Equine skeletal scintigraphy: Comparing normal bone-to-soft tissue ratio 2 and 4 hours after injection with either hydroxymethylene diphosphonate or methylene diphosphonate

Abstract

Background: In equine skeletal scintigraphy, there is no information about the possible influence of different phosphonate compounds on image quality. Methods: This prospective randomised study determined bone uptake changes and image quality for hydroxymethylene diphosphonate (HDP) and methylene diphosphonate (MDP) in equine patients at different time points. Scintigraphic images of the radius and the tibia of 20 horses were acquired at 2 and 4 hours after injection of either technetium-labelled HDP or MDP. Three regions of interest were identified—in the bone diaphysis, adjacent soft tissue and background area—to determine the normal bone-to-soft tissue ratio (BSR). Qualitative analysis was performed using a modified scoring system. Results: In terms of BSR and count rates, HDP showed a slightly better incorporation into bone compared to MDP, but significant differences were only detected for count rates at 4 hours after injection (p = 0.048). The radiopharmaceutical used did not influence qualitative image scoring, which was correlated with the BSR (ρ = 0.49; p ≤ 0.001). Conclusion: The choice of HDP or MDP for equine skeletal scintigraphy does not seem to substantially affect BSR and qualitative image scoring. Further studies with a larger sample size, including the evaluation of lesion detection ability for both bone-seeking agents, are needed.