Summary
The bone scan may be of value in the assessment of patients with metabolic bone disease. However the superiority of the bone scan when compared to radiology in conditions such as renal osteodystrophy, osteomalacia, primary hyperparathyroidism, and osteoporosis requires substantiation with the newer radiopharmaceuticals which have a higher affinity for bone. Two methods of quantitating skeletal uptake of tracer have been assessed to try to remove the subjective aspect of bone scan evaluation. Measurements of bone to soft tissue ratios have proved clinically disappointing, but 24 hour whole body retention of diphosphonate appears to provide a sensitive index of increased bone turnover.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Tofe A.J., Francis M.D., Harvey W.J. Correlation of neoplasm with incidence and localisation of skeletal metastases: An analysis of 1355 diphosphonate bone scans. J. Nucl Med, 1975, 16, 986–989.
Citrin D.L., Bessent R.G., Greig, W.R. A comparison of the sentivity and accuracy of the 99m-Tc-Phosphate bone scan and skeletal radiography in the diagnosis of bone metastases. Clin. Radiol, 1977, 28, 107–117.
Fogelman I., Skeletal uptake of diphosphonate: a review. Eur J Nucl Med, 1980, 5, 473–476.
Fogelman I., McKillop J.H., Bessent R.G. Boyle I.T., Turner J.G., Greig W.R. The role of bone scanning in osteomalacia. J Nucl Med, 1978, 19, 245–248.
Fogelman I., Citrin D.L., Turner J.G., Hay I.D., Bessent R.G., Boyle I.T. Semi-quantitative interpretation of the bone scan in metabolic bone diseases. Eur J Nucl Med, 1979, 4, 287–289.
Fogelman I., Pearson D.W., Bessent R.G., Francis M.D., Tofe A.J. A comparison of skeletal uptake of three diphosphonates by whole body retention. J Nucl Med (in press)
Fogelman I., Carr D. A comparison of bone scanning and radiology in the evaluation of patients with metabolic bone disease. Clin Radiol, 1980, 31, 321–326.
Wiegmann T., Rosenthall L., Kaye M. Technetium-99m-pyrophosphate bone scans in hyperparathyroidism. J Nucl Med 1977, 18, 231–235.
Krishnamurthy, G.T., Brickman A.S., Blahd W.H. Technetium-99m-Sn-pyrophosphate pharmacokinetics and bone image changes in parathyroid disease. J Nucl Med, 1977, 18, 236–242.
McFarlane J.D., Lutkin J.E., Burwood R.J. The demonstration by scintigraphy of fractures in osteomalacia. Br J Radiol, 1977, 50, 369–371.
Sy W.M., Mottola O., Lao R.S., Smith A., Freund H.R. Unusual bone images in hyperparathyroidism. Br J Radiol, 1977, 50, 740–744.
Evens R.G., Ashburn W., Bartter F.C. Strontium 85 scanning of a «brown tumour» in a patient with parathyroid carcinoma. Br. J. Radiol, 1969, 42, 224–225.
Sy W.M., Mittal A.K. Bone scan in chronic dialysis patients with evidence of secondary hyperparathyroidism and renal osteodystrophy. Br J Radiol 1975, 48, 878–884.
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, 1981, 6, 93–97.
Fogelman I., Bessent R.G., Turner J.G., Citrin D.L., Boyle I.T., Greig W.R. The use of whole body retention of Tc-99m diphosphonate in the diagnosis of metabolic bone disease. J Nucl Med, 1978, 19, 270–275.
Citrin D.L., Bessent R.G., McGinlay E., Gordon D. Dynamic studies with 99m-Tc-HEDP in normal subjects and in patients with bone tumours. J Nucl Med, 1975, 16, 886–890.
Author information
Authors and Affiliations
Additional information
Based on a lecture given at the XVIth European Symposium on Calcified Tissue Research, Knokke, Belgium, 16 September 1981.
Rights and permissions
About this article
Cite this article
Fogelman, I., Smith, M.L. Diphosphonates in the evaluation of metabolic bone disease. Clin Rheumatol 1, 41–44 (1982). https://doi.org/10.1007/BF02032475
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02032475