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Technetium (99mTc) butedronic acid, commonly known as technetium-99m dicarboxypropane diphosphonate (99mTc-DPD), is a diagnostic radiopharmaceutical used in nuclear medicine. It is a bone-seeking diphosphonate complex that selectively accumulates in the skeletal system by binding to hydroxyapatite crystals, particularly in areas of active bone remodeling and osteogenesis. Developed historically by Hoechst and Behringwerke, and currently marketed under the brand name Teceos by Curium, 99mTc-DPD is widely utilized for bone scintigraphy to detect skeletal metastases, fractures, and osteomyelitis. Additionally, it has emerged as a critical non-invasive diagnostic tool for identifying transthyretin amyloid cardiomyopathy (ATTR-CM) and differentiating it from light-chain amyloidosis (AL), as the tracer exhibits high affinity for amyloid-associated calcium deposits in the myocardium.
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