BONE Scan. Power point presentationnnnnnnnn
- 1. BONE SCAN
- 2. BONE SCAN A bone scan is a diagnostic test that detects areas of increased or decreased bone activity by injecting a certain radiopharmaceutical i.e tc-99m MDP/HDP. This test can be used by doctors to detect suspected bone diseases, determine the reason underlying unexplained bone pain, and track a patients response to treatment.
- 3. Indications Bone tumors benign tumors osteoid osteoma & chondroblastoma- malignant tumors osteosarcoma and metastasis. o Early detection (6 - 18 months earlier than X-ray) and staging. o Differentiation between benign and malignant neoplasms. Bone trauma: o Detection of bone trauma not obvious on X-ray. o Assessment of blood flow to the adjacent areas. Bone infections: osteomyelitis. Paget’s disease. Survey of whole skeleton
- 4. Radiopharmaceutical: 99m Tc-methylene di-phosphonate (MDP): mostly commonly used o Dose: 25 To 30 mci dose in bone scan for adults o (Pedia age + 1) / (age + 7) x(adult dose) o Half life: 6 hours. o Adjust dose for pediatric patients o Route: IV EQUIPMENT collimator Low energy high resolution, low energy all purpose (collimator) Gamma camera
- 5. • Patient preparation: • The patient should be well hydrated: the patient is asked to drink 1.5-2 liters of water. • The patient is asked to void immediately before imaging. • Frequent voiding before the procedure to reduce radiation dose to the bladder wall • Remove metallic object (coin, jewelry, keys etc) prior to imaging (can cause artifact due to attenuation)
- 6. • Procedure For whole body, patient is supine with arms at side
- 7. • 3 PHASE BONE • A 3 phase bone can assist in the diagnosis of complex regional pain. The various phases of a 3- phase scan can demonstrate positive findings at certain time points in the exam while being negative at other time points. • Indications • Flow phase and blood pool phase • Soft tissue abnormalities • cellulitis
- 8. 3 phase bone scan can be used to differentiate pathologies such as osteomyelitis and cellulitis 1.Flow phase • Demonstrate and characterizes relative perfusion to a particular area 2. Blood pool phase • . the blood pool image is obtained immediately after flow phase • . inflammation causes capillary dilation and increased blood flow 3 . Delayed phase • . the bone is obtained 2- 4 hours later • . urinary excretion has decreased the amount of the radionuclide in soft tissue.