Determination of bone turnover by urinary excretion of ^99mTc-MDP

Abstract

Two metods of estimating bone turnover were investigated. The 24 h whole body retention (WBR) of intravenously injected ^99mTc methylene disphosphonate (^99mTc-MDP), a precise, accurate, and generally accepted method, was compared with a new, simple, measurement involving assessment of the 24 h urinary excretion (UE) of ^99mTc-MDP. The WBR and UE were measured in 50 normal subjects, 10 patients with thyrotoxicosis, and 10 patients with chronic renal failure. The precision was 4.8% and 2.7%, respectively, and the two methods were highly significantly correlated (r=0.99, SEE=2.9%, p<0.001). In addition, urinary ^99mTc-MDP excretions at 0 h–4 h (UE₄) and 0 h–8 h (UE₈) after injection were calculated in 49 subjects. The estimation of WBR from UE₄ or UE₈ was considerably poorer than from UE (for UE₄: r=-0.83, SEE=8.7%, and for UE₈: r=-0.90, SEE=6.8%) and the precision of UE₄ and UE₈ was 7.2% and 7.8%, respectively, and greater than those of both UE and WRR. It is concluded that the UE bone turnover measurement may become a simple, radiation dose-saving method to diagnose and monitor the treatment of metabolic bone diseases.