Bone scintigraphy

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Bone scanscintigraphy
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Bone scintigraphy (a.k.a. bone scans) are a nuclear medicine (scintigraphic) study that makes use of Technetium 99mtechnetium-99m (commonly Tc99m-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. 

Clinical indications

Patient preparation

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

Tracer dose and route of administration

Tc99mTc-99m diphosphonate is administered intravenously, at a dose of 20 740 Mbq (20 mCi (740 Mbq) in in adults.

Phases (kinetic modelling)

Flow phase
  • 2-to-5 second images are obtained for 60 seconds after injection
  • demonstrates perfusion
  • characterises blood flow to a particular area
Blood pool phase
  • 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.

Delayed phase
  • 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 hyroxyapatitehydroxyapatite crystals (chemisorption) 5
  • degree of uptake depends on blood flow and rate of new bone formation
Delayed/delayed
  • obtained 24 hours after injection as a static image

See also

  • -<p><strong>Bone scans</strong> are a nuclear medicine (scintigraphic) study that makes use of Technetium <sup>99</sup>m (commonly <a href="/articles/technetium-99m-methyl-diphosphonate">Tc<sup>99</sup>m-methylene diphosphonate (MDP)</a>) as the active agent.</p><p>The study has three phases which follow intravenous injection of the tracer. Sometimes a fourth (delayed/delayed) phase is performed. </p><h4>Clinical indications</h4><ul>
  • +<p><strong>Bone scintigraphy</strong> (a.k.a. <strong>bone scans</strong>) are a nuclear medicine (scintigraphic) study that makes use of technetium-99m (commonly <a href="/articles/technetium-99m-methyl-diphosphonate">Tc-99m-methylene diphosphonate (MDP)</a>) as the active agent.</p><p>The study has three phases which follow intravenous injection of the tracer. Sometimes a fourth (delayed/delayed) phase is performed. </p><h4>Clinical indications</h4><ul>
  • -<li>detection of radiographically occult fractures, e.g. <a href="/articles/stress-fractures">stress</a> or <a href="/articles/insufficiency-fracture">insufficiency fractures</a>
  • +<li>detection of radiographically occult fractures, e.g. <a href="/articles/stress-fracture-2">stress</a> or <a href="/articles/insufficiency-fracture">insufficiency fractures</a>
  • -<li>hydration</li>
  • +<li>optimal hydration</li>
  • -</ul><h4>Tracer dose and route of administration</h4><p>Tc99m diphosphonate is administered intravenously, at a dose of 20 mCi (740 Mbq) in adults.</p><h4>Phases (kinetic modelling)</h4><h5>Flow phase</h5><ul>
  • +</ul><h4>Tracer dose and route of administration</h4><p>Tc-99m diphosphonate is administered intravenously, at a dose of 740 <a href="/articles/becquerel-si-unit">Mbq</a> (20 <a href="/articles/curie-unit">mCi</a>) in adults.</p><h4>Phases (kinetic modelling)</h4><h5>Flow phase</h5><ul>
  • -<li>mechanism of uptake is not known with certainty, although it has been proposed that the radiotracer attaches to hyroxyapatite crystals (chemisorption)<sup> 5</sup>
  • +<li>mechanism of uptake is not known with certainty, although it has been proposed that the radiotracer attaches to hydroxyapatite crystals (chemisorption)<sup> 5</sup>

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