[Whole-body retention of 99mTc-methylene diphosphonate in skeletal diseases]. / Die Ganzkörperretention von 99mTc-Methylen-Diphosphonat bei Skeletterkrankungen.

The 24 h-whole-body retention (WBR), determined by a whole-body counter, may be used to quantify exactly bone seeking properties of a radiopharmaceutical. The 24h-WBR of 99mTc-methylene-diphosphonate was determined in 200 patients and was found to be independent of kidney function if this function was normal or only slightly diminished. The 24h-WBR was slightly dependent on age since it decreased up to 20 years of age, reaching a minimum at 20-25 years, and then increased with increasing age. Normal values of 24h-WBR for individuals of more than 20 years of age were 31.8 +/- 5% of injected dose. Not more than two focal accumulations, i.e. skeletal metastases, failed to elevate the 24h-WBR significantly (p less than 0.1). However, a highly significant (p less than 0.001) difference to normals was found in patients with multiple metastases (24h-WBR: 38.2 +/- 7%), with diffuse osseous involvement as in primary hyperparathyroidism (24h-WBR: 49 +/- 11.7%, p less than 0.001) or with osteoporosis (24h-WBR: 45%). The 24h-WBR was found to be very sensitive in grading diffuse osseous involvement. This was shown in single-tumor patients by follow-up as the 24h-WBR in addition to bone scans was useful to describe progression or remission. Moreover, the 24h-WBR correlated closely with results of bone marrow biopsies in a small group of patients with malignancies of the lymphoreticular system.

A comparison of bone imaging with Tc-99m DPD and Tc-99m MDP: concise communication.

Bone to soft tissue (ST) ratios for both high-uptake bone (sacrum) and low-uptake bone (femoral diaphysis) were obtained with a derivative of phosphonic acid, TC-99m 2,3-dicarboxypropane-1, 1-diphosphonate (DPD), in 26 normal subjects and 177 patients with malignant disease but without metastases. Tests were run 2 hr after tracer injection. Similar ratios were obtained with Tc-99m methylene diphosphonate (MDP) in 220 normal subjects and 451 patients. With MDP, the influence of incubation time (5-10 min in 416 cases, 45 min in 185 cases) on these ratios was determined. DPD was superior to MDP for both ratios. With MDP, prolonged incubation time yielded significantly enhanced ratios; however, the ratios for the DPD were still higher. With either agent and preparation, sacrum-to-ST ratios decreased with increasing subject age, and in patients with malignant disease the ratios tended to be higher than those obtained from normals.

[Transluminal dilatation of the distal abdominal aorta and of the common and external iliac arteries (author's transl)]. / Transluminale Gefässdilatation der distalen Bauchaorta, der Arteria iliaca communis und externa.

Percutaneous transluminal angioplasty (PTA), a radiological procedure for dilating stenosed or occluded vessels, was carried out for 67 stenoses and three occlusions of the abdominal aorta or of the common or external iliac arteries. Seventy procedures were carried out; of these, 65 showed satisfactory primary results (observation period 15 days) ie, the clinical situation was improved. On four occasions the procedure had to be abandoned for technical reasons and, in one case, there was an early recurrence. Subsequently there were two late recurrences (after six and 24 months) during an observation period of three to 24 months. In the successfully dilated stenoses or occlusions there was a highly significant increase in the vessel diameter, with a highly significant reduction in the pressure gradient across the stenosis. The results are discussed. The authors conclude that in the presence of stenoses of the distal aorta or common or external iliac arteries PTA, which carries little risk and can be repeated, should be considered and attempted before surgical intervention.