Bone loss in patients with chronic renal disease: prediction with quantitative bone scintigraphy with SPECT.
OBJECTIVE
To determine whether quantitative bone scintigraphy (QBS) with single-energy photon emission computed tomography (SPECT) can help predict which patients with chronic renal disease will show bone mineral density (BMD) loss.


METHODS
In 18 patients, the percentage of injected dose of technetium-99m methylene diphosphonate per cubic centimeter of bone was measured with QBS SPECT in the lumbar vertebrae and femoral neck. The differences in BMD over an average of 20 months were measured and compared with SPECT measurements. QBS values were also compared with serum bone turnover markers.


RESULTS
There was a negative correlation (r = -.54, P < .05 for the lumbar spine and r = -.60, P < .01 for the femoral neck) between QBS values and bone loss. Positive and negative predictive values, sensitivity, and specificity of QBS for bone loss in the lumbar spine were 78%, 71%, 78%, and 71%, respectively, and in the femoral neck, 82%, 100%, 100%, and 78%, respectively. Differences between predictive values of serum bone turnover markers were not statistically significant.


CONCLUSIONS
QBS with SPECT enabled prediction of rapid bone loss in patients with renal disease.
Israel
O
O
Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel.
Gips
S
S
Hardoff
R
R
Rudoy
J
J
Frajewicki
V
V
Iosilevsky
G
G
Bettman
L
L
Frenkel
A
A
Hoffman
A
A
Kolodny
G M
GM
D015502:Absorptiometry, Photon; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D002118:Calcium / Q000097:blood; D002908:Chronic Disease; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000097:blood / Q000000981:diagnostic imaging*; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D013669:Technetium Tc 99m Medronate; D015899:Tomography, Emission-Computed, Single-Photon
D015415:Biomarkers; D010281:Parathyroid Hormone; D015675:Osteocalcin; D000469:Alkaline Phosphatase; D002118:Calcium; D013669:Technetium Tc 99m Medronate