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Tc-99m Methylene Diphosphonate Versus Tc-99m Pyrophosphate: Biologic and Clinical Comparison

University of Washington, Seattle, Washington

Correspondence: For reprints contact: Thomas G. Rudd, Dept. of Nuclear Medicine, University of Washington Hospital, Seattle, WA 98195.

ABSTRACT

The biologic and imaging characteristics of Tc-99m MDP and Tc-99m PP_i were compared in animals and patients using freeze-dried bone-imaging kits. Biodistribution data in rabbits showed Tc-99m MDP had slightly higher bone uptake, significantly lower blood levels, and faster urinary excretion compared with Tc-99m PP_i. Duplicate studies performed on ten patients showed the following: (a) blood clearance of Tc-99m MDP was more prompt and complete, resulting in significantly lower blood levels at 4 hr; (b) urinary excretion was greater with Tc-99m MDP than with Tc-99m PP_i; and (c) Tc-99m PP_i showed significant red-cell labeling, whereas Tc-99m MDP did not. Image quality was generally better with Tc-99m MDP than with Tc-99 m PP_i, although there was no obvious difference in diagnostic sensitivity between the two agents.