title: Diagnosis of Raynaud's phenomenon by (99m)Tc-hydroxymethylene diphosphonate digital blood flow scintigraphy after one-hand chilling.
abstract: OBJECTIVE
  We introduce the use of (99m)Tc-hydroxymethylene diphosphonate (HDP) digital blood flow scintigraphy to diagnose Raynaud's phenomenon (RP).
  
  
  METHODS
  Fifty-seven patients with RP and 60 healthy controls were recruited. One hand was chilled by immersion into water at 4 degrees C, and then an intravenous bolus of 740 MBq of (99m)Tc-HDP was injected. The radioactivity from the second to the fifth fingers of both hands was recorded. Acquisition was performed at a rate of one frame per 2 seconds until 155 frames. We calculated 4 ratios by comparing the activity curves of the chilled hand with those of the ambient hand.
  
  
  RESULTS
  The chilled to ambient hand ratio of the initial slope was significantly lower in the patients with RP (0.28 +/- 0.18) than in the controls (0.78 +/- 0.20) (p < 0.001). The chilled to ambient hand ratio of the first peak height, 30-second area under the curve, and blood pool uptake were also lower in the patients with RP than in controls (p < 0.001 for each). The initial slope ratio of 0.51, used as a cutoff value, showed a sensitivity of 91.2% and specificity of 93.3%. The loss of the initial spike curve, the presence of a slowly progressing radioactivity curve, and the inhomogeneous radioactivity uptake in the blood pool image in either hand were characteristic findings of the patients with RP (p < 0.001).
  
  
  CONCLUSIONS
  (99m)Tc-HDP digital blood flow scintigraphy after one-hand chilling is a noninvasive, accurate, and quantitative method to evaluate RP.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine; Occupational and Environmental Medicine; and Nuclear Medicine, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Seong-Ryul
authors.initials: SR
authors.lastname: Kwon
authors.forename: Mie-Jin
authors.initials: MJ
authors.lastname: Lim
authors.forename: Shin-Goo
authors.initials: SG
authors.lastname: Park
authors.forename: In-Young
authors.initials: IY
authors.lastname: Hyun
authors.forename: Won
authors.initials: W
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D003080:Cold Temperature; D005260:Female; D005385:Fingers / Q000098:blood supply*; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006801:Humans; D007101:Immersion; D008297:Male; D008875:Middle Aged; D011928:Raynaud Disease / Q000000981:diagnostic imaging* / Q000276:immunology / Q000503:physiopathology; D012039:Regional Blood Flow; D013669:Technetium Tc 99m Medronate; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D013669:Technetium Tc 99m Medronate