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Objective To summarize the features of 99mTc-methylene diphosphonate (MDP) whole-body bone scintigraphy (WBBS) in Erdheim-Chester disease (ECD) patients and to provide insights for clinical diagnosis and treatment. Methods Retrospective analysis was performed in ECD patients with bone lesion who underwent 99mTc-MDP WBBS at Peking Union Medical College Hospital from January 2015 to December 2022.The bone involvement sites and characteristic features in99mTc-MDP WBBS were summarized, and the correlation between bone lesion scores and bone metabolic biomarkers was analyzed. Results A total of 44ECD patients with bone involvement were included in the study.According to the 99mTc-MDP WBBS, the most commonly affected sites were the bones of the extremities (100%, 44/44), skull and maxillofacial bones (84.1%, 37/44), and appendicular bones (65.9%, 29/44), while involvement of the ribs and sternum (38.6%, 17/44) and spine (29.5%, 13/44) were less frequent.Bilateral and symmetric change of the lesions was an important feature of 99mTc-MDP WBBS in ECD.The proportion of patients with bilateral and symmetric bone lesions in the extremities, maxillofacial area, and clavicle was relatively high, particularly in the lower extremities (100%).In extremity bone lesions, there was mostly joint involvement of diaphysis and metaphysis, and 81.8%(36/44) patients demonstrated the typical scintigraphic characteristic: bilateral and symmetrical increased uptake in the distal femur and proximal tibia.The maxillofacial lesions mainly presented with focal uptake increase in the region of the paranasal sinuses, with or without diffuse increased uptake in the mandible-Lincoln sign (61.1%, 22/36).Spearman correlation analysis revealed that the bone metabolic biomarkers such as blood calcium, blood phosphate, alkaline phosphatase, and parathyroid hormone were not linearly correlated with bone lesion scores (all P>0.05). Conclusions ECD can cause multiple bone lesions, with involvement typically observed in the extremities, particularly in the lower extremities.Lesions in the skull and maxillofacial area are also frequently observed.Bilateral and symmetric uptake increase in the distal femur and proximal tibia is the most pathognomonic manifestation of 99mTc-MDP WBBS, providing valuable information for diagnosing and differentiating ECD.

Malignant otitis externa (MOE) with skull base osteomyelitis (SBO) is an aggressive infection that predominantly affects elderly, diabetic, or immunocompromised patients, and is associated with high disease-specific mortality. Pseudomonas aeruginosa is the most isolated microorganism. External otitis associated with granulation tissue and pain is the most common presenting feature; a biopsy is obtained to rule out malignancy. A proper consensus is lacking regarding the best imaging modality for early initial diagnosis and follow-up. 99mTechnetium (99mTc)-labeled ubiquicidin (UBI) 29-41 is a bacterial attaching peptide that does not bind to activated leukocytes. We report a case of SBO initially misdiagnosed as a chronic otitis media, but later proved to be a case of MOE. 99mTc methylene diphosphonate bone scan and 99mTc-UBI 29-41 scan with single-photon emission computed tomography/computed tomography scans were performed to corroborate the clinical diagnosis. SBO remains a great challenge due to its increasing prevalence and high morbidity are difficult to diagnose and are often confused with cholesteatoma and neoplastic process. The UBI scan could be an auxiliary noninvasive diagnostic alternative in early diagnosis. [ABSTRACT FROM AUTHOR]

Bone tissue engineering is a fast-growing field in regenerative medicine. Consequently, there is a high demand for new, fast and reliable methods to track and quantify the osteogenic differentiation of cells. Recently, a novel method was published to non-destructively quantify the hydroxyapatite content of monolayer and 3-dimensional mesenchymal stem cell cultures using the ability of 99mTechnetium-methylene diphosphonate (MDP), a well-established tracer in clinical nuclear medicine, to bind to newly synthesized hydroxyapatite. In the present study, two other commonly used 99mTechnetium tracers, 2,3-dicarboxypropane-1,1-diphosphonate (DPD) and hydroxydiphosphonate (HDP), were evaluated to see if they could also be used for the same purpose. Furthermore, we investigated if labelling at various timepoints influenced the effectiveness of the labelling. The results were analysed using one-factor ANOVA followed by Bonferroni post-hoc testing. This revealed a highly significant difference between the three osteogenic groups at each timepoint compared to their corresponding negative controls. However, there was no statistically significant difference between the three different tracers (MDP, DPD, HDP) in the osteogenic groups. Therefore all three tracers are of similar value when quantifying the extracellular hydroxylapatite content in osteogenic stem cells cultures. [ABSTRACT FROM AUTHOR]

The impact of different acquisition times (AqT) and technetium‐99 m–labeled (99mTc) diphosphonates on the image quality of bone scintigraphy is poorly documented in horses. The aim of this prospective experimental study was to evaluate the impact of varying 99mTc‐disphosphonates and AqT on semiquantitative and qualitative image parameters of bone scintigraphy in horses. Twenty‐four horses undergoing bone scintigraphy were divided equally and randomly into methylene‐ (MDP), hydroxymethylene‐ (HDP), and dicarboxypropane diphosphonate (DPD) groups. Lateral scintigraphic images of the antebrachium were obtained 3 h post 99mTC‐diphosphonate injection using three AqT (60, 90, 120 s). The images were analyzed semiquantitatively using the bone‐soft tissue ratio (B:ST), signal‐to‐noise ratio (SNR), contrast‐to‐noise ratio (CNR), and image contrast. Furthermore, a blinded qualitative analysis was performed using a visual grading analysis. The results showed that DPD images had a significantly higher B:ST ratio than MDP images (P <.01) but not HDP images in all AqT (P >.08). However, DPD and HPD images acquired at 60 s had significantly higher CNR (P <.05) than those acquired at 90 and 120 s. The qualitative analysis revealed no significant differences between 99mTc‐diphosphonates at AqT 60 and 90 s. However, MDP images acquired at 120 s had significantly lower image quality compared to DPD and HDP (P =.01 and.03, respectively). In conclusion, the bone tracers affected the semiquantitative image parameters but not the qualitative analysis findings. Increasing AqT did not necessarily improve the image quality. Therefore, decreasing the AqT enabled a reduction in personnel radiation exposure. [ABSTRACT FROM AUTHOR]

Background: Bone scintigraphy is an appropriate tool in the management of cancers for the detection of bone metastasis. Technetium 99 m-methylene diphosphonate (99mTc-MDP) is commonly used as a bone-seeking agent. The bones take up 99mTc-MDP through a process called chemisorption, which is more evident in areas of increased osteoblastic activities. Nevertheless, extra-osseous 99mTc-MDP uptake is an infrequent occurrence, which warrants a thorough clinical assessment to evaluate such findings. An example of extraosseous uptake discovery is rhabdomyolysis, which requires prompt recognition and immediate management. Rhabdomyolysis secondary to an adverse reaction towards iodinated contrast material is a rare condition that warrants a high index of clinical suspicion. Case presentation: We present a case of a 75-year-old gentleman with underlying benign prostatic hypertrophy, and chronic kidney disease who had undergone a coronary angiography examination and intervention for ischemic heart disease. Pre-scheduled bone scintigraphy with 99mTc-MDP for the work-up of raised serum prostate-specific antigen (PSA) was performed 2 weeks post coronary angiography examination. Whole-body bone scan with single-photon emission computed tomography/computed tomography (SPECT/CT) images showed an unexpected finding of extensive extra-osseous uptake in the muscles and soft tissues. Additional investigations confirmed the diagnosis of rhabdomyolysis. Nevertheless, despite the prompt recognition, administration of treatment and supportive care, the patient succumbed to life-threatening complications. Conclusion: This case highlights the importance of recognising and identifying the pattern of extra-osseous uptake on bone scintigraphy imaging to ensure early intervention of severe and life-threatening conditions such as rhabdomyolysis. [ABSTRACT FROM AUTHOR]

Tc-99m-methylene diphosphonate (MDP) bone scintigraphy is mainly directed toward identifying sites of altered skeletal metabolism and abnormal foci of calcium phosphate deposition due to various etiologies. One of the requirements of an ideal bone scintigraphy is little or no extraosseous uptake. Nonosseous uptake of MDP in the bone scintigraphy is an unusual finding. We report a case of carcinoma prostate referred for bone scan, where diffuse hepatic and splenic uptake has been seen on the bone scan. However, on a further repeat bone scan, there was no nonosseous uptake. [ABSTRACT FROM AUTHOR]

In this pictorial review, cases where benign diseases caused a diagnostic dilemma on bone scan are illustrated. This review highlights the value of correlative imaging - single-photon emission computed tomography/computed tomography (CT), CT, and magnetic resonance imaging in solving the diagnostic problem by exact localization and characterization of the lesions. All these eventually lead to increased diagnostic confidence, better and more accurate reporting and avoidance of delay in initiation of treatment due to equivocal results. The imaging features of these benign pathologies - which are "mimics of metastatic disease," are elaborated so that the reader can incorporate them while reporting so as to avoid mis-interpretations. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and radioactivity counts of technetium-99m methylene diphosphonate (99mTc-MDP) radiotracer by scintigraphy. Method: In this study, 7 healthy Wistar rats were anesthetized. Technetium was milked from molybdenum-technetium generator and added to methylene diphosphonate (MDP) kit. Scintigraphic scans were carried out in several areas of the rat's forelimbs by gamma camera 2 h after the injection of 99mTc-MDP via the tail vein. Accumulations of the radioisotope in the study areas were calculated using region of interest (ROI) technique. Results: Mean count of radioisotope in the right and left sides of the shoulder area was 4179.29 and 4074.24, respectively; in the right and left sides of the elbow joint areas, the count was 1662.14, 1645.28, respectively. The count in the right and left sides of the carpal joint and finger areas was 1908.42 and 2028.28, respectively. Conclusion: This study shows that 99mTc-MDP radiotracer can be used for survey radioactivity examination in different bones of the forelimb. Comparison of radioisotope counts in these areas can be used for the diagnosis of disease. [ABSTRACT FROM AUTHOR]

Bone tissue engineering is a fast-growing field in regenerative medicine. Consequently, there is a high demand for new, fast and reliable methods to track and quantify the osteogenic differentiation of cells. Recently, a novel method was published to non-destructively quantify the hydroxyapatite content of monolayer and 3-dimensional mesenchymal stem cell cultures using the ability of 99 Technetium-methylene diphosphonate (MDP), a well-established tracer in clinical nuclear medicine, to bind to newly synthesized hydroxyapatite. In the present study, two other commonly used m Technetium-methylene diphosphonate (MDP), a well-established tracer in clinical nuclear medicine, to bind to newly synthesized hydroxyapatite. In the present study, two other commonly used 99 m Technetium tracers, 2,3-dicarboxypropane-1,1-diphosphonate (DPD) and hydroxydiphosphonate (HDP), were evaluated to see if they could also be used for the same purpose. Furthermore, we investigated if labelling at various timepoints influenced the effectiveness of the labelling. The results were analysed using one-factor ANOVA followed by Bonferroni post-hoc testing. This revealed a highly significant difference between the three osteogenic groups at each timepoint compared to their corresponding negative controls. However, there was no statistically significant difference between the three different tracers (MDP, DPD, HDP) in the osteogenic groups. Therefore all three tracers are of similar value when quantifying the extracellular hydroxylapatite content in osteogenic stem cells cultures., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2021. Published by Elsevier Ltd.)

Tumoral calcinosis is a rare entity presenting with periarticular calcium deposits, leading to multiple swellings and biochemical hyperphosphatemia and normocalcemia. Skeletal scintigraphy in these cases is helpful by providing a whole-body survey and delineating the common multifocality of this entity. We present the case of a 16-year-old boy with multiple swellings around the knee and elbow joints, having developed over 4 years and diagnosed as tumor calcinosis. [ABSTRACT FROM AUTHOR]

Purpose To find out the method of optimal activity administration and scanning parameters to fulfil guidelines and diagnostic reference levels and to reach a maximal contrast-to-noise ratio ( CNR) in bone imaging. We also investigate the influence on CNR and bladder activity in well-hydrated patients. Methods A total of 225 patients were included. The first group of 101 patients was used to find out the optimal method to administer activity in terms of optimized CNR. The next two groups with 62 patients each were hydrated with 1500 ml water in two different time periods. CNR, bladder area and content were calculated. Results An administrated activity per metre body height gave the highest CNR (5·43). A standard activity had the lowest percentage (2%) of images with <1·5 million counts. Early hydration decreased CNR from 5·41 to 4·85 ( P = 0·06), with late hydration to 5·29 ( NS). Studies with too few pulses were increased from 2 to 11% to a level of 15-26% and 11-21%, respectively. Early hydration reduced the bladder activity from 20·7 to 10·1 MBq ( P<0·01), late hydration to 14·8 MBq ( P = 0·08). The bladder size was enlarged from the no hydrated group (1406 mm2) to the early hydrated group (2406 mm2, P<0·000) and between the early and late hydrated group (3183 mm2, P<0·05). Conclusion A standard activity in sufficient quantity is the most practical method, in addition to have the lowest percentage of images with too few pulses. A high fluid intake is not recommended because of problems with disturbing bladder content. [ABSTRACT FROM AUTHOR]

In nuclear medicine, 99mTc-methylene diphosphonate. (MDP) bone scan is one of the most commonly performed procedures. MDP uptake in nonosseous tissues is occasionally found in bone scan, and the knowledge of these kinds of extraosseous uptakes is of much clinical relevance. We report here two cases where bone scan showed extraosseous MDP uptake either hepatic or splenic apart from the physiological skeletal uptake. [ABSTRACT FROM AUTHOR]

Sclerotic bone dysplasias are diagnosed based on clinical and radiological features; however, in some instances pose a dilemma. We herewith report a case of a 38-year-old female who presented with right lower extremity pain, and was detected to have sclerotic diaphyseal lesion on X-ray. Triphasic 99mTc methylene diphosphonate (MDP) Bone scan helped in confirming the diagnosis of intramedullary osteosclerosis, a dysplastic bone disorder. [ABSTRACT FROM AUTHOR]