technetium tc 99m medronate


Summary: A gamma-emitting radionuclide imaging agent used primarily in skeletal scintigraphy. Because of its absorption by a variety of tumors, it is useful for the detection of neoplasms.

Top Publications

  1. Sadik M, Jakobsson D, Olofsson F, Ohlsson M, Suurkula M, Edenbrandt L. A new computer-based decision-support system for the interpretation of bone scans. Nucl Med Commun. 2006;27:417-23 pubmed
    ..A completely automated method can be used to detect metastases in bone scans. Future developments in this field may lead to clinically valuable decision-support tools. ..
  2. Gumuser G, Parlak Y, Topal G, Aras F, Ruksen E, Sayit E. Effects of 99mTc-MIBI and 99mTc-MDP administration on dual-energy X-ray absorptiometry bone mineral density measurements. Nucl Med Commun. 2009;30:445-8 pubmed publisher
    ..Scintigraphy and bone densitometry should be performed on different days to avoid artifactual reduction in BMD measurements. ..
  3. Moore A, Blake G, Fogelman I. Quantitative measurements of bone remodeling using 99mTc-methylene diphosphonate bone scans and blood sampling. J Nucl Med. 2008;49:375-82 pubmed publisher
    ..3%; spine, 16.6%; pelvis, 17.2%; arms, 11.1%; legs, 23.7%. The 3 methods gave consistent and accurate measurements of K(bone). The Patlak method can be used to study regional as well as total-skeleton values of K(bone). ..
  4. Moore A, Blake G, Taylor K, Rana A, Wong M, Chen P, et al. Assessment of regional changes in skeletal metabolism following 3 and 18 months of teriparatide treatment. J Bone Miner Res. 2010;25:960-7 pubmed publisher
    ..This is the first study showing a direct metabolic effect of TPTD at different skeletal sites in vivo, as measured by tracer kinetics. ..
  5. Heiba S, Kolker D, Mocherla B, Kapoor K, Jiang M, Son H, et al. The optimized evaluation of diabetic foot infection by dual isotope SPECT/CT imaging protocol. J Foot Ankle Surg. 2010;49:529-36 pubmed publisher
    ..This combined imaging technique promises to beneficially impact diabetic patient care. ..
  6. Even Sapir E, Metser U, Mishani E, Lievshitz G, Lerman H, Leibovitch I. The detection of bone metastases in patients with high-risk prostate cancer: 99mTc-MDP Planar bone scintigraphy, single- and multi-field-of-view SPECT, 18F-fluoride PET, and 18F-fluoride PET/CT. J Nucl Med. 2006;47:287-97 pubmed
    ..This added value of 18F-Fluoride PET/CT may beneficially impact the clinical management of patients with high-risk prostate cancer. ..
  7. Cook G, Houston S, Rubens R, Maisey M, Fogelman I. Detection of bone metastases in breast cancer by 18FDG PET: differing metabolic activity in osteoblastic and osteolytic lesions. J Clin Oncol. 1998;16:3375-9 pubmed
    ..In contrast, osteoblastic metastases show lower metabolic activity and are frequently undetectable by PET. The biologic explanation for this observation remains to be elucidated. ..
  8. Abe K, Sasaki M, Kuwabara Y, Koga H, Baba S, Hayashi K, et al. Comparison of 18FDG-PET with 99mTc-HMDP scintigraphy for the detection of bone metastases in patients with breast cancer. Ann Nucl Med. 2005;19:573-9 pubmed
    ..18FDG-PET should play a complementary role in detecting bone metastasis with bone scintigraphy. ..
  9. Ohta M, Tokuda Y, Kubota M, Makuuchi H, Tajima T, Nasu S, et al. Whole body PET for the evaluation of bony metastases in patients with breast cancer: comparison with 99Tcm-MDP bone scintigraphy. Nucl Med Commun. 2001;22:875-9 pubmed
    ..In conclusion, FDG-PET appears to be a powerful tool not only in the diagnosis of the primary lesion and soft tissue metastasis, but also in the diagnosis of bony metastasis among patients with breast cancer. ..

More Information


  1. Blake G, Park Holohan S, Fogelman I. Quantitative studies of bone in postmenopausal women using (18)F-fluoride and (99m)Tc-methylene diphosphonate. J Nucl Med. 2002;43:338-45 pubmed
  2. Yang S, Liang J, Lin F, Kao C, Lin C, Lee C. Comparing whole body (18)F-2-deoxyglucose positron emission tomography and technetium-99m methylene diphosphonate bone scan to detect bone metastases in patients with breast cancer. J Cancer Res Clin Oncol. 2002;128:325-8 pubmed
    ..2% and 94.5%, and of bone scan were 93.3% and 78.7%, respectively. Our findings suggest that FDG-PET shows a similar sensitivity and a better accuracy than bone scan for detecting bone metastases in patients with breast cancer. ..
  3. Loutfi I, Collier B, Mohammed A. Nonosseous abnormalities on bone scans. J Nucl Med Technol. 2003;31:149-53; quiz 154-6 pubmed
  4. Brenner W, Sieweke N, Bohuslavizki K, Kampen W, Zuhayra M, Clausen M, et al. Age- and sex-related bone uptake of Tc-99m-HDP measured by whole-body bone scanning. Nuklearmedizin. 2000;39:127-32 pubmed
    ..Furthermore, age- and sex-related normal bone uptake values of Tc-99m-HDP covering a wide range of age could be presented for this method as a basis for further studies on bone uptake. ..
  5. Inaoka T, Shuke N, Sato J, Ishikawa Y, Takahashi K, Aburano T, et al. Scintigraphic evaluation of pamidronate and corticosteroid therapy in a patient with progressive diaphyseal dysplasia (Camurati-Engelmann disease). Clin Nucl Med. 2001;26:680-2 pubmed
    ..In this case, pamidronate and corticosteroid produced different effects. Bone scintigraphy allowed an objective assessment of the response to these treatments, accurately reflecting clinical symptoms. ..
  6. Scillitani A, Dicembrino F, Chiodini I, Minisola S, Fusilli S, Di Giorgio A, et al. Global skeletal uptake of 99mTc-methylene diphosphonate (GSU) in patients affected by endocrine diseases: comparison with biochemical markers of bone turnover. Osteoporos Int. 2002;13:829-34 pubmed
    ..The behavior of GSU and OC and U-DPD is non-uniform in disorders characterized by a marked uncoupling between bone formation and resorption. ..
  7. Ziran N, Hill S, Wright M, Kovacs J, Robey P, Wientroub S, et al. Ribbing disease: radiographic and biochemical characterization, lack of response to pamidronate. Skeletal Radiol. 2002;31:714-9 pubmed
    ..In this report we present for the first time the finding of bone marrow edema with MRI as well as disease progression during intravenous pamidronate treatment. ..
  8. Tuncel M, Erbas B, Mahmoudian B. Gamut: soft tissue uptake of bone radiopharmaceuticals. Semin Nucl Med. 2003;33:334-7 pubmed
  9. Moore A, Hain S, Blake G, Fogelman I. Validation of ultrafiltration as a method of measuring free 99mTc-MDP. J Nucl Med. 2003;44:891-7 pubmed
    ..It is thus necessary to measure individual protein binding values for bone kinetic studies. ..
  10. Yurtkuran M, Yurtkuran M, Alp A, Sivrioglu K, Dilek K, Tamgac F, et al. Hand involvement in Behçet's disease. Joint Bone Spine. 2006;73:679-83 pubmed
    ..Hand involvement tends to be overlooked and careful examination is required in the evaluation of BD. The scintigraphic involvement detected in hands requires special consideration, too. ..
  11. Mebarki M, Medjahedi A, Menemani A, Betterki S, Terki S, Berber N. Osteosarcoma pulmonary metastasis mimicking abnormal skeletal uptake in bone scan: utility of SPECT/CT. Clin Nucl Med. 2013;38:e392-4 pubmed publisher
    ..SPECT/CT correctly identified them as pulmonary metastases. This case illustrates the potential advantages and utility of SPECT/CT imaging of skeletal bone scan in order to decide on the optimal treatment. ..
  12. Moschovi M, Alexiou G, Tourkantoni N, Balafouta M, Antypas C, Tsiotra M, et al. Cranial Ewing's sarcoma in children. Neurol Sci. 2011;32:691-4 pubmed publisher
    ..We present a case of a primary and a radiation-induced skull Ewing's sarcoma. The symptoms, neuroimaging findings and the treatment for these cases are reviewed. Both children were operated with favorable outcome. ..
  13. Feng H, Ouyang W, Liu J, Liu W. [Value of additional skull lateral static imaging in whole-body bone imaging for skull bone invasion evaluation in nasopharyngeal carcinoma patients: comparison with CT]. Nan Fang Yi Ke Da Xue Xue Bao. 2009;29:1216-8 pubmed
    ..Skull lateral static imaging can be of value in the diagnosis of skull base invasion in NPC patients and may serve as an effective means for screening skull base invasion in NPC. ..
  14. Loeffelbein D, Mielke E, Buck A, Kesting M, Holzle F, Mucke T, et al. Impact of nonhybrid 99mTc-MDP-SPECT/CT image fusion in diagnostic and treatment of oromaxillofacial malignancies. Mol Imaging Biol. 2010;12:71-7 pubmed publisher
    ..Though particularly in complex anatomical regions, a fixed preoperative diagnostic algorithm in image registration lead to a more precise evaluation and treatment of head and neck malignancies. ..
  15. Jackson S, George R, Lodge M, Piotrowski A, Wahl R, Gujar S, et al. The effect of regadenoson on the integrity of the human blood-brain barrier, a pilot study. J Neurooncol. 2017;132:513-519 pubmed publisher
  16. Gauguet J, Pace Emerson T, Grant F, Shusterman S, DuBois S, Frazier A, et al. Evaluation of the utility of 99m Tc-MDP bone scintigraphy versus MIBG scintigraphy and cross-sectional imaging for staging patients with neuroblastoma. Pediatr Blood Cancer. 2017;64: pubmed publisher
  17. Combalia A, Munoz Mahamud E, Palacin A, Pomes J, López V. Local recurrence of a parosteal osteosarcoma 21 years after incomplete resection. Chin J Cancer. 2011;30:861-6 pubmed publisher
    ..The patient underwent a wide en bloc resection in our hospital and was free of symptoms, with no signs of tumor recurrence or metastasis during a 53-month follow-up. ..
  18. Brooks J, Rivera Ramirez L, Errington L, Scheper M. Synchronous Paget disease of bone and hyperparathyroidism: report of a case with extensive craniofacial involvement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111:e19-24 pubmed publisher
    ..The patient underwent a partial parathyroidectomy and bisphosphonate administration was to be initiated upon extraction of the remaining dentition...
  19. Agner T, Herning M, Lund J, Mantoni M, Skinhøj P. [Picture of the month: bone scintigraphy]. Ugeskr Laeger. 2007;169:1328 pubmed
  20. Kwatra N, Shalaby Rana E, Majd M. Two-phase whole-body skeletal scintigraphy in children--revisiting the usefulness of the early blood pool phase. Pediatr Radiol. 2013;43:1376-84 pubmed publisher
    ..Technical aspects of this simple and fast scanning technique are also highlighted. ..
  21. Levren G, Sadik M, Gjertsson P, Lomsky M, Michanek A, Edenbrandt L. Relation between pain and skeletal metastasis in patients with prostate or breast cancer. Clin Physiol Funct Imaging. 2011;31:193-5 pubmed publisher
    ..02). In conclusion, a significant relation between pain and skeletal metastases could be found in patients with prostate cancer and a reverse relation in patients with breast cancer. ..
  22. Hirschmann M, Mathis D, Rasch H, Amsler F, Friederich N, Arnold M. SPECT/CT tracer uptake is influenced by tunnel orientation and position of the femoral and tibial ACL graft insertion site. Int Orthop. 2013;37:301-9 pubmed publisher
  23. Kim J, Nam K, Yoo J, Kim H. The role of preoperative bone scan for determining the treatment method for femoral neck fracture. Int Orthop. 2007;31:61-4 pubmed
    ..Preoperative bone scans appear to have no significant role to play in determining the operative treatment method for femoral neck fracture. ..
  24. Gorgas D, Luder P, Lang J, Doherr M, Ueltschi G, Kircher P. Scintigraphic and radiographic appearance of the sacroiliac region in horses with gait abnormalities or poor performance. Vet Radiol Ultrasound. 2009;50:208-14 pubmed
    ..002, right side P = 0.003). In conclusion, the conformation of the sacrum may play an important role in the scintigraphic appearance and may be the cause of increased radiopharmaceutical uptake. ..
  25. Levine D, Ross B, Ross M, Richardson D, Martin B. Decreased radiopharmaceutical uptake (photopenia) in delayed phase scintigraphic images in three horses. Vet Radiol Ultrasound. 2007;48:467-70 pubmed
    ..Photopenia may indicate the presence of ischemia and can be used to facilitate clinical decision making and prognosis assessment ..
  26. Yang F, Xu H, Li C, Yang J. Incidental finding of Tc-99m MDP bone scintigraphy in a case of X-linked spondyloepiphyseal dysplasia tarda. Clin Nucl Med. 2012;37:193-5 pubmed publisher
    ..Bone scintigraphy demonstrated a short spine in addition to abnormally increased activity in multiple joints. The patient was eventually diagnosed to have X-linked spondyloepiphyseal dysplasia tarda. ..
  27. Rajaram A, Tamurian R, Reith J, Bush C. Hip pain in an 18-year-old man. Clin Orthop Relat Res. 2008;466:248-54 pubmed publisher
  28. Lin Y, Lu Y, Wang H, Tsai S, Lin W. Accidental finding of bladder cancer in 99mTc methylene diphosphonate whole-body bone scan. Clin Nucl Med. 2013;38:643-5 pubmed publisher
    ..Four months later, she underwent an (18)F-FDG PET/CT scan. Unfortunately, tumor recurrence in the bladder cancer was diagnosed by the (18)F-FDG PET/CT scan. ..
  29. Moslehi M, Cheki M, Salehi Marzijarani M, Amuchastegui T, Gholamrezanezhad A. Predictors of bone metastasis in pre-treatment staging of asymptomatic treatment-naïve patients with prostate cancer. Rev Esp Med Nucl Imagen Mol. 2013;32:286-9 pubmed publisher
    ..The combination of PSA and ALP can be used to improve predictability of bone metastasis in newly diagnosed patients with prostate cancer, without affecting staging accuracy. ..
  30. Davenport M, Brown R, Frey K. Utility of delayed whole-body bone scintigraphy after directed three-phase scintigraphy. AJR Am J Roentgenol. 2009;193:338-42 pubmed publisher
    ..For most indications, delayed whole-body imaging after directed three-phase bone scintigraphy does not improve diagnostic yield, does not alter patient care, and may be an unnecessary use of medical resources. ..
  31. De Geeter F, Goethals L. Utility of pelvic bone SPET in imaging urinary bladder filling defects in urinary bladder carcinoma. Hell J Nucl Med. 2010;13:59-62 pubmed
    ..When compared with CT, pelvic SPET is more sensitive than planar imaging in recognizing bladder filling defects on bone scans and may allow distinguish between intrinsic and extrinsic bladder lesions. ..
  32. Spinelli A, Lo Meo S, Calandrino R, Sbarbati A, Boschi F. Optical imaging of Tc-99m-based tracers: in vitro and in vivo results. J Biomed Opt. 2011;16:116023 pubmed publisher
    ..This is important especially considering the large number of Tc-99m-based radiopharmaceutical currently available. ..
  33. Xie W, Padhy A, Wong W. Unusual presentation of extraosseous metastases on bone scintigraphy. Clin Nucl Med. 2012;37:793-7 pubmed publisher
    ..These findings were confirmed with histology and correlative cross-sectional imaging. ..
  34. Pal R, Thiruudaian T, Khan M. When is a bone scan study appropriate in asymptomatic men diagnosed with prostate cancer?. Asian J Androl. 2008;10:890-5 pubmed publisher
    ..Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis. ..
  35. Schoenberger J, Fuchs E, Fertig V, Szikszai A, Maenner P, Eilles C. Clinical value of planar and tomographic dual-isotope scintigraphy using 99mTc-methylene diphosphonate and 131I in patients with thyroid cancer. Nucl Med Commun. 2006;27:865-71 pubmed
    ..It can be performed easily and also transferred to other isotope combinations. ..
  36. Biyi A, Doudouh A, Farik M, Zekri A. [Thoracic soft tissue uptake on a bone scintigraphy. 2 cases]. Rev Pneumol Clin. 2006;62:237-42 pubmed
    ..We report two cases of 99m-Tc-HMDP uptake respectively in the lung, in a patient with localized amyloidosis, and on diaphragmatic metastasis of a PNET. Mechanisms of such uptake are discussed. ..
  37. Sung C, Lee H, Diang L, Lin S. Refractory diffuse bony pain 20 years after jejunoileal bypass. South Med J. 2010;103:570-3 pubmed publisher
    ..Osteomalacia is an easily misdiagnosed late complication of jejunoileal bypass. Early recognition can avoid circuitous diagnosis and inappropriate management. ..
  38. Shanmugam N, Chasse K, Gupta S. Spurious elevation of bone mass secondary to Paget disease in a patient with osteoporosis. Clin Nucl Med. 2006;31:575-7 pubmed
  39. van der Jagt O, Piscaer T, Schaden W, Li J, Kops N, Jahr H, et al. Unfocused extracorporeal shock waves induce anabolic effects in rat bone. J Bone Joint Surg Am. 2011;93:38-48 pubmed publisher
    ..After further examination and optimization, unfocused extracorporeal shock waves might enable local treatment of skeletal sites susceptible to fracture. ..
  40. Bulzico D, Vaisman F, Cordeiro de Noronha Pessoa C, Corbo R. Cavernous angioma mimicking a differentiated thyroid carcinoma brain metastasis. Clin Nucl Med. 2011;36:62-3 pubmed publisher
    ..Head magnetic resonance image found a well-circumscribed lesion in temporal was compatible with a vascular malformation. Angioresonance confirmed the diagnosis of cavernous angioma, a benign vascular tumor. ..
  41. Esnault V, Nakhla M, Delcroix C, Moutel M, Couturier O. What is the value of Tc-99m hydroxymethylene diphosphonate scintigraphy for the etiological diagnosis of mild rhabdomyolysis?. Clin Nucl Med. 2007;32:519-23 pubmed
    ..However, bone scintigraphy is often negative in mild nontraumatic lesions. ..
  42. Kim C, Park K. Characteristic appearance of facet osteoarthritis of the lower lumbar spine on planar bone scintigraphy with a high negative predictive value for metastasis. Clin Nucl Med. 2008;33:251-4 pubmed publisher
  43. Moore A, Blake G, Fogelman I. Validation of a blood-sampling method for the measurement of 99mTc-methylene diphosphonate skeletal plasma clearance. J Nucl Med. 2006;47:581-6 pubmed
    ..Correcting K(total) by factors in the range of 0.90-0.95 corrects for the error in the terminal exponential and brings K(bone) values measured using the AUC method into agreement with the gamma-camera results. ..
  44. Mitterhauser M, Toegel S. An in vitro model for the comparative evaluation of bone seeking pharmaceuticals. ALTEX. 2008;25:51-5 pubmed
    ..It could even be a basis for the development of a future pharmacopoeia-listed method allowing both the official quality control of bone seekers and a more respectful approach to animals. ..
  45. Yokokawa T, Shirai T, Ogata H, Furui S. [Insufficiency fracture of the sacrum after hormonal therapy and radiotherapy for prostate cancer: A case in which 99mTc-MDP bone scintigraphy was useful for differential diagnosis]. Kaku Igaku. 2005;42:403-7 pubmed
    ..In order to avoid unnecessary treatment, we think that the view of bone scintigram for diagnosis of sacrum insufficient fracture should be known. ..
  46. Niederkohr R, Chiu E, Katzel J. 99mTc-oxidronate uptake within urothelial carcinoma confirmed with SPECT/CT imaging. Clin Nucl Med. 2013;38:655-7 pubmed publisher
  47. Zhang W, Chen B, Deng H, Yang T, Ou X. Hepatic and splenic uptake on bone scintigraphy in patients with intravenous administration of 99mTc methylene diphosphonate prior to gadolinium-containing contrast. Clin Nucl Med. 2013;38:219-20 pubmed publisher
    ..Thus, we can conclude that Gd-DTPA after (99m)Tc MDP administration may also induce increased hepatic and splenic radioactivity on bone scan. ..
  48. Javery O, Jagannathan J, Saboo S, O Regan K, Hornick J, Ramaiya N. Case report: atypical lipomatous tumor with unusual extensive metaplastic ossification. Cancer Imaging. 2012;12:25-30 pubmed
    ..We report a case of ALT/WDLPS with unusual extensive metaplastic bone formation without an element of dedifferentiated liposarcoma. ..
  49. Ebrahimzadeh M, Ahmadzadeh Chabock H, Ebrahimzadeh A. Osteoid osteoma: a diagnosis for radicular pain of extremities. Orthopedics. 2009;32:821 pubmed publisher
    ..Osteoid osteoma should always be considered in young patients with radicular pain, even with subtle neurological signs and symptoms. ..
  50. Sasagawa Y, Akai T, Yamamoto K, Masuoka T, Itou S, Oohashi M, et al. Multiple cavernous hemangiomas of the skull associated with hepatic lesions. Case report. Neurol Med Chir (Tokyo). 2009;49:162-6 pubmed
    ..A patient with multiple cavernous hemangiomas should undergo systemic examination to look for latent lesions, and regular follow-up examinations. ..
  51. Gurbuzer B, Pikdoken L, Urhan M, Süer B, Narin Y. Scintigraphic evaluation of early osteoblastic activity in extraction sockets treated with platelet-rich plasma. J Oral Maxillofac Surg. 2008;66:2454-60 pubmed publisher
    ..05). The application of PRP alone into soft tissue impacted mandibular third molar extraction sockets failed to increase the osteoblastic activity in postsurgical weeks 1 and 4 in comparison to non-PRP-treated sockets. ..
  52. Sasaki H, Koyama S, Yokoyama M, Yamaguchi K, Itoh M, Sasaki K. Bone metabolic activity around dental implants under loading observed using bone scintigraphy. Int J Oral Maxillofac Implants. 2008;23:827-34 pubmed
    ..0- and 4.0-N loads; it was significantly higher until 6 weeks than it had been before load application. Bone metabolism around the implants increases with loading and depends on the magnitude and period of the loading. ..
  53. Mulazimoglu M, Karyagar S, Saglampinar S, Ozpacaci T. Does radioiodine treatment change the methylene diphosphonate uptake in a toxic thyroid nodule on bone scintigraphy?. Clin Nucl Med. 2008;33:731-3 pubmed publisher