18F-FDG PET/CT for Diagnosis of Osteosclerotic and Osteolytic Vertebral Metastatic Lesions: Comparison with Bone Scintigraphy

STUDY DESIGN: A retrospective study. PURPOSE: The aims of this study were to investigate the diagnostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in PET/computed tomography (CT) in the evaluation of spinal metastatic lesions. OVERVIEW OF LITERATURE: Recent studies described limitations regarding how many lesions with abnormal 18F-FDG PET findings in the bone show corresponding morphologic abnormalities. METHODS: The subjects for this retrospective study were 227 patients with primary malignant tumors, who were suspected of having spinal metastases. They underwent combined whole-body 18F-FDG PET/CT scanning for evaluation of known neoplasms in the whole spine. 99mTc-methylene diphosphonate bone scan was performed within 2 weeks following PET/CT examinations. The final diagnosis of spinal metastasis was established by histopathological examination regarding bone biopsy or magnetic resonance imaging (MRI) findings, and follow-up MRI, CT and 18F-FDG PET for extensively wide lesions with subsequent progression. RESULTS: From a total of 504 spinal lesions in 227 patients, 224 lesions showed discordant image findings. For 122 metastatic lesions with confirmed diagnosis, the sensitivity/specificity of bone scan and FDG PET were 84%/21% and 89%/76%, respectively. In 102 true-positive metastatic lesions, the bone scan depicted predominantly osteosclerotic changes in 36% and osteolytic changes in 19%. In 109 true-positive lesions of FDG PET, osteolytic changes were depicted predominantly in 38% while osteosclerotic changes were portrayed in 15%. CONCLUSIONS: 18F-FDG PET in PET/CT could be used as a substitute for bone scan in the evaluation of spinal metastasis, especially for patients with spinal osteolytic lesions on CT.

Studies of Rhei Rhizoma (Da-huang; Daio). (I). A Herbological Study on its Medicinal Effects and Medicinal Parts / 日本東洋医学雑誌

Although the crude drug Rhei Rhizoma (Chinese: Da-huang; Japanese: Daio) is now commonly employed as a purgative, some question remains as to whether it was originally used as a depurative (purifying agent; specifically an agent for expelling Stagnated Blood) or purgative in ancient times. There is also some confusion as to the medicinal part of the crude drug being sold on the market. This herbological study was carried out in order to clarify these issues.<br>The results showed that Rhei Rhizoma was originally used mainly as an agent to expel Stagnated Blood, although it was also used for its purgative and other properties. Until the Qing dynasty, the rhizome of the large Rheum species, including R. palmatum, was known as the best quality Da-huang. The recent use of the root is thought to be due to recognition of the purgative properties of Da-huang.<br>Da-huang has many medicinal properties in addition to its usefulness as a purgative, and there is a need for further study of these properties as well as the differences between the pharmacological actions of the rhizome and those of the root.