Bisphosphonate whole body retention test: relations to bone mineralization rate, renal function and bone mineral content in osteoporosis and metabolic bone disorders

Q3 · MEDICINE

Article

Author: F. Tågehøj Jensen ; C. Hasling ; P. Charles ; L. Mosekilde

Abstract. The bisphosphonate whole body retention test (WBR) has been used to estimate bone mineralization rate (bone turnover). Bisphosphonates given i.v. are taken up by bone or excreted in urine. The aim of the present investigation was to test the efficacy of WBR in estimating bone mineralization rate (m) and to evaluate the influence of renal function (Clcr) and bone mass (forearm bone mineral content; BMC) on WBR. The 24‐h retention of 3–7 MBq 99mTc‐HMBP (1‐hydroxymethylene‐1,1 ‐bisphosphonate) (Osteoscan®) given i.v. was measured by a medium sensitive whole body counter in thirty‐one patients with hyperparathyroidisme (n= 14), hyperthyroidism (n= 8) or hypothyroidism (n= 9) (group 1) and in seventy‐six females with postmenopausal spinal crush fracture osteoporosis (group 2). In the same individuals m was calculated from a 7‐day 47Ca‐kinetic study using the expanding calcium pool model. Multiple regression analysis of WBR vs. m and Clcr in group 1 disclosed that WBR correlated positively to m [rp= 0·49, P<0·01 (rp= partial correlation coefficient)] and inversely to Clcr (rp=‐0·44, P<0·02). Inclusion of BMC in the analysis did not reveal any significant partial correlation between WBR and BMC (rp=‐0·33, 0·05 <P<0·10). In group 2 WBR correlated inversely to Clcr (rp= ‐0·48, P<0·001) but showed no significant relation to m (rp= 0·10, NS). WBR was not related to BMC (rp= 0·09, NS), WBR was slightly inferior to serum alkaline phosphatase and renal hydroxyproline excretion in estimating bone mineralization rate in group 1 and, contrary to the biochemical markers, inapplicable in group 2. A model was developed that took into account that bisphosphonate is either taken up by bone or excreted in the urine. The model, however, did not improve the efficacy by which m could be predicted from simultaneous measurements of WBR and Clcr, probably because of an increase in the method error.We conclude that measurements of the whole body retention of HMBP is of no value in estimation bone turnover in the investigated metabolic states characterized by wide variations in bone turnover and no mineralization defects.

01 Apr 1984·RadiologyQ1 · MEDICINE

Amputation stumps studied by bone scanning. Work in progress.

Q1 · MEDICINE

Article

Author: Sankey, R R ; Gonzalez, A C ; Tarcan, Y ; Macon, P F

Nine diabetic and 7 nondiabetic (post-trauma) patients 24 to 63 years of age (mean, 49) were scanned following amputation below the knee, which was bilateral in 4. A three-phase scanning technique (flow, blood pool, and delayed equilibrium images) was employed, using Tc-99m-etidronate. Duration of the arterial and capillary phases was estimated during flow. Activity at the tip of the stump was plotted as a function of (a) time since amputation and (b) flow measurements. Activity was found to diminish over a period of nearly 50 months, usually becoming minimal or undetectable after 18 months. The stump demonstrated relative stasis compared to the intact limb, particularly in diabetics and patients with long-standing amputation.

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Indication	Country/Location	Organization	Date
Contrast agents	US	Curium US Holdings LLC	18 Feb 1981

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