Evaluation and optimization of administered activity, scanning parameters and hydration at 99m Tc hydroxymethylene diphosphonate adult whole-body bone imaging
Article first published online: 14 JUN 2012
© 2012 The Authors Clinical Physiology and Functional Imaging © 2012 Scandinavian Society of Clinical Physiology and Nuclear Medicine
Clinical Physiology and Functional Imaging
Volume 32, Issue 6, pages 431–436, November 2012
How to Cite
Starck, S.-Å. and Rosendahl, L. (2012), Evaluation and optimization of administered activity, scanning parameters and hydration at 99m Tc hydroxymethylene diphosphonate adult whole-body bone imaging. Clinical Physiology and Functional Imaging, 32: 431–436. doi: 10.1111/j.1475-097X.2012.01145.x
- Issue published online: 3 OCT 2012
- Article first published online: 14 JUN 2012
- Manuscript Accepted: 13 MAY 2012
- Manuscript Received: 11 JAN 2012
- bladder volume;
- bone scintigraphy;
- bone-to-soft-tissue ratio;
- image quality;
- methylene diphosphonate
To find out the method of optimal activity administration and scanning parameters to fulfil guidelines and diagnostic reference levels and to reach a maximal contrast-to-noise ratio (CNR) in bone imaging. We also investigate the influence on CNR and bladder activity in well-hydrated patients.
A total of 225 patients were included. The first group of 101 patients was used to find out the optimal method to administer activity in terms of optimized CNR. The next two groups with 62 patients each were hydrated with 1500 ml water in two different time periods. CNR, bladder area and content were calculated.
An administrated activity per metre body height gave the highest CNR (5·43). A standard activity had the lowest percentage (2%) of images with <1·5 million counts. Early hydration decreased CNR from 5·41 to 4·85 (P = 0·06), with late hydration to 5·29 (NS). Studies with too few pulses were increased from 2 to 11% to a level of 15–26% and 11–21%, respectively. Early hydration reduced the bladder activity from 20·7 to 10·1 MBq (P<0·01), late hydration to 14·8 MBq (P = 0·08). The bladder size was enlarged from the no hydrated group (1406 mm2) to the early hydrated group (2406 mm2, P<0·000) and between the early and late hydrated group (3183 mm2, P<0·05).
A standard activity in sufficient quantity is the most practical method, in addition to have the lowest percentage of images with too few pulses. A high fluid intake is not recommended because of problems with disturbing bladder content.