Assessment of therapeutic effect in patients with secondary hyperparathyroidism using bone scintigraphy.
OBJECTIVE
The semi-quantitative method of bone scintigraphy [bone to soft tissue (B/ST) ratio] has been used in diagnosing and evaluating systemic metabolic bone diseases. The aim of this study is to evaluate of the therapeutic effect of secondary hyperparathyroidism (SHP).


METHODS
The subjects were ten hemodialysis patients with SHP. Seven patients underwent parathyroidectomy (PTX), and 22-Oxacalcitoriol (derivative of 1,25-dihydroxyvitamin D3) (OCT) was given to three patients. Bone scintigraphy and blood tests [intact parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium (Ca), phosphorus (P), bone alkaline phosphatase (BALP), and deoxypridinoline (DPYD)] were performed before and after treatment. Regions of interest were drown around cranium, lumbar vertebrae, femoral neck and soft tissue of left medial thigh to calculate the B/ST ratio.


RESULTS
The B/ST ratios of cranium, lumbar vertebrae, and femoral neck were reduced significantly after PTX (cranium, p = 0.0079, lumbar vertebrae, p = 0.0282, femoral neck, p = 0.0252). Intact PTH, ALP, Ca, P, BALP and DPYD levels were reduced significantly after PTX (intact PTH, p = 0.003, Ca, p = 0.0005, P, p = 0.0393, ALP, p = 0.0051, DPYD, p = 0.0232, BALP, p = 0.0324). After OCT administration, the B/ST ratio of each bony region showed tendency to diminish, although not significantly. Intact PTH levels were reduced significantly, although ALP, BALP, and DPYD levels were not. Ca and P levels were increased significantly because of the medicinal action of OCT.


CONCLUSIONS
The B/ST ratio of cranium may be non-invasive method and have potential in evaluating the therapeutic effect of SHP.
Kaida
Hayato
H
Division of Nuclear Medicine, PET Center and Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. hayato@med.kurume-u.ac.jp
Ishibashi
Masatoshi
M
Nishida
Hidemi
H
Baba
Kenkichi
K
Hiromatsu
Yuji
Y
Okuda
Seiya
S
Hayabuchi
Naofumi
N
D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002117:Calcitriol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011877:Radionuclide Imaging; D013965:Thyroidectomy; D016896:Treatment Outcome
D002117:Calcitriol; C051883:maxacalcitol