Use of three-phase bone scans and SPET in the follow-up of patients with allogenic vascularized femur transplants

Bilateral hand transplantation: Bone healing under immunosuppression with tacrolimus, mycophenolate mofetil, and prednisolone

“…Therefore, bone healing may proceed normally, be delayed, or end in resorption 3,20 and can be assessed by radiography, Doppler ultrasound, or 3-phase bone scans. [17][18][19]21,22 According to the available literature various strategies were applied to optimize bone union. They were based first on maximal stability at the osteotomy site using various types and sizes of hardware and on measures that are believed to favor bone healing.…”

Clinical experience in allogeneic vascularized bone and joint allografting

“…41,42 Because our bone allograft was not easily accessible to monitoring, we were forced to use signs of local inflammation, which are not specific and could have caused many rejection episodes to go undetected. Serologic or functional parameters that could have been used for early detection are not available.…”

Dynamic Bone Imaging with99mTc-Labeled Diphosphonates and18F-NaF: Mechanisms and Applications

“…Although the utility of such an approach has not been tested and would depend on the particular technical characteristics of the PET scanner used, the approach would be expected to provide meaningful semiquantitative data that could replace a 3-phase bone scan at a fraction of time. (38)(39)(40). Bone scintigraphy performed early (days 2-11) after surgery allows assessment of graft microperfusion, with graft survival reliant on intact blood flow during this critical period (38).…”

“…3) and semiquantitative analysis such as the measurement of transplant-to-cranium ratios, with values greater than 1.0 reported to have a high predictive value for successful healing (41). Three-phase bone scans were used to assess the vitality of vascularized femur allografts, with hyperemia indicating excellent perfusion and patency of transplanted vessels, and suitable uptake at 12 mo predicting a healthy graft (40). 99m Tc-MDP bone scans have also been used to monitor new bone formation of the mandible during distraction osteogenesis for the treatment of hemimandibular abnormalities (42).…”