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.
Similar content being viewed by others
References
Avioli LV (1976) Senile and postmenopausal osteoporosis. Adv Intern Med 21: 391–415
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
Fogelman I, Greig WR, Bessent RG, Boyle IT (1977) Skeletal uptake of 99mTc-HEDP in primary hyperparathyroidism. J Nucl Med 18: 1040–1041
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
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
Holmes RA (1977) 99mTc-pyrophosphate in demonstrating bone disease of parathyroid dysfunction. J Nucl Med 18: 309–310
Holmes RA (1978) Quantitation of skeletal Tc-99m labelled phosphates to detect metabolic bone diasese. J Nucl Med 19: 330–331
Lien JWK, Wiegmann T, Rosenthall L, Kaye M (1976) Abnormal 99mTechnetium-tin-pyrophosphate bone scans in chronic renal failure. Clin Nephrol 6: 509–512
Merz WA, Schenk RK (1970) A quantitative histological study on bone formation in human cancellous bone. Acta Anat (Basel) 76: 1–15
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
Serafini AN (1976) Paget's disease of bone. Semin Nucl Med 6: 47–58
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
Wiegmann T, Rosenthall L, Kaye M (1977) Technetium-99m-pyrophosphate bone scans in hyperparathyroidism. J Nucl Med 18: 231–235
Author information
Authors and Affiliations
Rights 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
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00266417