Urinary 99m-Tc-diphosphonate excretion as a simple method to quantify bone metabolism

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Abstract
Twenty-four hour whole body retention (WBR) of 99mTc-methylene-diphosphonate (an index of bone turnover) was determined by whole-body counting (WBRs) and complementarily by urine counting (WBRu) in 19 subjects with normal to highly increased bone turnover. WBRs and WBRu correlated well (r = 0.94, P < 0.001), and gave almost the same results. Both WBR correlated equally well with serum alkaline phosphatase and urine hydroxyproline/creatinine (r = 0.82-0.93). Coefficient of variation in WBRu was 7.0%, determined by duplicate measurements in 16 normals. The injected dose of diphosphonate did not influence WBRu. Since almost 50% of the diphosphonate excreted in urine appeared during the 1st few h after the i.v. injection, the method of WBRu requires careful urine collection. The simple WBRu determination provides the same information on bone metabolism as does the more cumbersome and expensive WBRs technique.