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Blood Flow and Tracer Uptake in Normal and Abnormal Canine Bone: Comparisons with Sr-85 Microspheres, Kr-81m, and Tc-99m MDP

Hammersmith Hospital and Royal Postgraduate Medical School, London, England

Correspondence: For reprints contact: J. P. Lavender, Dept. of Radiology, Hammersmith Hospital and Royal Postgraduate Medical School, London, W12 0HS, England

ABSTRACT

The bone scan, showing the 4-hr residue in bone of technetium diphosphonate, is a widely used diagnostic tool. The question arises whether it reflects changes in local bloodflow to bone, or avidity, or both.

Two experimental approaches have been used in trying to answer this question. The first was to determine immediate single-passage clearance and 4-hr residue in normal and abnormal bone. If flow is the determinant of residue these should be the same since, in this event, extraction will not change. An osteotomy was produced in the dog tibia and retrograde catheterization of the anterior tibial artery allowed measured amounts of technetium-methylene-diphosphonate (Tc-99m MDP), to be infused into the nutrient artery. Similar preparation in normal bone allowed comparison of both clearance and 4-hr residue. Results have shown increased 4-hr residue 10 days after the osteotomy (normal 4.9% 13.4%).

The second approach involved use of a gamma camera to record profiles of blood flow in normal and abnormal bone, a) by injecting Sr-85 microspheres into the nutrient artery, and b) by infusing the short-lived radioactive gas, krypton-81m, thus producing an image of regional distribution of flow. Comparison of these profiles with the distribution of Tc-99m MDP shows that a moderate increase in flow is associated with a much greater increase in Tc-99m MDP residue.

We conclude that, although blood flow is one determinant of the distribution of bone-seeking radionuclides such as Tc-99m MDP, some other determinants of clearance and residue explain their localization.

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