Development of Nuclear Medicine Methodology for Bone and Calcium Metabolism

Research Project

Project/Area Number	61480240
Research Category	Grant-in-Aid for General Scientific Research (B)
Allocation Type	Single-year Grants
Research Field	Radiation science
Research Institution	Kawasaki Medical School
Principal Investigator	MORITA Rikushi Kawasaki Medical School, 医学部, 教授 (60026896)
Co-Investigator(Kenkyū-buntansha)	OTSUKA Nobuaki Kawasaki Medical School, 医学部, 講師 (20140519) FUKUNAGA Masao Kawasaki Medical School, 医学部, 助教授 (00093302)
Project Period (FY)	1986 – 1987
Project Status	Completed (Fiscal Year 1987)
Budget Amount *help	¥6,900,000 (Direct Cost: ¥6,900,000) Fiscal Year 1987: ¥500,000 (Direct Cost: ¥500,000) Fiscal Year 1986: ¥6,400,000 (Direct Cost: ¥6,400,000)
Keywords	Renal osteobystrophy / Bone scintigraphy / Measurement of bone mineral content / Single photon absorptiometry / Dual photon absorptionmetry / Parathyroid hormone / Secondary hyperparathyroidism / 副甲状腺シンチグラフィ / 骨塩量 / 骨シンチグラム / 骨組織像
Research Abstract	Bone scintigraphy, measurement of bone mineral content, blood biochemistry and parathyroid scintigraphy were performed on 93 patients undergoing long term hemodialysis and the pathophysiology of renal osteodystrophy was investigated. The bone scintigrams were divided into 4 growps; type F showed high uptake of ^<99m>Tc-MDP by the skull and entire skeleton, type A had minimum accumulation of the radionuclide, type D showed images similar to osteomalacia, type C was almost normal images. In blood biochemical parameters, serum phosphate levels were low in type D, alkaline phosphatase activity was markedly high in type F. Blood PTH levels were increased in type F and very low in type A by any of the N, C and M specific assay system. Relationahip between these scintigraphic types and histological findings are now under study. Bone mineral content was variable depending upon cortical or cancerons bone. The redial cortical bone mass, measured by single photon absorptiomety(SPA) gradually decreased with time in years of hemodialysis. The predominsntly cancerons bone mass of the lumbar spine, mesaured by dual photon absorptiometry(DPA) was variable showing high and low values, but generally decreased after 10 years of hemodialysis. The redial bone mass exclusively decreased in secondary hyperparathyroidism. On the other hand, the spinal bone mass decreased only in severe cases of secondary hyperparathyroidism. Scitigraphy with ^<201>T1 was proved to be lseful for the localization of hypertrophic parathyroid before surgery. Pathophisiology of renal osteodystrophy is variable and, threfore, the retional treatment for each thpe of the disease based on the pathophysiology should be established.