Skip to main content
Log in

A critical assessment of bone scan quantitation (bone to soft tissue ratios) in the diagnosis of metabolic bone disease

  • Published:
European Journal of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Accurate quantitation from the bone scan image of skeletal uptake of radiopharmaceutical would be of value in the assessment of patients with metabolic bone disease. Repeat measurements of bone to soft tissue (B/ST) ratios on the one set of images were made for 103 subjects, a) by the same observer using lumbar vertebra 2 for the area of bone; b) by the same observer using lumbar vertebra w then lumbar vertebra 4; c) by two observers both using lumbar vertebra 2. The median difference between repeat measurements by the same observer was well under 1% but the 5–95 percentile range was -13 to +14%. Between the two observers there was a median difference of 10.6% with a 5–95 percentile range of -11 to +44%.

We also measured B/ST ratios in 150 control subjects and 139 patients with various metabolic bone disorders. While statistically significant differences for B/ST ratios were found between the osteomalacia, renal osteodystrophy, Paget's groups, and the control population (P<0.001 in all cases), there was appreciable overlap between individual patient results and the control range.

It is concluded, therefore, that measurement of B/ST ratios for the individual is of limited value in clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Avioli LV (1976) Senile and postmenopausal osteoporosis. Adv Intern Med 21: 391–415

    Google Scholar 

  • Citrin DL, Bessent RG, McGinlay E, Gordon D (1975) Dynamic studies with 99m Tc-HEDP in normal subjects and in patients with bone tumours. J Nucl Med 16: 886–890

    Google Scholar 

  • Fogelman I, Greig WR, Bessent RG, Boyle IT (1977) Skeletal uptake of 99mTc-HEDP in primary hyperparathyroidism. J Nucl Med 18: 1040–1041

    Google Scholar 

  • Fogelman I, Bessent RG, Tuner JG, Citrin DL, Boyle IT, Greig WR (1978a) The use of whole body retention of 99mTc-diphosphonate in the diagnosis of metabolic bone disease. J Nucl Med 19: 270–275

    Google Scholar 

  • Fogelman I, McKillop JH, Bessent RG, Boyle IT, Turner JG, Greig WR (1978b) The role of bone scanning in osteomalacia. J Nucl Med 19: 245–248

    Google Scholar 

  • Holmes RA (1977) 99mTc-pyrophosphate in demonstrating bone disease of parathyroid dysfunction. J Nucl Med 18: 309–310

    Google Scholar 

  • Holmes RA (1978) Quantitation of skeletal Tc-99m labelled phosphates to detect metabolic bone diasese. J Nucl Med 19: 330–331

    Google Scholar 

  • Lien JWK, Wiegmann T, Rosenthall L, Kaye M (1976) Abnormal 99mTechnetium-tin-pyrophosphate bone scans in chronic renal failure. Clin Nephrol 6: 509–512

    Google Scholar 

  • Merz WA, Schenk RK (1970) A quantitative histological study on bone formation in human cancellous bone. Acta Anat (Basel) 76: 1–15

    Google Scholar 

  • Riggs BL, Randall RV, Wahner HW, Jowsey J, Kelly PJ, Singh M (1972) The nature of the metabolic bone disorder in acromegaly. J Clin Endocr Metab 34: 911–918

    Google Scholar 

  • Serafini AN (1976) Paget's disease of bone. Semin Nucl Med 6: 47–58

    Google Scholar 

  • Wiegmann T, Kirsh J, Rosenthall L, Kaye M (1976) Relationship between bone uptake of 99mTc-pyrophosphate and hydroxyproline in bone and urine. J Nucl Med 17: 711–714

    Google Scholar 

  • Wiegmann T, Rosenthall L, Kaye M (1977) Technetium-99m-pyrophosphate bone scans in hyperparathyroidism. J Nucl Med 18: 231–235

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fogelman, I., Bessent, R.G. & Gordon, D. A critical assessment of bone scan quantitation (bone to soft tissue ratios) in the diagnosis of metabolic bone disease. Eur J Nucl Med 6, 93–97 (1981). https://doi.org/10.1007/BF00266417

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00266417

Keywords

Navigation