Changes observed in radionuclide bone scans during and after teriparatide treatment for osteoporosis
Purpose Visual changes on radionuclide bone scans have been reported with teriparatide treatment. To assess this, serial studies were evaluated and quantified in ten postmenopausal women with osteoporosis treated with teriparatide (20 μg/day subcutaneous) who had 99m Tc-methylene diphosphonate (MDP)...
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Published in | European journal of nuclear medicine and molecular imaging Vol. 39; no. 2; pp. 326 - 336 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer-Verlag
01.02.2012
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Purpose
Visual changes on radionuclide bone scans have been reported with teriparatide treatment. To assess this, serial studies were evaluated and quantified in ten postmenopausal women with osteoporosis treated with teriparatide (20 μg/day subcutaneous) who had
99m
Tc-methylene diphosphonate (MDP) bone scans (baseline, 3 and 18 months, then after 6 months off therapy).
Methods
Women were injected with 600 MBq
99m
Tc-MDP, and diagnostic bone scan images were assessed at 3.5 h. Additional whole-body scans (10 min, 1, 2, 3 and 4 h) were analysed for
99m
Tc-MDP skeletal plasma clearance (K
bone
). Regional K
bone
differences were obtained for the whole skeleton and six regions (calvarium, mandible, spine, pelvis, upper and lower extremities). Bone turnover markers (BTM) were also measured.
Results
Most subjects showed visual changes on 3- and 18-month bone scan images that disappeared after 6 months off therapy. Enhanced uptake was seen predominantly in the calvarium and lower extremities. Whole skeleton K
bone
displayed a median increase of 22% (3 months,
p
= 0.004) and 34% (18 months,
p
= 0.002) decreasing to 0.7% (6 months off therapy). Calvarium K
bone
changes were three times larger than other sites. After 6 months off therapy, all K
bone
and BTM values returned towards baseline.
Conclusion
The increased
99m
Tc-MDP skeletal uptake with teriparatide indicated increased bone formation which was supported by BTM increases. After 6 months off therapy, metabolic activity diminished towards baseline. The modulation of
99m
Tc-MDP skeletal uptake during treatment was the result of teriparatide’s metabolic activity. These findings may aid the radiological evaluation of similar teriparatide patients having radionuclide bone scans. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1 |
ISSN: | 1619-7070 1619-7089 |
DOI: | 10.1007/s00259-011-1974-y |