Comparison of the diagnostic performances of two protocols of hand perfusion scintigraphy for Raynaud’s phenomenon

ObjectiveThe aim of this study was to compare the diagnostic performances of two hand perfusion scintigraphy protocols for diagnosing Raynaud’s phenomenon (RP). MethodsWe enrolled 130 patients who underwent hand perfusion scintigraphy for suspected RP and 40 normal controls. Of these, 66 patients (group A) and 25 normal controls underwent 99mTc-methylene diphosphonate hand perfusion scintigraphy without one-hand chilling, and the finger-to-palm ratio (FPR) was calculated. The remaining 64 patients (group B) and 15 normal controls underwent 99mTc-methylene diphosphonate hand perfusion scintigraphy with one-hand chilling, and three parameters (the chilled-to-ambient hand ratios of the first peak height, initial slope, and blood pool uptake) were calculated. ResultsForty-eight and 47 patients were clinically diagnosed with RP in groups A and B, respectively. In group A, patients with RP had significantly lower FPRs compared with those without RP, and the receiver operating characteristic curve analysis showed that an FPR of 0.51 was the best cutoff value for diagnosing RP, with a sensitivity of 63% and a specificity of 83%. In group B, the three aforementioned parameters differed significantly (lower or higher) between patients with and without RP. The receiver operating characteristic curve analysis provided highly sensitive and specific results for all three parameters. The initial slope ratio showed the highest sensitivity of 87% and a specificity of 88% when using cutoff values of 0.78 and 1.25. ConclusionAlthough both protocols for hand perfusion scintigraphy showed high specificity for diagnosing RP, the protocol with one-hand chilling showed higher diagnostic ability compared with that without one-hand chilling.

[1]  G. Purdie,et al.  Prevalence of Raynaud's phenomenon in the adult New Zealand population. , 2009, The New Zealand medical journal.

[2]  E. Rosato,et al.  Laser Doppler Perfusion Imaging Is Useful in the Study of Raynaud’s Phenomenon and Improves the Capillaroscopic Diagnosis , 2009, The Journal of Rheumatology.

[3]  I. Hyun,et al.  Diagnosis of Raynaud’s Phenomenon by 99mTc-Hydroxymethylene Diphosphonate Digital Blood Flow Scintigraphy After One-hand Chilling , 2009, The Journal of Rheumatology.

[4]  M. Cutolo,et al.  [Role of videocapillaroscopy in early detection of transition from primary to secondary Raynaud's phenomenon in systemic sclerosis]. , 2011, Reumatismo.

[5]  D. Wernicke,et al.  Color Doppler ultrasonography of hand and finger arteries to differentiate primary from secondary forms of Raynaud's phenomenon. , 2008, The Journal of rheumatology.

[6]  H. Hutter,et al.  Transition from primary Raynaud's phenomenon to secondary Raynaud's phenomenon identified by diagnosis of an associated disease: results of ten years of prospective surveillance. , 2006, Arthritis and rheumatism.

[7]  L. Galuska,et al.  Raynaud’s Syndrome: comparison of late and early onset forms using hand perfusion scintigraphy , 2006, Rheumatology International.

[8]  A. Herrick.  Pathogenesis of Raynaud's phenomenon. , 2005, Rheumatology.

[9]  L. Galuska,et al.  Microcirculation of the fingers in Raynaud’s syndrome , 2005, Nuklearmedizin.

[10]  F. Ingegnoli,et al.  [Raynaud's phenomenon]. , 2011, Reumatismo.

[11]  A. Sarıkaya,et al.  Assessment of digital ischaemia and evaluation of response to therapy by 99mTc sestamibi limb scintigraphy after local cooling of the hands in patients with vasospastic Raynaud's syndrome , 2004, Nuclear medicine communications.

[12]  Tim D Spector,et al.  Use of thermographic criteria to identify Raynaud's phenomenon in a population setting. , 2003, The Journal of rheumatology.

[13]  K. Kutomi,et al.  Accumulation of Tc-99m tetrofosmin in multiple myeloma. , 2002, Clinical nuclear medicine.

[14]  K. Kutomi,et al.  Improvement in cold-induced Raynaud's syndrome with administration of ticlopidine hydrochloride detected by Tc-99m DTPA human serum albumin scintigraphy. , 2002, Clinical nuclear medicine.

[15]  L. Bajnok,et al.  The clinical usefulness of the fingers-to-palm ratio in different hand microcirculatory abnormalities , 2000, Nuclear medicine communications.

[16]  M. Weinrich,et al.  Geographic variation in the prevalence of Raynaud's phenomenon: a 5 region comparison. , 1997, The Journal of rheumatology.

[17]  J. Roush,et al.  Scintigraphic assessment of distal extremity perfusion in 17 patients. , 1997, Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association.

[18]  T Moore,et al.  Increased nailfold capillary dimensions in primary Raynaud's phenomenon and systemic sclerosis. , 1996, British journal of rheumatology.

[19]  D A Isenberg,et al.  ABC of Rheumatology: RAYNAUD'S PHENOMENON, SCLERODERMA, AND OVERLAP SYNDROMES , 1995, BMJ.

[20]  M. Weinrich,et al.  Geographic variation in the prevalence of Raynaud's phenomenon: Charleston, SC, USA, vs Tarentaise, Savoie, France. , 1993, The Journal of rheumatology.

[21]  Sang Min Lee,et al.  Evaluation of Finger Blood Flow with Tc-99m MDP (methylene diphosphonate) , 1992, The Korean journal of internal medicine.

[22]  M. Lee,et al.  Measurement of Finger Blood Flow in Raynaud's Phenomenon by Radionuclide Angiography , 1987 .