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Is intermittent pneumatic compression (IPC) an appropriate method for increasing 99m Tc-MDP uptake in bone scan?

Susan Shafiei, Narjess Ayati, Hamideh Sadra, Gholam Hossein Kazemzadeh, Samira Zare Namdar, Baharak Attar, Seyyed Rasoul Zakavi.

Background: Currently, intermittent pneumatic compression (IPC) is a standard method of lymphedema treatment. Recently, the effect of this modality in patients with limb arterial insufficiency has been researched. It has been suggested that the arterial inflow to the long bones is also increased by IPC. The purpose of this paper is to assess the effect of lower limb IPC on the blood flow as well as delayed bone uptake. Methods: In this prospective study, we evaluated 30 patients who were referred for whole body bone scan to our Nuclear Medicine Department. All the patients had been examined by a vascular surgeon for ruling out any peripheral neuropathy, vasculopathy or ulcer in the lower limbs. Also, all the patients were questioned about hypertension, diabetes mellitus, and other chronic diseases with peripheral complications. Following 925MBq of 99mTc-methylenediphosphonate (MDP) injection, perfusion and blood pool images of both legs as well as static delayed images were done after the completion of IPC. Results: Thirty patients (10 male) with the age range of 3084 years (mean = 53.4) were included. Radiotracer uptake in flow and blood pool images in the compressed limb was significantly more than the contralateral limb, however, on delayed images, no significant difference was noted between two limbs. Conclusion: Although IPC can significantly increase blood flow of the compressed limb, MDP uptake on the delayed images was not increased. According to this study, IPC may not be useful as a technique to increase releasing chemotherapy drugs or other substances to the bone and promoting bone growth.

Key words: Intermittent pneumatic compression, IPC, bone scan, MDP uptake, vascular flow.

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