Quantifizierung des Knochenstoffwechsels in der konventionellen Skelettszintigraphie

Zusammenfassung

Die vorliegende Arbeit beschreibt eine einfache Methode der Analyse des Ganzkörper-Knochenstoffwechsels und fasst mögliche Anwendungen bei Patienten mit systemischen Skeletterkrankungen zusammen. Die Bestimmung der prozentualen Aufnahme des diagnostischen Radiopharmakons ^99mTc-HDP sowie der therapeutisch genutzten Bisphosphonate ¹⁸⁶Re-HEDP und ¹⁵³Sm-EDTMP in den Knochen, die Kinetik ihrer Urinausscheidung und der in den Weichteilen retinierten Aktivität erfolgt mittels einfacher Region-of-Interest-Analyse konventioneller Skelettszintigramme. Die so erhaltenen Daten erlauben den Vergleich verschiedener osteotroper Radiopharmaka und ermöglichen eine genauere Dosimetrie im Vergleich mit der herkömmlichen Messung der Ganzkörperretention über die Aktivitätsbestimmung im Sammelurin. Darüber hinaus kann eine Abschätzung des systemischen Knochenstoffwechsels auch bei der Diagnostik von Erkrankungen hilfreich sein, bei denen die Skelettszintigraphie keine fokalen pathognomonischen Befunde liefert. Die Methode ist in der klinischen Routine problemlos einsetzbar und ihre Ergebnisse stimmen mit Literaturdaten anderer Methoden gut überein.

Abstract

This paper describes a simple method for the analysis of whole-body bone metabolism and summarizes possible applications in patients suffering from metabolic bone diseases. Quantification of bone uptake, soft-tissue retention and urinary excretion of radiopharmaceuticals both for diagnostics such as ^99mTc-HDP and ¹⁸⁶Re-HEDP and ¹⁵³Sm-EDTMP for radionuclide therapy is achieved by regions-of-interest analysis of conventional bone scans. The data obtained allow a comparison between different osteotropic radiopharmaceuticals as well as an improved and reliable dosimetry compared to the most frequently applied method of whole-body retention measurement by simple analysis of urinary excretion. Moreover, estimation of whole-body bone uptake using the described technique can be helpful for the diagnosis of systemic bone disease in which bone scanning does not reveal focal pathologies. The method described here is routinely applicable in daily clinical routine and the data are well in line with those obtained by other methods.

Schlüsselwörter

Knochenszintigraphie - ROI-Analyse - Radionuklidtherapie - Knochenstoffwechsel

Key words

Bone scanning - ROI-analysis - radionuclide therapy - bone metabolism

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