Evaluation of scintigraphic and roentgenologic studies in Paget's disease under treatment

Scintigraphic and roentgenological studies in 9 patients, treated for Paget's disease, were evaluated before and during treatment and related to the values of serum alkaline phosphatase. On the initial studies--before treatment--25 lesions were found on both scintigram and roentgenogram. One lesion--proven by biopsy--was only seen on the scintigram. The roentgenograms showed no changes during this period, ranging from 6-16 months, except for one lesion with dubious progression. The scintigrams, carried out using 99Tcm-EHDP, showed both a qualitative and quantitative improvement in 7 cases. The ratios of radionuclide accumulation in Pagetoid bone and normal bone corresponded well with the values of serum alkaline phosphatase. In 4 out of 9 cases, however, the scintigram still demonstrated pathologic uptake of radioactivity, while serum alkaline phosphatase levels had dropped to normal values. It is concluded that bone scintigraphy may be of value for the follow up of patients under treatment for Paget's disease.