原发性骨肿瘤646例统计分析

目的探讨我院骨肿瘤的发病情况及构成比率。方法对我院2002年1月～2011年10月经病理检查证实的646例骨肿瘤病例的住院病历进行统计分析。结果良性骨肿瘤607例,原发恶性骨肿瘤39例,良性骨肿瘤以骨软骨瘤、骨瘤最多见,原发恶性骨肿瘤以骨肉瘤与软骨肉瘤为主,肿瘤患者男性多于女性,好发年龄小于30岁。结论骨肿瘤发病率男性高于女性,良性较为多见。良性骨肿瘤的发病率远高于恶性骨肿瘤。     

肩胛骨肿瘤的临床及影像学分析

目的分析肩胛骨肿瘤的临床及影像学表现。方法选取2010年1月~2020年1月经手术病理证实的50例肩胛骨病变的临床及影像学资料进行回顾性分析。结果50例肩胛骨病变中,良性肿瘤24例(48%),中间型肿瘤7例(14%),恶性肿瘤19例(38%),病变类型共14种。良性肿瘤中骨软骨瘤最多见,共21例(占良性肿瘤87.5%),中间型肿瘤中以骨软骨瘤伴局部生长活跃多见,共3例,嗜酸性肉芽肿2例,恶性肿瘤中按发生比率多见的依次为转移瘤11例(占57.9%)、尤文肉瘤4例(21.1%)。结论肩胛骨病变相对少见,以软骨类肿瘤及转移瘤多见,两者均好发于肩胛骨体部,且前者影像表现较为典型。     

MR imaging of edema accompanying benign and malignant bone tumors

To evaluate the incidence, quantity, and presentation of intra- and extraosseous edema accompanying benign and malignant primary bone lesions, the magnetic resonance (MR) studies of 63 consecutive patients with histologically proven primary bone tumors were reviewed. MR scans were assessed for the presence and quantity of marrow and soft tissue edema and correlated with peroperative findings, resected specimens and follow-up data. The signal intensity and enhancement of tumor and edema prior to and after intravenous administration (if any) of gadolinium-labled diethylene triamine pentaacetate (Gd-DTPA) was analyzed. Marrow edema was encountered adjacent to 8 of 39 malignant tumors and 14 of 24 benign lesions. Soft tissue edema was found accompanying 28 of 39 malignancies and 10 of 24 benign disorders. On unenhanced T1-weighted MR images tumor and edema were difficult to differentiate. Tumor inhomogeneity made this differentiation easier on T2-weighted sequences. In 36 patients the contrast medium Gd-DTPA was used. Edema was present in 27 of these patients and the respective enhancement of tumor and edema could be compared. Edema always enhanced homogeneously, and in most cases it enhanced to a similar degree as or more than tumor. Marrow and, more specifically, soft tissue edema is a frequent finding adjacent to primary bone tumors. The mere presence and quantity of marrow and soft tissue edema are unreliable indicators of the biologic potential of a lesion. Unenhanced MR scans cannot always differentiate between tumor and edema, but the administration of Gd-DTPA is of assistance in differentiating tumor from edema. Awareness of marrow and/or soft tissue edema adjacent to bone lesions is of importance because edema can be a pitfall in the diagnostic work-up and staging prior to biopsy or surgery.     

Primary tumors of the spine

Primary osseous tumors of the spine are rare lesions and much less frequently encountered than metastases, multiple myeloma, and lymphoma. The interpreting radiologist must be aware of the typical radiographic appearance of the most common nonmyeloproliferative tumors of the spine because these tumors must be considered when a solitary spinal lesion is encountered. The purpose of this article is to describe the radiologic appearance and radiologic staging of the most common benign (hemangioma, enostosis, osteoid osteoma, osteoblastoma, giant cell tumor, aneurysmal bone cyst, and osteochondroma) and malignant (chordoma, chondrosarcoma, Ewing tumor, and osteosarcoma) osseous spine tumors.     

颅内间变性血管外皮细胞瘤伴骨转移一例

笔者报道了1例颅内间变性血管外皮细胞瘤（AHPC）伴骨转移的病例,从临床表现、影像学检查尤其是全身骨显像检查以及术后病理综合分析了该病特点。并通过文献复习加深了对AHPC骨转移的认识。多数恶性肿瘤常见骨转移,而颅内AHPC是一种少见的中枢神经系统肿瘤,较少发生骨转移。通过全身骨显像发现了该例患者多处骨骼病变,术后病理提示颅内AHPC骨转移,因此提示恶性肿瘤尤其是少见骨转移者应把骨显像检查作为随访的一个重要检查,对于早期发现骨转移、确定临床分期及治疗方案的选择等都是至关重要的。     

Clinical evaluation of tumor scanning with 169-Yb-citrate.

169-Yb-citrate was used as the tumor-scanning agent in 360 patients with malignant tumors and in 55 others with benign lesions and the results compared with 67-Ga-citrate studies in other series. In malignant tumors, the overall positive detection rate for ytterbium was 65.3%; in benign lesions, the false-positive rate was 29.1%. Good results were obtained in the extremities, head and neck, and pelvic area. Of all tumors visualized, squamous cell carcinoma was detected most effectively (77.5%). 169-Yb-citrate has a long shelf life, photon peaks of 178 and 198 kev, clears from the blood more rapidly than 67-Ga-citrate and has an extremely low soft-tissue background uptake. Its main disadvantage is its high radiation dose: 1.74 R/500 muCi whole-body and 5.77 R to the bone.     

常规MRI联合DWI在腮腺常见肿瘤中的诊断价值

目的:探讨常规MRI联合DWI对腮腺常见肿瘤的诊断价值。方法:回顾性分析经病理证实的62例腮腺肿瘤的MRI图像,根据其DWI图行ADC图重建,测量肿瘤的ADC值。按发病率将62例病例分成3组:多形性腺瘤、腺淋巴瘤、恶性肿瘤。多形性腺瘤31例,全部单发;腺淋巴瘤19例,9例单发,10例多发,共30个病灶;恶性肿瘤12例,3例淋巴瘤多发,其余均为单发,共18个病灶。比较分析3种肿瘤的ADC值。结果:多形性腺瘤和腺淋巴瘤多发生于腮腺浅叶(43个,70.5%),肿瘤边界多清楚,体积一般较恶性肿瘤小;恶性肿瘤位于深叶者8个(44.4%),边界清楚或不清楚,多伴有颈部淋巴结肿大(10例,83.3%)。多形性腺瘤及恶性肿瘤平均ADC值均高于腺淋巴瘤(P=0.000、0.002),且多形性腺瘤平均ADC值高于恶性肿瘤(P=0.001)。结论:腮腺肿瘤的常规MRI征象具有一定特点,联合DWI能为腮腺常见肿瘤的诊断及鉴别诊断提供更多依据。     

Imaging tumors of the patella

Background

Patellar tumors are rare; only a few series have been described in the literature and radiographic diagnosis can be challenging. We reviewed all patellar tumors at one institution and reviewed the literature.

Materials and methods

In an evaluation of the database at one institution from 1916 to 2009, 23,000 bone tumors were found. Of these, 41 involved the patella. All had imaging studies and microscopic diagnostic confirmation. All medical records, imaging studies, and pathology were reviewed.

Results

There were 15 females and 26 males, ranging from 8 to 68 years old (average 30). There were 30 benign tumors; eight giant cell tumors, eight chondroblastomas, seven osteoid osteomas, two aneurysmal bone cysts, two ganglions, one each of chondroma, exostosis, and hemangioma. There were 11 malignant tumors: five hemangioendotheliomas, three metastases, one lymphoma, one plasmacytoma, and one angiosarcoma.

Conclusion

Patellar tumors are rare and usually benign. As the patella is an apophysis, the most frequent lesions are giant cell tumor in the adult and chondroblastoma in children. Osteoid osteomas were frequent in our series and easily diagnosed. Metastases are the most frequent malignant diagnoses in the literature; in our series malignant vascular tumors were more common. These lesions are often easily analyzed on radiographs. CT and MR define better the cortex, soft tissue extension, and fluid levels. This study presents the imaging patterns of the more common patellar tumors in order to help the radiologist when confronted with a lesion in this location.     

Diagnostic value of TI-201 and three-phase bone scintigraphy for bone and soft-tissue tumors

PURPOSE: Although TI-201 is highly sensitive for detecting bone and soft-tissue tumors, its uptake is not specific for malignant lesions. This study assessed the differentiation of malignant and benign lesions and evaluated the sensitivity, specificity, and accuracy of TI-201 imaging and three-phase bone scans. MATERIALS AND METHODS: Forty bone and soft-tissue tumors (16 malignant and 24 benign) were evaluated. TI-201 static images were acquired 10 minutes (early) and 2 hours (delayed) after injection of the radionuclide. Within 14 days, three-phase bone scintigraphy was performed using Tc-99m HMDP with the patient in the same position. The count ratio of the lesion compared with the normal contralateral or adjacent site (L:N ratio) was measured. RESULTS: With TI-201 scintigraphy, mean (+/- SD) values of early and delayed L:N ratios were 3.36 +/- 1.25 and 2.88 +/- 1.20, respectively, in malignant lesions; and 1.88 +/- 1.14 and 1.48 +/- 0.76, respectively, in benign lesions. TI-201 accumulation in benign lesions was significantly less than that of malignancies on early and delayed images. However, an overlap of both ratios between malignant and benign lesions was seen. No such significance was detected on three-phase bone scintigraphy (L:N ratios of malignant and benign tumors were 2.57 +/- 1.22 and 2.24 +/- 2.11, respectively, for blood flow imaging; 2.41 +/- 0.78 and 2.26 +/- 1.54, respectively, for blood pool imaging; and 2.80 +/- 2.10 and 2.89 +/- 4.55, respectively, for bone imaging). When we assumed that the tumor was malignant when the delayed TI-201 L:N ratio exceeded the blood pool phase L:N ratio with bone scintigraphy, the sensitivity rate was 81%, specificity rate was 100%, and accuracy rate was 93%. CONCLUSIONS: TI-201 imaging for bone and soft-tissue tumors was better than three-phase bone scintigraphy alone but was not good enough to clearly differentiate malignant lesions from benign ones. TI-201 scintigraphy, performed in combination with three-phase bone scintigraphy, may be superior to either one of the two imaging procedures alone for bone and soft-tissue tumor diagnosis.     

Benign clavicular lesions that may mimic malignancy

Nontraumatic lesions of the clavicle are infrequent. Of these, malignant tumors are more common than benign lesions. From January 1988 to January 1990, we examined 17 patients with benign lesions of the clavicle; in 8, the morphologic appearance of the lesion raised the possibility of malignancy in the differential diagnosis. The radiologic findings in these patients are presented. We propose that the unique shape and embryologic development of the clavicle may contribute to the atypical, aggressive presentation of some benign lesions in that bone.     

骨肿瘤与瘤样病变周围组织影像表现分析

目的 分析骨肿瘤与瘤样病变引起的骨髓水肿(BME)和软组织水肿(STE)的影像表现,加强对此征象的认识.方法 复习绛手术病理证实的99例骨肿瘤与瘤样病变资料,将病变分成良性组和恶性组,观察病灶周围BME和STE范围、信号特点、是否有强化、BME区域在X线平片和(或)CT 上是否有骨质硬化、有无关节积液等,比较BME和STE出现率及范围差异.采用X2检验对组间数据进行比较.结果 良性组40例,恶性绀59例.BME和STE在T1WI上呈低信号,脂肪抑制T1WI上为高信号;部分BME在T2WI上呈低信号,相应区域在X线平片和(或)CT上为骨质硬化,离病灶越近,密度越高,在脂肪抑制T2TI上信号越低.增强扫描BME、STE皆均匀强化.BME、骨质硬化出现率及BME、STE范围长径中位数良性组分别为57.5%(23/40)、25.0%(10/40)、2.7 cm、1.3 cm,恶性组分别为32.2%(19/59)、3.4%(2/59)、1.6 cm、1.7 cm,差异均有统计学意义(P值均<0.05);STE和关节积液出现率良性组分别为50.O%(20/40)、12.5%(5/40),恶性组分别为52.5%(31/59)、8.5%(5/59),差异无统计学意义(P值均>0.05);良性绀内BME和STE 出现率差异无统计学意义(P>0.05);恶性组内BME和STE的出现率筹异有统计学意义(P<0.05).结论 良性骨肿瘤与瘤样病变及恶性骨肿瘤周围均可出现BME和STE,良性组BME范围大于恶性组,恶性骨肿瘤STE范围大于良性组.

Abstract：

Objective To explore the imaging features of bone marrow edema(BME)and soft tissue edema(STE)caused by bone tumors and tumor-like lesions.Methods Ninety nine patients with bone tumors and tumor-like lesions which were proved by surgical pathology were reviewed.The patients were divided into benign and malignant groups.Evaluation parameters included the size and signal intensity of BME and STE,the features of enhancement,the bone sclerosis and its relation with BME,and joint effusion,et al.The data of two groups were analyzed by X2 test.Results There were 40 patients in benign group and 59 patients belonged to malignant group.BME and STE demonstrated low signal on T1-weighted images and high signal on fat-suppressed T2-weighted images.Some BMEs demonstrated low signal on T2weighted images,which corresponded to sclerosis on X-ray film and(or)CT.Both BME and STE demonstrated uniform enhancement.There were statistically significant differences between benign and malignant groups including the frequency of BME.sclerosis.the median of the size of the BME and STE (P<0.05),which were 57.5%(23/40),25.0%(10/40),2.7 cm,1.3 cm,and 32.2%(19/59).3.4%(2/59),1.6 cm,1.7 cm respectively.No significant differences between the frequency of STE,joint effusion in 2 groups(P>0.05).Conclusions Both benign bone tumors and tumor-like lesions and malignant bone tumors can be accompanied by BME and STE.The size of BME in the benign bone tumors and tumor-like lesions is bigger than those in malignant ones,and the size of STE in malignant bone tumors is bigger than benign ones.     

Morphology and diagnosis of bone tumors of the foot

We report on 554 bone tumors and tumor-like lesions of the foot, which have been diagnosed within the period from 1945-1985 in the Department of Diagnostic Radiology, in the Surgical and Orthopedic Departments and in the Division of Pathology of Bone Tumors of the University of Freiburg. Schajowicz' WHO classification criteria for bone tumors were used. Morphological aspects, clinical symptoms and pattern of distribution differ widely from lesions of other skeletal regions. Bone tumors of the foot are much more frequently associated with pain caused by the special anatomy of the foot. Malignant lesions are very rare in the foot. We found only 42 malignant tumors corresponding to 1.4% of all malignant bone tumors. By contrast 13% of all benign bone tumors are localized in the foot. However, 90% of them are osteochondromas and chondromas. Other benign lesions are rare, especially tumors arising from connective tissue of bone. In several cases correct diagnosis was only possible by histologic examination whereas modern digital imaging did not substantially add to conventional plain film and tomographic examination. Preoperative CT scans were very useful for exact planning of surgical procedures especially in benign tumors.     

骨小细胞恶性肿瘤的影像特征分析

目的 分析骨小细胞恶性肿瘤（SCMT）的临床及影像表现,以提高临床诊断水平。 方法 回顾性选取经病理证实的骨SCMT病人75例,其中恶性非霍奇金淋巴瘤（MNHL）25例[男20例、女5例,平均年龄（50.0±18.3）岁],骨的浆细胞瘤（PB）37例[男20例、女17例,平均年龄（59.1±12.4）岁]、尤文肉瘤（ES）13例[男11例、女2例,平均年龄（17.1±6.7）岁]。分析3种肿瘤病人临床资料、病灶X线摄影或CT特征及MRI特征。采用单因素方差分析、卡方检验或Fisher确切概率检验比较3组病人的临床资料和影像特征分布。 结果 3组间年龄、性别、骨质破坏类型、骨皮质破坏类型、膨胀性改变和残留骨嵴、病灶周围水肿、软组织肿块、骨膜反应差异均有统计学意义（均P<0.05）。MNHL组及PB组病人的平均年龄均高于ES组,3组男性均多于女性。3组X线及CT特征中,PB组中骨质破坏、骨皮质破坏、膨胀性改变及病变内残留骨嵴征象的占比均高于其余2组;其中PB组病人均可见骨质破坏和骨皮质破坏（100%）,且骨质破坏多呈溶骨性改变（90.6%）,并以骨皮质缺损多见（84.4%）。3组MRI特征中,ES组出现病灶周围水肿、软组织肿块和骨膜反应的占比均最高,其次为MNH组和PB组。ES组出现软组织肿块的占比高达100%,MNHL组和PB组中出现骨膜反应者仅占5.6%和4.8%。3组发生部位、T₂WI信号特点间的差异均无统计学意义（均P>0.05）。 结论 结合病人的年龄及影像学表现有助于鉴别骨SCMT。     

FDG PET of primary benign and malignant bone tumors: standardized uptake value in 52 lesions

PURPOSE: To evaluate the standardized uptake value (SUV) of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) at positron emission tomography (PET) in the differentiation of benign from malignant bone lesions. MATERIALS AND METHODS: Fifty-two (19 malignant, 33 benign) primary bone lesions were examined with FDG PET prior to tissue diagnosis. The SUVs were calculated and compared between benign and malignant lesions and among histologic subgroups that included more than four cases. RESULTS: There was a statistically significant difference in SUV between benign (2.18 +/- 1.52 [SD]) and malignant (4.34 +/- 3.19) lesions in total (P =.002). However, giant cell tumors (n = 5; SUV, 4.64 +/- 1.05) showed significantly higher SUV than chondrosarcomas (n = 7; SUV, 2.23 +/- 0.74) (P =.036, adjusted for multiple comparisons) and had no statistically significant difference in SUV compared with osteosarcomas (n = 6; SUV, 3.07 +/- 0.96) (P =.171). There was no statistically significant difference in SUV between fibrous dysplasias (n = 6; SUV, 2.05 +/- 0.98) and osteosarcoma (P =.127) or chondrosarcomas (P =.667). Although the number of cases was small, three chondroblastomas, one sarcoidosis, and one Langerhans cell histiocytosis showed levels of FDG accumulation as high as that of osteosarcomas. CONCLUSION: Radiologists should be aware of the high accumulation of FDG in some benign bone lesions, especially histiocytic or giant cell-containing lesions. Consideration of histologic subtypes should be included in analysis of SUV at FDG PET of primary bone tumors.     

儿童胸壁病变的影像表现与临床分析

目的 探讨儿童胸壁病变的临床及影像表现特点，提高对胸壁病变的诊断水平。方法 收集我院2009年10月-2018年6月经手术及病理证实的50例胸壁病变患儿，包括感染组（4例）和非感染组（46例），非感染组进一步分为良性肿瘤组（41例）和恶性肿瘤组（5例）。50例患儿均行超声、CT或MRI检查。对所有病例的临床及影像表现进行回顾性分析。结果 3组病例的临床及影像表现各有不同。①临床表现：感染组病人全部出现发热、胸痛、病灶局部红肿热的临床表现，且病变均质软；良性肿瘤组中质软出现率为90.2%（37/41）；恶性肿瘤组全部病变均质韧。3组病变移动性均差。感染组及恶性肿瘤组全部病例均有局部压痛，而良性肿瘤组压痛的发生率仅为7.3%（3/41）。②影像表现：良性肿瘤组中，75.6%（31/41）病变显示内部均匀，65.9%（27/41）边缘清晰；而感染组及恶性肿瘤组病灶内部不均匀，边缘模糊。良性肿瘤组中仅9.8%（4/41）病灶可见钙化，2.4%（1/41）病灶有出血，19.5%（8/41）病灶内部出现囊腔影，14.6%（6/41）病例可见肋骨破坏；恶性肿瘤组全部侵犯入胸腔并破坏肋骨；感染组均无肋骨破坏。感染组与恶性肿瘤组病变均呈明显强化，而良性肿瘤组中80.5%（33/41）表现为无/轻度强化。结论 不同性质胸壁病变临床特点各异，结合临床和影像特征可更好地诊断胸壁病变。     

Tumour and tumour-like lesions of the patella – a multicentre experience

Fifty-nine cases of lesions presenting in the patella were identified after review of the databases of four European bone tumour registries. Of the 59 cases, 46% were non neoplastic, 39% were benign and 15% were malignant. The commonest benign neoplasm was giant cell tumour (GCT) (11 cases). Younger patients were more likely to have a benign neoplasm. Lesions in patients less than 40 years of age included giant cell tumour, chondroblastoma, aneurysmal bone cyst (ABC), osteomyelitis, osteoid osteoma and solitary bone cyst. In patients older than 40 years, the following were common lesions: intra-osseous gout, metastasis and intra-osseous ganglion. Expansion of the patella with thinning of cortex was seen more commonly in GCT and brown tumour in hyperparathyroidism. There was associated soft tissue extension in gout and malignant lesions.     

Time-dependent changes in signal intensity in neoplastic and inflammatory lesions of the musculoskeletal system following intravenous administration of Gd-DTPA

In 48 patients with primary and secondary bone and soft tissue tumors and in 6 patients with inflammatory diseases of bone, the increase in signal intensity after i.v. administration of Gd-DTPA (0.1 mmol/kg body wt) was assessed in pathologic and normal tissues of the musculoskeletal system by means of a FLASH sequence (TR = 40 ms, TE = 10 ms, tip angle 90 degrees). In normal tissues the increase of signal intensity was slower and less pronounced than in lesions. Malignant tumors showed a more pronounced and rapid increase in signal intensity than benign tumors and inflammatory tissue. It was possible to differentiate necrotic areas and peritumorous edema from tumorous and inflammatory tissue. The increase in signal intensity was perceptibly slower and less pronounced in malignant tumors exposed to cytostatic therapy than in malignant tumors without therapy.     

Quantitative assessment of 201Tl-SPECT in tumors of bone and soft tissue]

201Tl-SPECT was performed to diagnose the malignancy of bone and soft tissue tumors by visual and quantitative assessment in 48 patients (17 malignant lesions and 31 benign lesions). SPECT images were obtained in the early phase (15 min after injection) and the delayed phase (240 min). By visual assessment a tumor was considered malignant if high accumulation was found in the tumor in the early phase and the accumulation was confirmed in the delayed phase. Tumors which did not meet these criteria were considered benign. For quantitative assessment, the ROI (region of interest) accumulation ratios of the tumor to the contralateral normal tissue in the early phase (ER) and in the delayed phase (DR), the ROI accumulation ratio of the delayed phase to the early phase of the tumor (Td/Te), and the ROI accumulation ratio of the delayed phase to the early phase of the contralateral normal tissue (Nd/Ne) were obtained. Sixteen patients with malignant tumors each had a high accumulation each but 12 of 31 benign lesions had no high accumulation on visual assessment. Furthermore, the accuracy was 85.4%, sensitivity 94.1%, and specificity 80.6%. Quantitative assessment was performed for 36 cases of high accumulation. The ER of malignant and benign lesions was 5.51 +/- 3.73 and 2.75 +/- 2.17, respectively, and the ER of malignant lesions was significantly higher than that of benign lesions. The DR did not demonstrate a significant difference. If the tumor having an ER greater than 3.9 was assumed to be malignant, the accuracy for differentiating malignant lesions from benign lesions was 85.4%. The Td/Te of benign lesions (0.97 +/- 0.28) was higher than that of malignant lesions (0.77 +/- 0.09). The Nd/Ne of normal tissue which contained muscles in both lesions were higher than 1.4. In conclusion, 201Tl-SPECT was very useful for the differential diagnosis of benign or malignant bone and soft tissue tumors. The ER was important for quantitative assessment, but a delayed image was necessary for visual assessment.     

Radiologic-pathologic correlations in tumors and tumor-like lesions of the hand (author's transl)

Since 1972, 267 tumors or tumor-like lesions of the hand in 257 patients were examined at the bone tumor registry by the Swiss Society of Pathology in Basel, Switzerland. This is 9% of a total of 2,800 bone tumors submitted. An analysis revealed 254 benign tumors or tumor-like lesions and 13 malignant tumors, among them 2 metastases of tumors of unknown origin. As expected, enchondromas (n=81) and pigmented villo-nodular synovitis of the tendon sheath (n=104) were the most frequent tumors. All other tumors or tumor-like lesions appeared only as solitary cases or in small numbers. The radiologic characteristics of some of the lesions are reviewed and their histology is presented. Furthermore, some important points of differential diagnosis are discussed.     

Detectability of metastatic bone tumor by Ga-67 scintigraphy

Ga-67 scintigrams in patients with malignant diseases sometimes reveal uptake of the tracer in the bone metastases. Detectability of Ga-67 scintigraphy for metastatic bone tumors and benign bone lesions was compared with that of Tc-99m bone scintigraphy. Countable bone metastases detected by bone scintigraphy were evaluated whether the lesion showed apparent, faint, or negative Ga-67 uptake. Of 47 lesions 23 (49%) showed apparent uptake and 17 (36%) showed negative uptake. On the other hand, of 71 benign bone lesions, only 7 (10%), mostly fracture/osteotomy, showed apparent uptake of the tracer. Uptake in the other benign lesions such as trauma of the ribs, spondylosis deformans, and arthrosis deformans was rather faint. In patients with multiple bone metastases, 9 patients (82%) out of 11 showed more prominent abnormal findings in Tc-99m MDP bone scintigraphy than in Ga-67 scintigraphy; that is, Ga-67 scintigraphy was not able to reveal all metastatic bone lesions. In patients with untreated or recurrent tumors, relation between Ga-67 uptake in the tumors and that in the bone metastases was evaluated. Of 7 patients with negative Ga-67 uptake in the primary tumors, 5 showed positive Ga-67 uptake in the bone metastases; that is, there seemed to be little relation between Ga-67 affinity to the primary tumors and that to the bone metastases. Mechanisms of the Ga-67 uptake in the bone metastases were discussed. Not only the tumor cells or tissues in the bone metastases but also bone mineral or osteoclasts might be the deposition sites of Ga-67.