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Effect of Clodronate Treatment on Bone Scintigraphy in Metastatic Breast Cancer

Departments of Oncology and Nuclear Medicine, Lainz Hospital, Vienna, Austria
Department of Internal Medicine I (Endocrinology), University of Heidelberg, Germany
Ludwig Boltzmann-Institut für Klinische Endokrinologie, Vienna, Austria

Correspondence: For correspondence or reprints contact: Dr. Martin Pecherstorfer, 1st Department of Medicine and Medical Oncology, Wilhelminenspatial, Montleartstrasse 37, A-1171 Vienna, Austria.

ABSTRACT

Because of their high affinity for bone, bisphosphonates are used both in the treatment of benign and malignant bone disease and in radiopharmaceutical bone imaging. A prospective study was undertaken to evaluate whether intravenous clodronate (dichloromethylene bisphosphonate) therapy might affect the results of bone scintigraphy with ^99mTC-labeled methylene diphosphonate (MDP). In 11 female patients with breast cancer and metastatic bone disease, quantitative bone scans were obtained using a region of interest (ROI) method on Days 0 and 22. After intravenous clodronate therapy from Day 1 to Day 21, all metastatic bone lesions were still detectable, and median ROI ratios did not differ to a statistically significant extent from baseline values. Serum calcium level a decreased (p = 0.0449), whereas parathyroid hormone concentrations showed an increase (p = 0.0053). Mean serum levels of creatinine, inorganic phosphorus, osteocalan, gamma glutaminyl-transpeptidase and alkaline phosphatase remained unchanged. However, a more than two fold rise in the serum activity of alkaline phosphatase was measured in three patients. We conclude that 3 wk of intravenous clodronate treatment did not impair the sensitivity of ^99mTc-MDP bone scintigraphy in detecting bone lesions in patients with metastatic breast cancer.

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