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Technetium-99m diphosphonate is a generic class of diagnostic radiopharmaceuticals used as bone scanning agents in nuclear medicine. It consists of a small-molecule chelate of the radionuclide technetium-99m complexed with a diphosphonate carrier, such as methylene diphosphonate (MDP) or hydroxydiphosphonate (HDP). Following intravenous injection, the agent localizes to bone surfaces by chemisorption onto hydroxyapatite crystals, with uptake depending on local blood flow and osteoblastic activity. It is widely used in gamma scintigraphy and single-photon emission computed tomography (SPECT) to image skeletal conditions, including Paget's disease, fractures, osteomyelitis, bone tumors, and bone metastases, as well as to differentiate cardiac transthyretin amyloidosis (ATTR) from light chain amyloidosis (AL).
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