Dynamic blood flow imaging with (99m)Tc-hydroxymethylene diphosphonate as a therapeutic response marker in patients with Raynaud’s phenomenon

We evaluated the predictive value of dynamic blood flow scintigraphy with (99m)Tc-HDP (hydroxymethylene diphosphonate) for therapeutic response in patients with Raynaud’s phenomenon (RP). Eighty patients who underwent dynamic blood flow scintigraphy using the one-hand chilling method were enrolled. We analyzed the quantitative variables as the ratio of chilled fingers to ambient fingers (CA(finger)), that of the chilled hand to ambient hand (CA(hand)), and that of chilled fingers to ambient palm (FPR) (CA(FPR)) at 15 and 30 s after (99m)Tc-HDP bolus injection. Total cumulative radioactivity counts for 180 s were obtained. We evaluated the clinical utility of these quantitative parameters with other clinical variables, including RP severity, therapeutic compliance, types of RP, and scintigraphic interpretation of findings in patients with RP. Fifty-two patients showed poor therapeutic response. There were significant differences between good- and poor-therapeutic responder groups in RP intensity (p = 0.003), CA(finger15s) (p = 0.008), CA(finger30s) (p = 0.002), CA(finger180s) (p = 0.011), CA(hand15s) (p = 0.008), CA(hand30s) (p = 0.007), CA(hand180s) (p = 0.017), CA(FPR30s) (p = 0.004), and CA(FPR180s) (p = 0.002). After multivariate logistic regression analysis, only CA(finger30s) (p = 0.002) had an independent predictive value of the therapeutic response. (99m)Tc-HDP dynamic blood flow scintigraphy could be helpful in predicting the therapeutic response in patients with RP.