Quantitative bone scintigraphy in the management of monostotic paget's disease of bone

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Abstract
Objective. To assess the use of quantitative bone scanning (QBS) in the monitoring of patients with intravenous pamidronate–treated symptomatic mono-stotic Paget's disease of bone in whom biochemical markers of bone turnover are relatively normal. Methods. QBS was performed in 9 patients and the results were expressed as a ratio, obtained by comparing isotope uptake at an affected and a control (unaffected) site. Results. Serum alkaline phosphatase levels were normal in 7 of the 9 patients and changed minimally with treatment. The median QBS ratio was 2.72 (range 1.69–24.6) at baseline and 1.49 (range 0.63–4.18) post- treatment (P = 0.008). The median symptom score decreased with treatment, but QBS ratios provided the only objective measure of disease activity by which response to pamidronate therapy could be judged. Conclusion. QBS may be a useful technique for evaluating the effects of treatment in patients with Paget's disease of bone.