Quantitative bone scintigraphy in renal osteodystrophy

The need for noninvasive sensitive techniques for the diagnosis and follow-up of metabolic bone disease in dialysis patients has stimulated the author's interest in the efficacy of more detailed quantitative bone scintigraphy. Using hemodialysis to reduce elevated soft-tissue activity at scintigraphy, an attempt was made to assess the diagnostic sensitivity of quantitative bone scintigraphy as compared to qualitative bone scintigraphic, biochemical, radiographic and bone histologic studies. The second aim of these studies was to determine if one of the two major components of renal osteodystrophy is a major determinant for skeletal radiotracer uptake. The clinical observations on the efficacy and possible specificity of quantitative bone scintigraphy in the diagnosis and follow-up during treatment of renal osteodystrophy are presented briefly in this chapter. Thus, the use of scintigraphy for the routine detection and follow-up of renal osteodystrophy in dialysis patients may reduce the need for repeated bone biopsies or provide additional information since it informs about the extent of osteodystrophy in the whole skeleton. The dialysis method, however, needs perfecting to improve the bone image quality and the accuracy of the quantitative skeletal analysis in patients with only minimal renal osteodystrophy. (Auth.)