By I. Fogelman (auth.), Ignac Fogelman BSc, MD, MRCP (eds.)
The most often asked research in any nuclear drugs division continues to be the technetium-99m (99mTc)-labelled diphosphonate bone experiment. regardless of quick advances in all imaging modalities. there was no critical problem to the function of bone scanning within the overview of the skeleton. the most cause of this is often the beautiful sensitivity of the bone experiment for lesion detection. mixed with transparent visualisation of the entire skeleton. lately numerous new diphosphonate brokers became on hand with claims for greater imaging of the skeleton. primarily. all of them have better affinity for bone. hence permitting the conventional skeleton to be visualised all of the extra basically. even though. as can be dis stubborn. this can happen at a few fee to the important position of bone scanning. lesion detection. the most important power of nuclear medication is its skill to supply useful and physiological details. With bone scanning this results in excessive sensitivity for focal ailment if there was any disturbance of skeletal metabolism. in spite of the fact that. in lots of different medical events. and especially in metabolic bone ailment. extra generalised alteration in skeletal turnover may perhaps take place. and quantitation of diphosphonate uptake via the skeleton offers priceless scientific information.
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Additional resources for Bone Scanning in Clinical Practice
Gordon D (1975b) Dynamic studies with "mTc-HEDP in normal subjects and in patients with bone tumours. J Nucl Med 16: 886--890 Eckelman WC. Reba RC. Kubota H. Stevenson JS (1974) "mTcpyrophosphate for bone imaging. I Nucl Med 15: 279-283 Fink-Bennett D. Johnson J (1985) Stippled ribs-a potential pitfall in bone scan interpretation. I Nucl Med 26: 82 (abstract) Fink-Bennett D. Vicuna-Rios J (1980) The deltoid tuberosity-a potential pit-fall (the "delta sign") in bone scan interpretation: concise communication.
1981). The reason for this is not known but it is possible that it is in some way related to the method which was used to prepare the radiopharmaceutical. Littlefield injected 20 mCi (740 MBq) 99mTc into a vial for each patient dose, whereas Rosenthall injected a large dose, of several hundred millicuries, into a vial and obtained multiple patient doses. Pauwels et al. (1983) evaluated 20 patients with bone metastases. Paired studies were carried out using MDP and either HMDP or dicarboxypropane diphosphonate (DPD).
Indeed, Rudd commented that in various clinical situations MDP and HEDP may have different binding mechanisms: In one patient with prostatic carcinoma a lesion was better visualised with HEDP, whereas in a patient with benign vertebral collapse the lesion was better visualised with MDP. Fogelman et al. (1979) compared MDP and HEDP in paired studies in 1 7 patients with skeletal metastases. Although no difference in the number oflesions detected was found, LIB ratios were significantly higher with HEDP.
Bone Scanning in Clinical Practice by I. Fogelman (auth.), Ignac Fogelman BSc, MD, MRCP (eds.)