Deconvolution analysis of sup(99m)Tc-methylene diphosphonate kinetics in metabolic bone disease

The kinetics of sup(99m)Tc-methylene diphosphonate (MDP) and 47Ca were studied in three patients with osteoporosis, three patients with hyperparathyroidism, and two patients with osteomalacia. The activities of sup(99m)Tc-MDP were recorded in the lumbar spine, paravertebral soft tissues, and in venous blood samples for 1 h after injection. The results were submitted to deconvolution analysis to determine regional bone accumulation rates. 47Ca kinetics were analysed by a linear two-compartment model quantitating short-term mineral exchange, exchangeable bone calcium, and calcium accretion. The sup(99m)Tc-MDP accumulation rates were small in osteoporosis, greater in hyperparathyroidism, and greatest in osteomalacia. No correlations were obtained between sup(99m)Tc-MDP bone accumulation rates and the results of 47Ca kinetics. However, there was a significant relationship between the level of serum alkaline phosphatase and bone accumulation rates (R = 0.71, P < 0.025). As a result deconvolution analysis of regional sup(99m)Tc-MDP kinetics in dynamic bone scans might be useful to quantitate osseous tracer accumulation in metabolic bone disease. The lack of correlation between the results of sup(99m)Tc-MDP kinetics and 47Ca kinetics might suggest a preferential binding of sup(99m)Tc-MDP to the organic matrix of the bone, as has been suggested by other authors on the basis of experimental and clinical investigations. (orig.)