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Observations on Serial Radionuclide Blood-Flow Studies in Paget's Disease: Concise Communication

Royal Victoria Hospital, Jewish General Hospital, and McGill University, Montreal, Quebec, Canada

Correspondence: For reprints contact: Dr. Robert Lisbona, Dept. of Nucl. Med., Royal Victoria Hospital—687 Pine Ave. West, Montreal, Quebec, H3A 1A1, Canada.

ABSTRACT

Twenty-four symptomatic patients with symptoms of active Paget's disease of bone were evaluated, during the course of their therapy, a total of 71 times (24 baseline and 47 follow-up examinations) by serial alkaline phosphatase levels (AP), Tc-99m MDP bone scans, and radionuclide blood-flow studies. The flow study correlated with disease activity in all of the baseline studies and in at least 85 % of the follow-up studies. In five patients (seven follow-up studies) the changes in local blood flow correctly anticipated the eventual rise or fall of AP. In comparison with the bone scan, the changes in blood flow preceded the bone-scan alterations or were more reliable indicators of disease activity in 12 of the 13 follow-up studies in which the results of the two examinations disagreed. We conclude that the radionuclide flow study provides useful additional clinical information in the management of Paget's disease.