The visualization of femoral vessels in delayed bone scans ? a sign of arteriosclerosis? A comparison of 99mTc-MDP and 99mTc-DPD

Abstract

The activity of femoral vessels in delayed bone scans was evaluated visually in 237 consecutive patients and quantified in 40 female patients. In visual analysis the patients were randomly divided into three groups and in quantitative analysis into four groups of equal size. Two different MDP preparations and one DPD preparation were used as bone-seeking agents. With aging, the activity in femoral vessels increased with all agents in visual analysis, significantly with MDPs (P less than 0.001) between patients less than or equal to 60 years and greater than 60 years. In female patients with all agents a significant increase in femoral activity was found (P less than 0.001 with MDPs, P less than 0.05 with DPD). In patients greater than 60 years, the femoral uptake was significantly higher with MDP when compared with the DPD uptake (P less than 0.01 with MDP1, P less than 0.05 with MDP2). Between the MDPs no significant differences were found. In quantitative analysis the femoral vessel to soft tissue ratio was significantly higher in patients greater than 70 years when compared with patients less than or equal to 50 years with MDP. No difference was found with DPD. Histological examination of excised arteries of ten patients with intense femoral uptake of MDP showed arteriosclerosis and calcification in all cases. The findings suggest that the femoral visualization in delayed bone scans is probably related to arteriosclerosis and is not a non specific finding. There may be age-related differences in the distribution of MDP and DPD.

Pitfalls and Limitations of Radionuclide Planar and Hybrid Bone Imaging

“…10). 31 Minor uptake is frequently identified at the tibial tubercles at the proximal, anterior aspect of the tibia and could be owing to repeated stress at the patella tendon insertion; however, intense uptake may be noted in an avulsion fracture of the tubercle. 3 The "hot patella" sign or increased patellar uptake may be seen in approximately 30% of patients.…”