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It was hypothesised that exercise may promote perfusion of the distal part of the limbs and enhance uptake of radiopharmaceutical into bone, but bandaging and lameness would have no effect. Two hundred and two horses undergoing routine nuclear scintigraphic examination for assessment of lameness or poor performance between November 1998 and November 1999 were assigned randomly to one of 4 groups: no bandages and no exercise (NB/NE); bandages and no exercise (B/NE); no bandages and exercise (NB/E); bandages and exercise (B/E). In the bandage groups, the distal forelimbs were bandaged for at least 16 h prior to injection of radiopharmaceutical. In the exercise groups, horses were lunged for 15 min at trot and canter prior to injection. Quantitative values for perfusion of the front feet and uptake of the radiopharmaceutical into the bones of the distal limb were obtained from scintigraphic measurements during the vascular and bone phases of radiopharmaceutical distribution. Perfusion of the front feet was classified as good in 60% of limbs, reduced in 21% and poor in 19%. There was a strong positive relationship between exercise and both perfusion of the front feet and uptake of the radiopharmaceutical into bone. Bandaging had no effect. There was a relationship between environmental temperature and both perfusion and uptake of the radiopharmaceutical into bone. Estimation of foot surface temperature using thermography was helpful in predicting perfusion of the distal limbs. There was no relationship between lameness and uptake of the radiopharmaceutical into bone. It is therefore recommended that, whenever possible, horses are exercised for 15 min prior to injection of radiopharmaceutical if nuclear scintigraphy of the distal parts of the limb is to be performed.
OBJECTIVE: The uptake of bone-seeking radiopharmaceuticals depends on the blood flow, which is influenced by the sympathetic nervous system. Our aim was to study the effect of sympathomimetic drugs on the distribution of bone-seeking agents. MATERIAL AND METHODS: Various sympathomimetic and beta-blocking drugs were injected in mice at different times in relation to the administration of 99mTc-HDP. Three hours after this, venous blood and various organs were removed and their activities were related to the administered activity. A kinetic study of the whole-body activity retention after administration of terbutaline was also made. RESULTS: The biodistribution of 99mTc-HDP was similar after the administration of sympathomimetics and of beta-antagonists. All drugs gave rise to an increased soft tissue activity and a decreased bone activity, corresponding to a lowered quality of the potential bone scan. Terbutaline gave rise to an increased excretion of 99mTc-HDP. The mechanisms behind the findings cannot be entirely explained. CONCLUSION: Drug interference with the sympathetic nervous system causes undesirable effects on the biodistribution of 99mTc-HDP in the mouse. Studies in humans are necessary to evaluate whether clinical treatment with sympathotropic drugs affects the bone scintigram.
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Patients with diffuse increased accumulation in both kidneys on 99mTc-MDP bone scintigram were evaluated quantitatively. Among 1,100 cases, 7 (0.63%) showed this finding. The accumulation density ratios of kidneys/lumbal vertebra in A/D exchanged images of these patients were compared with control group, so that these ratios of patient group were higher than control group statistically. In conclusion, the accumulation density ratio was made the index of diffuse increase accumulation in both kidneys on 99mTc-MDP bone scintigram.
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OBJECTIVE: To evaluate the benefit of osteoporosis therapy with alendronate, estimating the number of patients necessary to treat to prevent a fracture (NNT) and the number of prevented fractures (NPF) by treating 100 patients. METHOD: Analysis of different clinical scenarios from estimations of the incidence of osteoporotic fractures in western countries and the decrease in the relative risk of fracture obtained in recent clinical trials. Consideration was given to the influence of the possible post-therapy residual effects, life expectancy and functional impact of fractures. RESULTS: Results varied largely depending on the fracture risk of patients. Under the model assumptions, the NNT for hip fractures ranged from 7 (for women aged 80 with a bone mineral density [BMD] with Z < -2) to 333 (for women aged 50 with Z values ranging from 0 and -1). Thus, therapy of 100 women aged 80 years with a Z value < -2 for three years would prevent 14 hip fractures, 33 vertebral fractures and 8 wrist fractures. Therapy of 100 women aged 50-55 years with a Z value ranging from 0 to -1 would prevent 1 hip fracture, 2 vertebral fractures and 2 wrist fractures. CONCLUSION: The proposed model allows for estimating the expected benefit for the different types of patients and underscores the relevance of concentrating therapeutic efforts in the groups of patients with the highest risk. On the other hand, it suggests that the obtained benefit when treating elderly female patients with low BMD is higher than that obtained with therapy during the years following menopause.
A 66-year-old man affected by polyostotic form of fibrous dysplasia in consequence of worsening of lower extremity bone pain aggravated by walking and concomitant increase of serum alkaline phosphatase and osteocalcin, was subjected first to a radionuclide study. Bone scan demonstrated a pathological uptake of the radiotracer in the craniofacial bones, right scapula, left and right posterior ribs, right hemipelvis and lower extremities confirming the diagnosis but establishing especially the extent of bone involvement, greater than expected on the basis of symptoms and X-ray findings, underlying the importance of nuclear medicine imaging in the assessment and follow-up of this rare disease.
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