Early monitoring of osteoporosis treatment response by technetium-99m-methylene diphosphonate bone scan

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Abstract

Objective

The aim of this study was to investigate the effectiveness of a technetium-99m-methylene diphosphonate (99mTc-MDP) bone scan and the bone mineral density (BMD) test in monitoring the efficacy of osteoporosis (OP) treatment.

Patients and methods

A total of 50 women with OP were prospectively enrolled in this study from January 2011 to October 2016 in our hospital. All the patients underwent a 99mTc-MDP whole-body bone scan and the BMD test before and after alendronate sodium treatment at 3, 6, 12 and 18 months, respectively. Bone metabolism rate on the 99mTc-MDP bone scan was analysed and expressed as the region-of-interest (ROI) ratio of target bones (L1–L4 vertebrae and femoral neck) to the control right tibia shaft, which was subsequently compared with the bone mass on BMD test at each time point of the treatment.

Results

The mean ROI ratio of the L1 vertebra on the 99mTc-MDP bone scans decreased significantly starting at 3 months and continued to decrease at 6, 12 and 18 months, respectively (P<0.001). The mean ROI ratio decreased significantly starting at 6 months at the L2 (P<0.001) and L3 (P<0.001) and starting at 12 months at the L4 (P<0.001) and the right femoral head (P<0.001), respectively. In contrast, the BMD levels of the L1, L2, L3 and L4 vertebrae and the femoral neck increased significantly after 12, 12, 18, 18 and 18 months alendronate treatment respectively.

Conclusion

99mTc-MDP bone scan can detect the alendronate therapeutic efficacy for OP much earlier than the BMD test.

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