Bone scintigraphy

Bone scintigraphy (a.k.a. bone scans) are a nuclear medicine (scintigraphic) study that makes use of technetium-99m (commonly Tc-99m-methylene diphosphonate (MDP)) as the active agent.

The study has three phases which follow intravenous injection of the tracer. Sometimes a fourth (delayed/delayed) phase is performed. 

  • optimal hydration
  • remove metal objects
  • void immediately before study

Tc-99m diphosphonate is administered intravenously, at a dose of 740 Mbq (20 mCi) in adults.

  • 2-to-5 second images are obtained for 60 seconds after injection
  • demonstrates perfusion
  • characterizes blood flow to a particular area
  • obtained 5 minutes after injection
  • demonstrates the blood pool (balance between plasma and interstitium), not the blood flow
  • inflammation causes capillary dilatation and increased blood flow

If the study is going to be a triphasic bone scan, a third phase is added.

  • obtained 2-4 hours later
  • urinary excretion has decreased the amount of the radionuclide in soft tissue
  • mechanism of uptake is not known with certainty, although it has been proposed that the radiotracer attaches to hydroxyapatite crystals (chemisorption) 5
  • degree of uptake depends on blood flow and rate of new bone formation
  • obtained 24 hours after injection as a static image

Article information

rID: 8888
Synonyms or Alternate Spellings:
  • Triple phase bone scans
  • Radionuclide bone scans
  • Triple phase bone scan
  • Triphasic bone scans
  • Isotope bone scans
  • Bone scans
  • Isotope bone scintigraphy
  • Bone scan
  • Triphasic bone scan
  • Radionuclide bone scan
  • Isotope bone scan

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Cases and figures

  • Case 1: osteoid osteoma
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  • Case 2: metastases
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  • Case 3: secondary hyperparathyroidism
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  • Case 4: stress fracture
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  • Case 5: calcified hepatic metastases: prostate carcinoma
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  • Case 6: hypertrophic pulmonary osteoarthropathy
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  • Case 7: Paget disease of tibia
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  • Case 8: breast cancer skeletal metastases
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  • Case 9: breast cancer lytic metastasis
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  • Case 10: vertebral compression fracture
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  • Case 11: osteomyelitis
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  • Case 12: osteomyelitis
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  • Case 13: prostate cancer skeletal metatases
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