Pentavalent Technetium-99m-Dimercaptosuccinic Acid Scintigraphy in Renal Osteodystrophy

Pentavalent 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy and 99m Tc-hydroxymethylene diphosphonate (HMDP) bone scan were performed in one patient with renal osteodystrophy (ROD) before and after vitamin D 3 pulse therapy. The bone scan showed diffusely increased tracer uptake in the whole skeleton, and no change of tracer distribution was noted before or after vitamin D 3 pulse therapy. However, 99m Tc(V)-DMSA scintigraphy revealed diffusely increased tracer uptake in the whole skeleton before therapy, and markedly decreased tracer uptake in the bones was seen at 5 mo after therapy. Increased uptake of 99m Tc(V)-DMSA was observed at 7 mo after therapy, which reflected the laboratory findings. Technetium-99m-(V)-DMSA scintigraphy appeared to be more sensitive than the conventional 99m Tc-HMDP bone scan in assessing the characteristics and therapeutic effect of bone disease in ROD.