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Quantitative Bone Scintigraphy Using SPECT

Departments of Nuclear Medicine and Neurosurgery, Rambam Medical Center and Technion-Israel Institute of Technology, Haifa, Israel
Division of Nuclear Medicine, Department of Radiology, Beth Israel Hospital and Harvard Medical School, Boston

Correspondence: For reprints contact: Dov Front, MD, PhD, Dept. of Nuclear Medicine, Rambam Medical Center, Haifa 35254, Israel.

ABSTRACT

A quantitative single photon emission computed tomography (SPECT) technique for measuring radiopharmaceutical uptake in humans has been applied to bone scintigraphy. The method was validated by comparing SPECT measured percent of injected [^99mTc]MDP in 16 normal skulls with well counter measurements of samples of the same bones obtained at surgery. A very good correlation (r = 0.96) was found. A very good interobserver correlation (r = 0.99) and agreement were also obtained when using quantitative bone scintigraphy (QBS). Control SPECT studies of uptake in the right and left iliac bones and the right and left sacroiliac regions in each patient showed no significant differences between the contralateral sides. Studies done in seven subjects at 2 and 4 hr after the same injection and in nine subjects 4 to 8 mo later in the same subjects showed a very good agreement and no significant differences between the two measurements were found. QBS is suggested as an accurate and reproducible index for assessment of the mass of remodeling bone. Preliminary results showed differences in QBS of normal subjects at different ages. A group of 68 young patients aged 18–26 yr showed a significant higher QBS (p < 0.001) when compared to an older group of 62 patients aged 50–85 yr. There was, however, a wide range of uptake values for the same bone in the same group, suggesting that the method should best be used for following individual patients over time.

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