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47. Indications of bone scintigraphy. The significance and indications of 3-phase bone scintigraphy.
- Bone scintigraphy/scan
- Screening method of choice for
- Detection of bone metastases
- Diagnosing fractures which aren’t visible by conventional imaging
- Advantages
- Widely available
- Inexpensive
- Shows entire skeleton
- Disadvantages
- Poor spatial resolution
- Poor contrast resolution
- Tc99m-MDP is the most frequently used radiopharmaceutical
- Injection -> Wait 2 – 4 hours -> Imaging
- Normal bone scan only has this delayed “phase”
- Indications
- Metastasis of bone
- Primary bone tumor
- Osteomyelitis
- Fractures
- Metabolic bone diseases
- Osteonecrosis
- Three-phase bone scintigraphy
- A special type of bone scan
- Produces dynamic images as well as static
- 3 phases
- Flow phase = perfusion phase
- Imaging obtained for 60 seconds after injection
- Demonstrates the perfusion of a particular area
- Blood pool phase
- Imaging obtained 5 minutes after injection
- Demonstrates the pooling of blood in a particular area
- Increased in inflammation
- Delayed phase = bone phase
- Imaging obtained 2 – 4 hours after injection
- Demonstrates blood flow and rate of bone formation
- Indications
- Osteomyelitis
- Especially to differentiate osteomyelitis from cellulitis
- Bone pain
- Skeletal metastases
- Arthritis
- Dual energy x-ray absorptiometry (DEXA)
- = Bone densitometry
- Measures bone density
- Good for osteoporosis
