99mTc(V)-DMSA scintigraphy in monitoring the response of bone disease to vitamin D3 therapy in renal osteodystrophy

Renal osteodystrophy (ROD) is a common and serious complication for uremic patients and patients are treated with 1,25-dihydroxyvitamin D3. The bone scanning agent 99mTc-phosphate has also been used to evaluate in ROD but it is not clear that bone scintigraphy has a role in the follow-up of treatmen...

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Bibliographic Details
Published in:Annals of nuclear medicine 2002-02, Vol.16 (1), p.19-23
Main Authors: Sarikaya, Ali, Sen, Saniye, Hacimahmutoglu, Sevim, Pekindil, Gökhan
Format: Article
Language:English
Subjects:
Adult
Aged
Alkaline Phosphatase - blood
Bone Density
Calcitriol - administration & dosage
Calcium - blood
Chronic Kidney Disease-Mineral and Bone Disorder - diagnostic imaging
Chronic Kidney Disease-Mineral and Bone Disorder - drug therapy
Chronic Kidney Disease-Mineral and Bone Disorder - physiopathology
Diagnosis, Differential
Female
Follow-Up Studies
Humans
Male
Middle Aged
Osteomalacia - blood
Osteomalacia - diagnostic imaging
Osteomalacia - drug therapy
Osteoporosis - blood
Osteoporosis - diagnostic imaging
Osteoporosis - drug therapy
Parathyroid Hormone - blood
Phosphates - blood
Radionuclide Imaging
Radiopharmaceuticals
Reproducibility of Results
Sensitivity and Specificity
Technetium Tc 99m Dimercaptosuccinic Acid
Treatment Outcome
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Summary:Renal osteodystrophy (ROD) is a common and serious complication for uremic patients and patients are treated with 1,25-dihydroxyvitamin D3. The bone scanning agent 99mTc-phosphate has also been used to evaluate in ROD but it is not clear that bone scintigraphy has a role in the follow-up of treatment. In this study 99mTc(V)-DMSA scintigraphy was performed in eleven patients [age 40.7 +/- 17.3 (mean +/- SD) yr] with ROD before and after vitamin D3 therapy. Images were obtained after hemodialysis performed following tracer injection to maintain normal blood levels of the radiopharmaceutical and to reduce soft tissue activity. Lumbar vertebra-to-soft tissue uptake ratios (LUR) were quantified with the planar 99mTc(V)-DMSA images. Alkaline phosphatase and parathyroid hormone levels after treatment had significantly decreased compared with pre-therapy. In all patients there was visually decreased uptake in bone structures after treatment. After treatment the mean LUR ratio was significantly lower than those of before treatment (3.59 +/- 2.63 vs. 1.65 +/- 0.62; p = 0.01). LUR values were correlated with pre-therapy alkaline phosphatase and parathyroid hormone. These findings indicate that 99mTc(V)-DMSA scintigraphy is sensitive in evaluating the response of ROD to vitamin D3 therapy.
ISSN:0914-7187