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Pentavalent Technetium-99m-Dimercaptosuccinic Acid Scintigraphy in Renal Osteodystrophy

Departments of Nuclear Medicine, Diagnostic Radiology and Internal Medicine, Gunma University School of Medicine, Gunma, Japan

Correspondence: For correspondence or reprints contact: Tetsuya Higuchi, MD, Department of Nuclear Medicine, Gunma University School of Medicine, 3-39-22 Showamachi, Mebashi, Gunma, 371, Japan.

ABSTRACT

Pentavalent ^99mTc-dimercaptosuccinic acid (DMSA) scintigraphy and ^99mTc-hydroxymethylene diphosphonate (HMDP) bone scan were performed in one patient with renal osteodystrophy (ROD) before and after vitamin D₃ pulse therapy. The bone scan showed diffusely increased tracer uptake in the whole skeleton, and no change of tracer distribution was noted before or after vitamin D₃ pulse therapy. However, ^99mTc(V)-DMSA scintigraphy revealed diffusely increased tracer uptake in the whole skeleton before therapy, and markedly decreased tracer uptake in the bones was seen at 5 mo after therapy. Increased uptake of ^99mTc(V)-DMSA was observed at 7 mo after therapy, which reflected the laboratory findings. Technetium-99m-(V)-DMSA scintigraphy appeared to be more sensitive than the conventional ^99mTc-HMDP bone scan in assessing the characteristics and therapeutic effect of bone disease in ROD.

Key Words: technetium-99m • dimercaptosuccinic acid • renal osteodystrophy • hemodialysis • 1,25-dihydroxyvitamin D₃