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Bone Uptake Studies in Rabbits Before and After High-Dose Treatment with ¹⁵³Sm-EDTMP or ¹⁸⁶Re-HEDP

Clinic of Nuclear Medicine, University Hospital Kiel, Kiel, Germany

The aim of this animal study was to measure the bone uptake of ^99mTc-hydroxymethylene diphosphonate (HDP) before and after high-dose treatment with ¹⁵³Sm-ethylenediaminetetramethylenephosphonate (EDTMP) or ¹⁸⁶Re-(tin)1,1-hydroxyethylidene diphosphonate (HEDP) to prove or disprove post-therapeutic alterations of bone uptake of radiolabeled bisphosphonates. Methods: Quantitative bone scanning using 100 MBq ^99mTc-HDP was performed on 12 rabbits before and 8 wk after radionuclide therapy with 1,000 MBq of either ¹⁵³Sm-EDTMP or ¹⁸⁶Re-HEDP. Whole-body images were acquired at 3 min, 3 h, and 24 h after injection, and the activities for the whole body, urinary bladder, and soft tissue were measured by region-of-interest technique. From these data, bone uptake was calculated as initial whole-body activity minus urinary excretion and remainder soft-tissue activity. Results: In animals treated with ¹⁵³Sm-EDTMP (n = 6), no differences could be proven for the bone uptake of ^99mTc-HDP at 24 h after injection before and after therapy (51.1% ± 5.5% vs. 48.0% ± 6.1%, P > 0.05). There were also no significant differences for the remainder soft-tissue activities and the urinary excretion rates before and after therapy. Similar results were obtained in rabbits treated with ¹⁸⁶Re-HEDP: Bone uptake (44.8% ± 6.7% vs. 40.4% ± 4.9%, P > 0.05) and urinary excretion revealed no significant differences before and after treatment. Conclusion: No significant impairment of bone uptake of ^99mTc-HDP could be observed 8 wk after high-dose radionuclide bone therapy. Because both the biokinetic data obtained for ¹⁸⁶Re-HEDP and ¹⁵³Sm-EDTMP and the myelotoxic effects were quite similar in rabbits to those in patients, it seems justifiable to expect the same result (i.e., no significant alteration of bone uptake of radiolabeled bisphosphonates) in patients undergoing a second radionuclide therapy within 2–3 mo after standard treatment with ¹⁸⁶Re-HEDP or ¹⁵³Sm-EDTMP.

Key Words: ^99mTc-hydroxymethylene diphosphonate • ¹⁸⁶Re-(tin)1,1-hydroxyethylidene diphosphonate • ¹⁵³Sm-ethylenediaminetetramethylenephosphonate • bone uptake • post-therapeutic alterations