Skip to main content
Log in

Diphosphonate bone scanning agents — Current concepts

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

Abstract

The bone scan is generally recognized to be an extremely powerful investigational tool in the evaluation of patients with skeletal disease. Currently 99mTc-methylene diphosphonate is the most widely used bone scanning agent, but recently several new diphosphonate compounds have been introduced which appear to have relatively higher skeletal affinity, leading to greater absolute uptake of tracer by bone. While the resulting improved contrast between bone and background soft-tissue may provide more pleasing scan images, it is not clear that increased bone uptake of tracer is equally desirable for identification of disease. Nevertheless, to date, no significant difference in lesion detection has been found in any comparative study of diphosphonate compounds.

In this review the clinical studies evaluating diphosphonate bone scanning agents are summarized and the properties required of an ideal bone scanning agent in both benign and malignant discase discussed.

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

  • Ackerhalt RE, Blau M, Bakshi S, Sondel JA (1974) A comparative study of three 99mTc-labeled phosphorus compounds and 18F-fluoride for skeletal imaging. JNM 15:1153–1157

    Google Scholar 

  • Arnold JS, Barnes WE, Khedkar N, Nelson M (1978) Computerized kinetic analysis of two 99mTc-Sn-diphosphonates demonstrating different binding characteristics (abstract). AJR 131:553

    Google Scholar 

  • Bevan JA, Tofe AJ, Benedict JJ, Francis MD, Barnett BL (1980) Tc-99m HMDP (Hydroxymethylene Diphosphonate): A radiopharmaceutical for skeletal and acute myocardial infarct imaging. 1. Synthesis and distribution in animals. JNM 21:961–966

    Google Scholar 

  • Castronovo FP, Callahan RJ (1972) New bone scanning agent: 99mTc labeled 1-hydroxyethylidene-1, 1-disodium phosphonate. JNM 13:823–827

    Google Scholar 

  • Citrin DL, Bessent RG, Greig WR (1974) Clinical evaluation of 99mTc-labeled monofluorophosphate: A comparison with ethane-hydroxy-diphosphonate. JNM 15:1110–1112

    Google Scholar 

  • Citrin DL, Bessent RG, Tuohy JB, Elms ST, McGinley E, Greig WR, Blumgart LH (1975) A comparison of phosphate bonescanning agents in normal subjects and patients with malignant disease. Br J Radiol 48:118–121

    Google Scholar 

  • Davis AG, Jones AG (1976) Comparison of 99mTc-labeled phosphate and phosphonate agents for skeletal imaging. Semin Nucl Med 6:19–31

    Google Scholar 

  • Domstad PA, Coupal JJ, Kim EE, Blake JS, DeLand FH (1980) 99mTc-Hydroxymethane diphosphonate: A new bone imaging agent with a low tin content. Radiology 136:209–211

    Google Scholar 

  • Dunson GL, Stevenson JS, Cole CM, Mellor MK, Hosain F (1973) Preparation and comparison of technetium-99m diphosphonate, polyphosphate and pyrophosphate in nuclear bone imaging radiopharmaceuticals. Drug Intell Clin Pharm 7:470–474

    Google Scholar 

  • Fletcher JW, Solaric-George E, Henry RE, Donati RM (1973) Evaluation of 99mTc-pyrophosphate as a bone imaging agent. Radiology 109:467–469

    Google Scholar 

  • Fogelman I, McKillop JH, Citrin DL (1977) A clinical comparison of 99mTc-hydroxyethylidene diphosphonate (H.E.D.P.) and 99mTc-pyrophosphate in the detection of bone metastases. Clin Nucl Med 2:364–367

    Google Scholar 

  • Fogelman I, Bessent RG, Turner JG, Citrin DL, Boyle IT, Greig WR (1978) The use of whole-body retention of Tc-99m diphosphonate in the diagnosis of metabolic bone disease. JNM 19:270–275

    Google Scholar 

  • Fogelman I, Citrin DL, McKillop JH, Turner JG, Bessent RG (1979) A clinical comparison of 99mTc-HEDP and 99mTc-MDP in the detection of bone metastases: Concise communciation. JNM 20:98–101

    Google Scholar 

  • Fogelman I, Pearson DW, Bessent RG, Tofe AJ, Francis MD (1981) A comparison of skeletal uptake of three diphosphonates by whole-body retention: Concise communication. JNM 22:880–883

    Google Scholar 

  • Francis MD, Ferguson DL, Tofe AJ, Bevan AJ, Michaels SE (1980) Comparative evaluation of three diphosphonates: In vitro adsorption (C-14 labeled) and in vivo osteogenic uptake (Tc-99m complexed). JNM 21:1185–1189

    Google Scholar 

  • Hale TI, Jucker A, Vgenopoulos K, Sauter B, Wacheck W, Bors L (1981) Clinical experience with a new bone seeking 99mTc radiopharmaceutical. Nuc Compact 12:54–55

    Google Scholar 

  • Hughes SPF, Jeyasingh K, Lavender PJ (1975) Phosphate compouds in bone scanning. J Bone Joint Surg [Br] 57:214–216

    Google Scholar 

  • Krishnamurthy GT, Tubis M, Endow JS, Singhi V, Walsh CF, Blahd WH (1974) Clinical comparison of the kinetics of 99mTc-labeled polyphosphate and diphosphonate. JNM 15:848–855

    Google Scholar 

  • Lundell G, Marell E, Backstrom A, Casseborn S, Ruden B-I (1975) Bone scanning with 99Tcm compounds in metastasizing mammary carcinoma. Acta Radiol Ther Phys Biol 14:333–336

    Google Scholar 

  • Nelson MF, McKee LC, Van Wazer JR (1977) Clinical evaluation of some phosphorus bone-imaging agents: Concise communication. JNM 18:566–569

    Google Scholar 

  • Pendergrass HP, Potsaid MS, Castronovo FP (1973) The clinical use of 99mTc-diphosphonate (HEDSPA). Radiology 107: 557–562

    Google Scholar 

  • Rosenthall L, Arzoumanian A, Lisbona R, Itoh K (1977) A longitudinal comparison of the kinetics of 99mTc-MDP and 99mTc-HEDP in humans. Clin Nucl Med 2:232–234

    Google Scholar 

  • Rosenthall L, Arzoumanian A, Damtew B, Tremblay J (1981) A crossover study comparing Tc-99m-labeled HMDP and MDP in patients. Clin Nutr Med 6:353–355

    Google Scholar 

  • Rudd TG, Allen DR, Smith FD (1979) Technetium-99m-labeled methylene diphosphonate and hydroxyethylidine diphosphonate-biologic and clinical comparison: Concise communication. JNM 20:821–826

    Google Scholar 

  • Schwarz A, Kloss G (1981) Technetium-99m DPD-a new skeletal imaging agent (abstr). JNM 22:77

    Google Scholar 

  • Serafini AN, Watson DD, Nelson JP, Smoak WM (1974) Bone scintigraphy-comparison of 99mTc-polyphosphate and 99mTc-diphosphonate. JNM 15:1101–1104

    Google Scholar 

  • Silberstein EB, Saenger EL, Tofe AJ, Alexander GW, Park H-M (1973) Imaging of bone metastases with 99mTc-Sn-EHDP (diphosphonate). 18F, and skeletal radiography. A comparison of sensitivity. Radiology 107:551–555

    Google Scholar 

  • Silberstein EB, Maxon HR, Alexander GW, Rauf C, Bahr GK (1978) Clinical comparison of technetium-99m diphosphonate and pyrophosphate in bone scintigraphy: Concise communication. JNM 19:161–163

    Google Scholar 

  • Silberstein EB (1980) A radiopharmaceutical and clinical comparison of 99mTc-Sn-hydroxymethylene diphosphonate with 99mTc-Sn-hydroxyethylidene diphosphonate. Radiology 136:747–751

    Google Scholar 

  • Subramanian G, McAfee JG (1971) A new complex of 99mTc for skeletal imaging. Radiology 99:192–196

    Google Scholar 

  • Subramanian G, McAfee JG, Bell EG, Blair RJ, O'Mara RE, Ralston PH (1972a) 99mTc-labeled polyphosphate as a skeletal imaging agent. Radiology 102:701–704

    Google Scholar 

  • Subramanian G, McAfee JG, Blair RJ, Mehter A, Connor T (1972b) 99mTc-EHDP: A potential radiopharmaceutical for skeletal imaging. JNM 13:947–950

    Google Scholar 

  • Subramanian G, McAfee JG, Blair RJ, Kallfelz FA, Thomas FD (1975) Technetium-99m-methylene diphosphonate — A superior agent for skeletal imaging: Comparison with other technetium complexes. JNM 16:744–755

    Google Scholar 

  • Subramanian G, McAfee JG, Thomas FD, Feld T, Zapf-Longo C, Palladino E (in press) Localization of new Tc-99m labeled diphosphonates in experimental bone lesions. In: Proceedings of 19th International Annual Meeting of the European Society of Nuclear Medicine

  • Tofe AJ, Francis MD (1972) In vitro optimization and organ distribution studies in animals with the bone scanning agent 99mTc-Sn-EHDP (abstr). JNM 13:472

    Google Scholar 

  • Weber DA, Keyes JW, Wilson GA, Landman S (1976) Kinetics and imaging characteristics of 99mTc-labeled complexes used for bone imaging. Radiology 120:615–621

    Google Scholar 

  • Yano Y, McRae J, Van Dyke DC, Anger HO (1973) Technetium-99m-labeled stannous ethane-1-hydroxy-1 1-diphosphonate: A new bone scanning agent. JNM 14:73–78

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fogelman, I. Diphosphonate bone scanning agents — Current concepts. Eur J Nucl Med 7, 506–509 (1982). https://doi.org/10.1007/BF00257217

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00257217

Keywords

Navigation