were treated with I-131. The participants were checked 6 months and 12 months after the beginning of the treatment. The results show normalization of the laboratory parameters and hormonal status at the control examinations after 6 months and 12 months therapy with I-131. The side effects did not appear in any of the patients, which demonstrates safe application.

[Thyroid scintigraphy as diagnostic method evaluation of thyroid diseases]. / Scintigrafija stitne zlijezde kao dijagnosticka metoda u evaluaciji oboljenja stitne slijezde.

The thyroid is one of the largest endocrine glands in the body. It may enlarge substanially during pregnancy and when affected by a variety of diseases. The thyroid gland produces hormones, that regulates all metabolic processes and affect the growth and rate of functioning of many other systems in the body. Studies of the endocrine system are among the original procedures in nuclear medicine. Thyroid scintigraphy and radiotracer uptake studies remain an important part of the practice of nuclear medicine. Scintigraphy reveales functional and anatomy changes in status of thyroid gland. A systematic and complete interpretation of the thyroid scintigrams requires assessments of thyroid size and configuration and identification and description of focal abnormalities, including hot and cold nodules and extratyroidal activity in the neck or mediastinum.

[Evaluation of thyroid diseases in nuclear medicine]. / Evaluacija tireoidnih oboljenja u nuklearnoj medicini.

The thyroid is one of the larger endocrine glands in the body. The thyroid size is 15-20 gr. The gland produces hormones that regulate all metabolic processes in large number of tissues in the body, and produces hormones that affect the growth and rate of function of many other systems in the body. Studies of the endocrine system are among the original procedures in nuclear medicine. Thyroid scintigraphy and radio-tracer uptake studies remain an important part of the practice of nuclear medicine. Scintigraphy reveals functional and anatomic status of thyroid gland. A systematic and complete interpretation of the thyroid scintigrams requires assessments of thyroid size and configuration and identification and description of focal abnormalities, including hot and cold nodules and extrathyroidal activity in the neck or mediastinum. Early diagnosis and treatment of thyroid disease have made possible the reduction of morbidity and mortality associated with these disorders.

Screening of pulmonary embolism by ventilation / perfusion tomography-SPECT and comparation with planar scintigraphy--our experiences.

UNLABELLED: Pulmonary embolism (PE) affects up to 1 per 1000 people every year and is one of the commonest preventable causes of death among hospital inpatients. Laboratory chemical test alone cannot confirm or exclude PE but are used together with the clinical test probability for risk stratification. Ventilation/ perfusion tomographic imaging may be the best practical way to accomplish on this larger scale. The aim of this study was to screen the pulmonary embolism by ventilation/perfusion tomography V/P SPECT. We also compared V/P SPECT with planar scintigraphy. RESULTS: A total of 40 patients with clinically suspected pulmonary embolism were examined. Fifteen patients (37.5%) considered to have perfusion defect with preserved ventilation using ventilation/ perfusion tomography-SPECT. In this group five patients (33%) had multiple perfusion defects (RoPer = 16 poens, RoVent = o poens). Correlation coefficient has been sign among visual analysis and quantitative analysis (C = 0.510). In 25 patients (62.5%) we have found normal ventilation/ perfusion scintigraphy. On the planar scintigraphy PE with high probability was considered in five (26.6%) patients. Intermediate and low probability was considered in seven patients with planar ventilation/ perfusion scintigraphy. Sub-segmental perfusion defect with preserved ventilation we have found in two patients (13%). On the planar scintigraphy the same defect was unclear. CONCLUSIONS: Ventilation/ Perfusion tomography-SPECT is clinically relevant in the diagnosis of pulmonary embolism, and may help reduce the number of non-diagnostic scintigraphy results. On the planar perfusion scintigraphy patients tended to have fewer perfusion defects corresponding pulmonary embolism.

N-terminal pro-brain natriuretic peptide (NT-proBNP) serum concentrations in apparently healthy Bosnian women.

Brain natriuretic peptide (BNP) is a cardiac hormone secreted predominantly from the ventricles. This hormone is produced as pre-prohormone BNP (pro BNP), than cleaved by corine to biologically active 32-aminoacid BNP and non-biologically active N-terminal-pro brain natriuretic peptide (NTproBNP). NTproBNP has been found to be a useful marker for the diagnosis of heart failure and left ventricular systolic dysfunction. Recent studies showed that concentration of BNP and NTproBNP predict cardiovascular disease in apparently healthy individuals but their full screening characteristics are not firmly established. As NTproBNP serum concentration is altered by numerous factors there are also interindividual variations in NTproBNP values. There are no previous results for Bosnian population so the aim of this study was to asses normal range of NTproBNP serum concentrations in apparently healthy women using electrochemiluminescence immunoassay (Elecsys, Roche Diagnostic). A group of 45, healthy females, aged 39.19 (+/-6.62), were enrolled in this study. Mean serum concentration of NTproBNP was 60.32 (+/-36.25) pg/ml, with the range of 112,60 pg/ml (minimum-maximum: 13.6-126.00 pg/ml). We conclude that NTproBNP serum concentration in apparently healthy Bosnian women was not different from the average values of NTproBNP obtained on Europen's population. Thus, we suggest that the NTproBNP serum upper cut off values measured by using electrochemiluminescence immunoassay "ECLIA" (Elecsys 2010, Roche Diagnostic) for Bosnian females, aged < or =50 years, should be 155 pg/ml as reported by Roche Diagnostic.

[Perfusion myocardial scintigraphy - SPECT with TC-99m MIBI in detection coronary artery desease in diabetic patients]. / Perfuziona scintigrafija miokarda-SPECT sa TC-99m MIBI u detekciji koronarne bolesti kod pacijenata sa diabetes mellitus-om.

UNLABELLED: Diabetes mellitus is very frequent disease. The prevalence of coronary artery disease is higher in diabetic than in non-diabetic patients. Coronary artery disease (CAD) is the main cause of morbidity and mortalitiy in patients with Diabetes mellitus. The aim of this study was to evaluate usfulnes of myocardial perfusion scintigraphy in diabetic patients for detection of coronary artery disease. PATIENTS AND METHODS: this study included 15 patients with verified diabetes mellitus. All patients were treated with oral hypoglicemic or insulin. Parameters observed for every patients were level of lipemia (cholesterol, triglycerides), family hystory of CAD, hystory of chest pain. All patients underwent sress/rest Tc-99m MIBI study. We have performed one day protocol. Exercise tolerance test were performing in all patients according to the Bruce protocol. 260MBq was injected intravenously at peak exercise. 740MBg was injected for the rest. Myocardial perfusion scintigraphy was clasified as: 1. normal, 2. reversible defect or 3. irreversible defect. RESULTS: reversible perfusion defect we have found in 8 patients. The same patients had elevated glicemia, high level of lipemia; 1 patient had fixed defect, without any previous known history for myocardial infarction. In 6 patients we could not see any significant defect during stress/rest scintigraphy. CONCLUSION: The frequency of abnormal myocardial perfusion scintigraphy suggest that this procedure can be very useful in the detection of high-risk diabetic patients.

Lymphoscintigraphy and radiation--occupational exposure during sentinel node assay.

Ionizing radiation has many practical applications, but it is also, as it is well known, dangerous to human health. The purpose of this study was to estimate the dose and exposure for medical staff involved in sentinel node assay and to determine how safe this assay really is. The theoretical method was used for calculation. Three groups of medical staff were selected: nuclear medicine specialist, nuclear medicine technologist and a surgeon. The results obtained show that the most exposed staff member is nuclear medicine specialist and that dose received by the surgeon is smaller then the dose limit.

No influence of body composition on serum growth hormone response to acute dynamic exercise.

Physical effort is a strong physiological stimulus that provokes an increase in blood growth hormone (GH) concentration. Interactions between GH and body composition are very complex. Seven athletes and seven age-matched controls completed a single 30-min bout of upright cycling exercise (5 % of VO(2max).) in order to estimate the influence of body composition on serum GH concentration during exercise. The serum GH concentration was measured in blood samples by standard immunoradiometric (IRMA) method. Anthropometric measurements were used for the calculation of body composition. There were no significant differences in total body mass or body mass index between the groups. The athletes had significantly less fat and higher bone and muscle mass. Serum GH concentration was 2.39 times higher in the athlets versus the control in the period of rest. During acute exercise, the serum GH concentration increased in both groups. No statistically significant differences between the groups in serum GH concentration were found either during the exercise or in the recovery. No correlation between body composition and serum GH concentration was found. Body composition depends on the level of physical activities but if the total body mass is in physiologycal range it does not influence the serum GH response to acute exercise.

Serum growth hormone and glucose levels in acute exercise and in the recovery period in athletes.

Growth hormone exerts several metabolic effects, including effects on proteins, fats and carbohydrates. Among the many metabolic activities of GH, two contradictory actions were described: acute and early insulin-like activity and chronic and late anti-insulin like activity also called diabetogenic activity. A dramatic increase in plasma concentration of GH was found during endurance exercise, but its role during exercise is not well known. According to its metabolic effects a possible role of growth hormone may be in maintenance of glucose level during exercise. The aim of this study was to analyze dynamics of changes in GH and glucose levels during acute workload and in the recovery period, in a group of well trained athletes. All the subjects exercised for 30 minutes on cycle ergometer in sitting position (work intensity 50% of VO2 max, RPM 60/min). Serum GH concentrations were measured by IRMA (immunoradiometric assays) method in blood samples obtained at rest and 6-min intervals during exercise, and 15-min intervals during recovery period. Serum glucose levels were determined by standard enzymatic method glucose oxidase (GOD PAP) at the same intervals. There were no correlations between serum GH and glucose levels either during exercise or in the recovery period. There were no differences between glucose levels during exercise, so we can not exclude possible role of GH in glucose concentration maintenance.

Correlation between bone scintigraphy and tumor markers in patients with breast carcinoma.

A characteristic feature of many cancer types is their ability to metastasise to the skeleton. Bone is the most common site of metastatic invasion, after hematogenous spreading of breast cancer. Early detection of bone metastases is mandatory in the evaluation and management of these patients. Bone scintigraphy is commonly performed in detection and evaluation bone metastases. Tumor markers are present in healthy individuals as well as in patients with malignant diseases but in different concentration. Aim of study was to correlate serum levels of tumor marker Ca (15-3), CEA and presence of bone metastases detected by bone scintigraphy. Study included 25 patients with breast cancer, previously surgically treated. All patients underwent whole body scintigraphy. Ca (15-3) and CEA was measured by radioimmunoassay. Presence, number of bone metastases were correlated with Ca (15-3) and CEA levels. Median age of patients included in study was 50 varying from 30 to 67. Bone scintigraphy revealed bone metastases in 16 (64%) patients. A weak correlation was found between number of metastases and level of Ca (15-3) (r=0.139, p=0.254). Significant differences in Ca (15-3) level was found in patient with metastases compared to patients without metastases (chi square 0, p=1.0). Good correlation was found between number of metastases and serum level of CEA. Correlation between level of two tumor markers Ca (15-3) and CEA was a weak (r = 0.096 , p=0.323). Bone scintigraphy is a sensitive diagnostic toll for detecting breast cancer metastases to bone. Serum levels of tumor markes in isolation can not give complete accuracy about bone metastases.

The relationship between the serum prostate specific antigen and whole body scintigraphy in prostate cancer patients after prostatectomy.

BACKGROUND AND AIM: Bone metastases are of the most frequent in prostate cancer. Serum prostate specific antigen--PSA has been suggested as an accurate means of monitoring prostate cancer. Whole body scintigraphy are currently the most widely used diagnostic procedures for metastases to the bone, the most common site of distant tumor spread. Aim of the study was to determinate relation between PSA level, number of metastases and 99mTc- MDP (methyl-diphosponate) uptake in patients with previous prostatectomy for prostate cancer. PATIENTS AND METHODS: Study enrolled 15 patients after previous prostatectomy for prostate cancer (histologically proven). Standard whole body scintigraphy (WBS) was performed 3 hours after intravenous application of 740 MBq 99mTc-MDP. Total PSA was measured by MEIA-Microparticle Enzyme Immunoassay. RESULTS: Group 1: 12/15 (80%) patients were with WBS detected metastases. Correlation of PSA level and number of detected bone metastases was good (r=0.79). Correlation of PSA level and uptake intensity of 99mTc-MDP (score 3) was positive and significant (r=0.706). CONCLUSION: PSA values were highly predictive for WBS results. PSA values correlated well with number of metastases. We propose no WBS in patients with normal PSA level. WBS is a sensitive diagnostic tool for detecting prostate cancer metastases to bone. PSA levels is good and simpler marker for disease progression, but that neither technique in isolation gives complete accuracy.

Role of bone scintigraphy and tumor marker-Ca 15-3 in detection of bone metastases in patients with breast cancer.

Breast cancer is one of the most frequent types of cancer affecting women. After hematogenous spreading of cancer, axial skeleton is most frequently involved. Bone scintigraphy is commonly performed in detection and evaluation of bone metastases. In breast cancer, marker Ca 15-3 is widely accepted in follow-up and detection of disease recurrence. Aim of the study was to correlate levels of tumor marker Ca 15-3 and presence of bone metastases detected by bone scintigraphy. Study included 25 patients with breast cancer, previously surgically treated. All patients underwent total body scintigraphy. Ca 15-3 was measured by radioimmunoassay. Presence, number and location of bone metastases were correlated with Ca 15-3 levels. Bone scintigraphy revealed bone metastases in 16 (64%) patients. 11 (44%) patients with metastases and 1 patient (4%) without scintigraphically visible metastases had elevated Ca 15-3 levels. Significant difference in distribution of metastases was found for spine (t=3.930, p=0.008). Correlation between intensity of radiopharmaceutical uptake and level of Ca 15-3 in patients was positive (r =0.405). A weak correlation was found between number of metastases and level of Ca 15-3 (r=0.139). Significant differences in Ca 15-3 level was found in patients with metastases compared to patients without metastases (chi square 0, p =1.0). Since no significant correlation was found between level of Ca 15-3 and number of metastases, we consider scintigraphy an appropriate method for assessment of bone metastases in breast cancer.