When bone tissue undergoes tumor and other pathological lesions, a thorough diagnosis is required to determine the disease. In this case, specialists often resort to such a diagnostic method as scintigraphy.
Usually it is used to determine bone metastasis, for the detection of arthritis and other pathological processes.
What is osteoscintigraphy?
Skeletal bone scintigraphy is a diagnostic imaging technique used in medical practice to determine the degree of metastasis of malignant processes, to assess the extent of the pathological process in bone tissues and the human musculoskeletal system.
Advantages and disadvantages of the
procedure The scintigraphic study has a number of advantages, one of which is the possibility of detecting pathological processes in the bones even at the initial stages of their development, approximately 4-6 months before the possibility of determining them through traditional radiography.
- This method, unlike other diagnostic techniques, allows to identify the pathological process at a stage when structural changes are not yet available, but the functionality of the affected organ is already broken.
- The procedure is usually well tolerated and does not cause complications, although in rare cases, patients experience allergic reactions.
- The radiation emitted by the administered substance is very low and does not depend on the number of images or the duration of the diagnostic study.
The only drawback of scintigraphy experts call the lack of information to establish an accurate diagnosis.
In this study, some types of cancerous lesions of bones are not visible, such anomalies and normal bone growths do not distinguish between these. Therefore, to determine the etiology of the pathological process, additional studies such as biopsy, computer and magnetic resonance imaging or radiography are carried out.
Indications and contraindications to the use of
A similar study is prescribed only with specific indications:
- Suspected metastasis in bone tissue;
- Lesions of bone structures( myeloma, etc.);
- Therapy of bone lesions like usual, stressful or compression fractures;
- Detection of inflammatory pathologies in articular and bone structures( arthropathies of dismetabolic type, arthritis or osteomyelitis);
- To identify the causes of vertebral pain, diagnose various types of articular inflammation, as a differential diagnosis of benign tumor processes or malignant pathologies of a secondary nature;
- To identify pathologies of incomprehensible origin associated with muscle, articular or osseous structures;
- To determine the viability or functionality of bone grafts;
- In order to evaluate the effectiveness and effectiveness of radionuclide treatment, radiotherapy or chemotherapy, etc.;
- For the detection of infectious inflammatory processes or the inferiority of joint prostheses.
The procedure is harmless to the body, but with its appointment, a number of existing contraindications such as breastfeeding and pregnancy, allergic reaction or intolerance of the radio preparation should be taken into account.
If there is an urgent need for a diagnosis, then breastfeeding should be stopped for 3 days.
In addition, scintigraphy can not be performed by a patient with a severe health condition. After irradiation with a gamma machine, contact with children or pregnant women due to radiated radiation must be avoided within 24 hours.
After the procedure, it is necessary to wash the clothes in which the patient was during the procedure, and also to wash thoroughly.
Preparation for scintigraphy
No special preparation is required for osteoscintigraphy of the bones of the skeleton. The patient should inform the expert in advance about the available allergy to medicines.
The patient must necessarily sign a consent for the diagnosis. The study itself is a long and routine diagnostic procedure.
Patients are advised to use more fluid before and after the study. This is necessary for better spread of contrast and for its rapid removal after diagnosis.
The waiting time after the introduction of contrast depends on the type of substance - some spread throughout the body per hour, while others take up to 5 hours to do this.
Scintigraphy procedure is meaningless in patients taking drugs containing vitamin D and calcium.
These substances contribute to reducing the absorption of radioactive contrast. In addition, before the procedure is to exclude the use of estrogen and antitumor drugs.
How is bone scintigraphy performed?
It is necessary to pass the examination by removing ornaments, in loose clothing or a special gown.
- The patient is given an intravenous injection of a radioactive substance( radioactive strontium or isotope of technetium).The injected drug spreads through organic structures, concentrating in bone tissues.
- Scan is carried out after 2-3 hours after the introduction of contrast.
- If the purpose of the study is to diagnose osteomyelitis or infectious-inflammatory lesions, several pictures can be taken immediately after the introduction of contrast.
- In other cases, in the waiting process, doctors recommend drinking more liquid to avoid delaying the radioactive substance in the inorganic structures. But before the scan, you must necessarily empty the bladder.
- The patient is placed on a special table, where he needs to lie still, because even minor activity negatively affects the quality and readability of the images.
- The procedure is absolutely painless, although prolonged stay in immobilized condition can cause some inconvenience.
- The scan duration is about an hour, after which the patient returns to normal life.
- Within 2 days after diagnosis, it is necessary to drink more liquid to accelerate the removal of radioactive contrast.
Evaluation and interpretation of the results
The patient decides the transcript of scintigraphic images, recommendations and extracts immediately after diagnosis, the next day or a few days later.
The results are processed in accordance with various parameters:
- Depending on the number of metastases;
- In accordance with impulse indicators over healthy and affected areas;
- Relative to the impulse activity over bone tissues to background indices.
In the process of research, the specialist receives various categories of images: synchronized, tomographic, dynamic and static. Each of the images is able to show the structure of the organs and the degree of their damage, which provides extensive and thorough study of the functionality of the bone structures being studied.
Most often metastasis is detected in the costal, cranial, pelvic and vertebral bones.
As a result of the diagnosis, positive sites can be identified, so-called.hot spots, which are characterized by a congestion of radioactive contrast, indicating bone damage. There may be negative areas or cold spots - these are places where there is no contrast isotope, so there are no bone lesions in these areas.
Adequate interpretation of the results has a leading significance in terms of the correctness, quality and effectiveness of the subsequent therapeutic process. This is especially important in cases of suspicion of vertebral cancer.
Where to make a radioisotope test?
The procedure for scintigraphy of the bones of the skeleton is available in the state medical centers and private specialized clinics of the capital in the order of preliminary consultation and recording.
Similar services render in clinics like:
- City Clinical Hospital №1 named after. Pirogova;
- of OJSC "Medicine";
- FBTC them. Burnazyan;
- LRC of the Ministry of Health of the Russian Federation;
- Research Institute of JV.Sklifosovsky, etc.
The price of the procedure
The cost of the procedure for scintigraphic examination of the bones of the skeleton depends on the status of the clinic and its location:
- In Moscow medical institutions the price of the study will be about 2600-13080 rubles;
- In Krasnodar, such a procedure will cost 2400-8600 rubles;
- Ekaterinburg clinics are ready to conduct osteoscintigraphy for 2500-8000 rubles.
Although the price for conducting this research is quite high, its significance exceeds any costs.
Osteoscintigraphy is much more effective than X-ray diagnostics and allows detecting bone pathologies at the initial stages of their formation, which contributes to timely therapy and prolongation of patients' life in the case of oncology.
Video about the radioisotope method of studying the bones of the skeleton: