A comparison of 99mTc-MDP and 99mTc-pertechnetate by computerized quantitative joint scintigraphy

Area of Science:

• Nuclear Medicine
• Rheumatology
• Radiopharmacology

Background:

• Joint scintigraphy is crucial for diagnosing inflammatory arthropathies.
• Quantitative analysis of radiotracer uptake can enhance diagnostic accuracy.
• Comparing different technetium-based radiotracers is essential for optimizing imaging protocols.

Purpose of the Study:

• To compare the efficacy of 99mTc-MDP and 99mTc-pertechnetate in quantitative joint scintigraphy for active arthritis.
• To evaluate the diagnostic sensitivity of each tracer in differentiating types of arthritis.
• To assess the prognostic value of 99mTc-MDP uptake for destructive joint changes.

Main Methods:

• Computerized, quantitative joint scintigraphy was performed on 17 joint pairs with asymmetric active arthritis.
• Utilized both 99mTc-MDP and 99mTc-pertechnetate tracers.
• Calculated the joint activity ratio by comparing inflamed to contralateral symptomless joints.

Main Results:

• 99mTc-MDP demonstrated a very high joint activity ratio in septic arthritis with osteolytic lesions.
• Activity ratios were consistently higher with 99mTc-MDP compared to 99mTc-pertechnetate in rheumatoid joints.
• In reactive arthritis, mean joint activity ratios were similar for both tracers.

Conclusions:

• 99mTc-MDP exhibits superior sensitivity over 99mTc-pertechnetate in detecting active rheumatoid arthritis.
• Elevated 99mTc-MDP uptake may serve as a prognostic indicator for destructive arthritic changes.
• Quantitative scintigraphy with 99mTc-MDP offers valuable diagnostic and prognostic information in inflammatory joint diseases.