Comparative Evaluation of the role of Scintimetric Characterization by Dr. V. Siva's Retention Ratio and the Triple Phase Bone Scan in the Skeletal Fracture Assessment

Abstract

Aim: This prospective analysis of the findings of bone scans done for skeletal fracture assessment was undertaken to compare the findings of the Triple phase Bone scan and the Scintimetric Characterization by Dr.V.Siva’s retention ratio in the assessment and evaluation of the skeletal fracture. Materials and Method: In this total study population of 39, had 19 males and 20 females. The 3 phases were acquired immediately after the intra-venous injection of 25 mCi of Tc99m MDP in a dynamic fashion centering over the fracture site. The dual head gamma camera e-Cam was used. The static Skeletal phase image and the 4 h whole body bone scan images were acquired 4 h after injection. The images were processed, and the results were tabulated. The 24 h static Skeletal phase image was acquired the next day. The 4/24 h Dr.V.Siva’s retention ratios were calculated using the region ratio protocol and tabulated. Results: The 3phase bone scan analysis revealed that 18/39 46 % were of malignant nature and 21/39 54% were of benign or non-malignant causes. The Scintimetric Characterization of the malignant lesions by Dr.V.Siva’s retention ratio was 12.8 +/- 1.79 and that of the Non- malignant lesions was 5.8 +/- 2.41 indicating the gross difference between the two groups. The statistical analysis also confirmed the significant difference between the two groups. There was absolute concordance between the Triple phase bone scan findings and the Scintimetric Characterization by Dr.V.Siva’s retention ration in 30/39=77% of patients and the discordant between the two was noted in 9/39=23 % patients. Conclusion: It can be concluded that the Scintimetric Characterization of fracture site by Dr.V.Siva’s Retention ratio along with the Triple phase bone scan findings helps in the proper identification of the underlying pathological process in as high as 23% of the study.