Musculoskeletal system

Abstract

Bone scintigraphy is used as a common screening test for suspected bone metastases because of its high sensitivity, availability, low cost, and ability to scan the entire skeleton. Historical data and clinical experience has established bone scintigraphy as the reference standard in the search for skeletal metastatic disease and many indications have become established for benign skeletal disorders (Table 10.1). Chiewitz and Hevesy first described the use of radionuclides to study the skeleton in 1935 where phosphorus-32 ( 32P) activity was measured in rat organs with a Geiger-Müller counter and where uptake of 32P from blood to bone was noted, suggesting that skeletal metabolism is a dynamic process. Fleming and colleagues produced the first radionuclide skeletal images in 1961 using 85Sr (Fleming et al. 1961) and this radioisotope was commonly used for bone scanning and the study of skeletal kinetics. Although 87mSr was introduced as an alternative bone scanning agent with a more suitable gamma ray for imaging of 388 keV and half-life of 2.8 h, the introduction of 18F-fluoride and then 99mTc labelled compounds superseded this. In 1971, Subramanian and McAfee successfully prepared technetium-99m-polyphosphates. © 2007 Springer-Verlag Berlin Heidelberg.