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technetium (99mTc) butedronic acid (also known as technetium-99m-3,3-diphosphono-1,2-propanedicarboxylic acid or 99mTc-DPD) is a diagnostic radiopharmaceutical used in nuclear medicine. It is a bone-seeking bisphosphonate tracer that binds with high affinity to hydroxyapatite crystals in areas of active bone remodeling. Reconstituted from a cold kit (marketed under the brand name Teceos), it is primarily indicated for bone scintigraphy to detect skeletal metastases, trauma, and degenerative bone diseases. Additionally, 99mTc-DPD has emerged as a key non-invasive diagnostic tool for transthyretin cardiac amyloidosis (ATTR-CA), where it accumulates in myocardial amyloid deposits, allowing clinicians to confirm ATTR-CA with high accuracy without the need for endomyocardial biopsy.
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