Seong-Ryul Kwon1, Mie-Jin Lim, Shin-Goo Park, In-Young Hyun, Won Park. 1. Division of Rheumatology, Department of Internal Medicine; Occupational and Environmental Medicine; and Nuclear Medicine, Inha University Hospital, Incheon, Republic of Korea.
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). CONCLUSION: (99m)Tc-HDP digital blood flow scintigraphy after one-hand chilling is a noninvasive, accurate, and quantitative method to evaluate RP.
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). CONCLUSION: (99m)Tc-HDP digital blood flow scintigraphy after one-hand chilling is a noninvasive, accurate, and quantitative method to evaluate RP.