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A Journal on Nuclear Medicine and Molecular Imaging


A Journal on Nuclear Medicine and Molecular Imaging
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  NUCLEAR MEDICINE APPLICATIONS FOR BONE METASTASES


The Quarterly Journal of Nuclear Medicine 2001 March;45(1):18-26

language: English

Radiopharmaceuticals for bone lesions. Imaging and therapy in clinical practice

Páuwels E. K. J., Stokkel M. P. M.

From the Leiden University Medical Centre, Department of Radiology, Division of Nuclear Medicine, Leiden, The Netherlands


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Bone scin­tig­ra­phy con­tin­ues to be one of the ­most com­mon­ly per­formed pro­ce­dures in nucle­ar med­i­cine. The radio­nu­clide ­bone ­scan ­remains an excel­lent modal­ity to ­detect met­a­stat­ic dis­ease in ­patients suf­fer­ing ­from pri­mary malig­nan­cies. This arti­cle ­reviews a num­ber of ­aspects of ­bone scin­tig­ra­phy ­such as ­bone phys­iol­o­gy, radio­phar­ma­ceu­ti­cals and ­uptake mech­a­nisms. As 99mTc ­labelled bis(di)phos­pho­nates are the ­most fre­quent­ly ­used ­this ­articke is cen­tred ­around ­these imag­ing ­agents. In addi­tion to diag­nos­tic ­bone scin­tig­ra­phy the use of var­i­ous ­bone seek­ing ­agents has ­been extend­ed to the pal­li­a­tive treat­ment of ­bone metas­ta­ses. In ­this con­text the radio­bi­o­log­i­cal char­ac­ter­is­tics of var­i­ous radio­nu­clides as 89Sr, 32P, 153Sm, 186Re and 117Sn is elu­ci­dat­ed. In addi­tion, the clin­i­cal effi­ca­cy for ­pain kill­ing of ­these radio­nu­clides is elu­ci­dat­ed on the ­basis of the radi­a­tion prop­er­ties of ­these ­agents. It is con­clud­ed ­that 89Sr and 186Re are pres­ent­ly the radio­nu­clides of ­choice. The lat­ter ­agent has a ­slight advan­tage as its imag­ing pho­tons ­enable indi­vid­u­al dosim­e­try, result­ing in an opti­mosed appli­ca­tion ­scheme.

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