Skeletal blood flow: Implication for bone scan interpretation

Journal of Nuclear Medicine (Impact Factor: 6.16). 02/1980; 21(1):91-8.
Source: PubMed


The dispersion of the skeleton throughout the body and its complex vascular anatomy require indirect methods for the measurement of skeletal blood flow. The results of one such method, compartmental analysis of skeletal tracer kinetics, are presented. The assumptions underlying the models were tested in animals and found to be in agreement with experimental observations. Based upon the models and the experimental results, inferences concerning bone-scan interpretation can be drawn: decreased cardiac output produces low-contrast ("technically poor") scans; decreased skeletal flow produces "photon-deficient" lesions; increase of cardiac output or of generalized systemic blood flow is undetectable 1--2 hr after dose; increased local skeletal blood flow results from disturbance of the bone microvasculature and can occur from neurologic (sympatholytic) disorders or in association with focal abnormalities that also incite the formation of reactive bone (e.g., metastasis, fracture, etc.). Mathematical solutions of tracer kinetic data thus become relevant to bone-scan interpretation.

Full-text preview

Available from:
  • Source
    • "However, the significance of changed uptake of bone seeking isotopes in various arthritic conditions in children remains uncertain . Uptake of gs"Tc-diphosphonates in bone is dependent on the regional blood flow, the product of permeability and surface area in the vascular bed, the amount of interstitial fluid and the metabolic state of the bone (Sagar et al. 1979, Charkes 1980, Hughes 1980). Using a scintimetric technique, a quantitative measure of metabolic changes within circumscribed regions of the juxtaarticular bone can be achieved (Bauer et al. 1980, Wingstrand et al. 1985). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Unilateral arthritis of the knee was induced in mongrel puppies by intra-articular injections of 1% Carragheenan. Bone metabolism was studied by a scintimetric technique on static 99mTc-diphosphonate bone scans every 2nd week during the induction of arthritis for 3 months and monthly in a postarthritic phase of another 3 months. Changes in uptake of radionuclide were present after 2 weeks. The induction phase was characterized by a decreased uptake in the calcification layer of the juxta-articular growth plates and a moderately increased epiphyseal uptake. The postarthritic phase was characterized by normalization of growth plate uptake and a marked increase in epiphyseal uptake. Using contact autoradiography, the epiphyseal uptake was seen mainly in a narrow subchondral and subsynovial bone layer, around bone cysts and osteophytes, whereas central epiphyseal bone was osteopenic with decreased uptake of tracer. The study suggests that the early scintigraphic appearance of juvenile non-suppurative arthritis may be an overall decrease in uptake of 99mTc-diphosphonate due to a depression of growth plate metabolism.
    Full-text · Article · Jan 1986 · Acta Orthopaedica
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Die Wertigkeit der Drei-Phasen-Skelettszintigraphie für die Diagnostik des Komplexen Regionalen Schmerzsyndroms (CRPS) ist umstritten. Deshalb wurde in dieser Untersuchung eine qualitative Auswertung von Szintigraphien mit einer quantitativen ROI Auswertung verglichen. Die qualitative Auswertung zeigt eine niedrige Sensitivität (26%-43%) bei hoher Spezifität (67%-91%). Die ROI Auswertung der Hände ergibt nur für die 3. Phase eine hohe Sensitivität (69%) und Spezifität (75%) [ROI-Wert = 1,32]. Mit zunehmender Erkrankungsdauer nehmen die ROI-Werte der 3. Phase von Patienten mit einem CRPS der Hand ab. In der ROI Auswertung der Füße lässt sich nicht zwischen den Patienten mit einem CRPS und denen der Kontrollgruppe differenzieren. Zusammenfassend bleibt festzuhalten, dass zur Diagnostik eines CRPS der Hand eine ROI Auswertung der 3. Phase innerhalb der ersten 5 Monate durchgeführt werden sollte. Das Protokoll zur Durchführung der Skelettszintigraphien der Füße sollte modifiziert werden.
    Preview · Article ·
  • Source

    Preview · Article · Sep 1980 · British medical journal
Show more