title: Diagnosis of Raynaud's phenomenon by99mTc-pertechnetate hand perfusion scintigraphy: a pilot study.
abstract: We assess the usefulness of99mTc-pertechnetate hand perfusion scintigraphy in patients with Raynaud's phenomenon (RP). The study population consisted of 18 patients with primary RP, 25 patients with secondary RP within systemic sclerosis (SSc), and ten healthy individuals. Gamma camera dynamic first-pass study during the first 60 s and a static scintigraphy after 5 min were recorded following a bolus injection of99mTc-pertechnetate via a cubital vein. Regions of interest were drawn on the summed images around the fingers and the palmar region. The fingers-to-palm ratios were then calculated. The mean fingers-to-palm ratio for dynamic study (blood flow) was 0.58 ± 0.19 for the healthy group, 0.45 ± 0.18 for the primary RP, and 0.43 ± 0.21 for the SSc patients. The mean fingers-to-palm ratio for static study (blood pool) was 0.44 ± 0.06 for the healthy group, 0.42 ± 0.06 for the primary RP, and 0.36 ± 0.07 for the SSc patients. Analysis of variance showed these differences to be significant (p = 0.039 from blood flow and p = 0.004 from blood pool). The receiver operating characteristic curve showed sensitivity of 80% and a specificity of 60% when using cutoff values of 0.40 for blood flow and sensitivity of 79% and a specificity of 70% when using cutoff values of 0.37 for blood pool. Our method is able to differentiate between patients with normal and those with abnormal microcirculation of the hands. Dynamic study separates the healthy subjects from patients with RP, while static study separates primary from secondary RP.
authors: Institute of Rheumatology, School of Medicine, University of Belgrade, Resavska 69, 11000, Belgrade, Serbia. dolijan@eunet.rs.
authors: Slavica
authors: http://orcid.org/0000-0003-2366-9244
authors: S
authors: Pavlov-Dolijanovic
authors: Center for Nuclear Medicine, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Nebojsa
authors: N
authors: Petrovic
authors: Institute of Rheumatology, School of Medicine, University of Belgrade, Resavska 69, 11000, Belgrade, Serbia.
authors: Nada
authors: N
authors: Vujasinovic Stupar
authors: Institute of Rheumatology, School of Medicine, University of Belgrade, Resavska 69, 11000, Belgrade, Serbia.
authors: Nemanja
authors: N
authors: Damjanov
authors: Institute of Rheumatology, School of Medicine, University of Belgrade, Resavska 69, 11000, Belgrade, Serbia.
authors: Goran
authors: G
authors: Radunovic
authors: Institute for Medical Statistics and Informatics, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Dragan
authors: D
authors: Babic
authors: Center for Nuclear Medicine, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Dragana
authors: D
authors: Sobic-Saranovic
authors: Center for Nuclear Medicine, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Vera
authors: V
authors: Artiko
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D010865:Pilot Projects; D011928:Raynaud Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D012595:Scleroderma, Systemic / Q000150:complications / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m
chemical_list: D013670:Sodium Pertechnetate Tc 99m
keywords: 99mTc-pertechnetate; Raynaud’s phenomenon; Scintigraphy