Limb-sparing procedures: postoperative planar bone scan appearance.

OBJECTIVE

The objective of this study was to evaluate the postoperative technetium-99m-labeled methylene diphosphonate (99mTc-MDP) scintigraphic appearance of limb-sparing procedures in patients treated for bone tumors.

MATERIALS AND

METHODS

We retrospectively reviewed the medical records and assessed planar bone scans, subjectively and semiquantitatively, of all patients treated with limb-sparing procedures at our institution who survived at least 1 year following resection of the primary lesion.

RESULTS

The operative sites of 20 of the evaluable 45 patients (44%) demonstrated normal tracer avidity during follow-up (median 12 months). Nine patients (20%) demonstrated normal avidity on their first follow-up bone scans (median 6 months). Coincident 99mTc-MDP bone scans were obtained on 11 patients who developed 12 postoperative complications or injury during the study and accurately identified the lesion in eight (67%).

CONCLUSION

Although many patients have abnormal 99mTc-MDP avidity in the operative site after limb-sparing surgery, almost half eventually have normalization of uptake. However, planar bone scans have limited use for assessing the primary tumor site postoperatively as persistent abnormal avidity may preclude detection of changes associated with development of postoperative complications.