Frequency of Discordance between Facet Joint Activity on Technetium Tc99m Methylene Diphosphonate SPECT/CT and Selection for Percutaneous Treatment at a Large Multispecialty Institution

Lehman, Vance T.; Murphy, Robert C.; Kaufmann, Timothy J.; Diehn, Felix E.; Murthy, Naveen S.; Wald, John T.; Thielen, Kent R.; Amrami, Kimberly K.; Morris, Jonathan M.; Maus, Timothy P.

doi:10.3174/ajnr.a3731

Cited by 32 publications

(11 citation statements)

References 16 publications

(25 reference statements)

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“…CT has been said to have no place in the diagnosis of facet joint pain [27]. Other promising modalities such as SPECT/CT have shown discordance with therapeutic decisions in clinical settings [25]. Repeated controlled medial branch blocks, however, are the established gold standard for diagnosis of facet joint pain [34,29].…”

Section: Discussionmentioning

confidence: 99%

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Magnetic Resonance Imaging Can Detect Symptomatic Patients with Facet Joint Pain. A Retrospective Analysis

Freund¹,

Weber²,

Meier³

et al. 2017

J Clin Med Exp Images

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Background: Low back pain has recently been reported as the leading cause for disability worldwide. The diagnostic value of imaging has been estimated low. Led by own positive experience, however, we hypothesized that MRI can detect signs of facet joint pain.Methods: 15 patients and 15 controls were retrospectively assessed by two readers. They compared deidentifi ed T2 weighted lumbar spine MRI scans. Facet joint size, shape, angle, joint space signal and degeneration were rated. Pain aetiology was proven with the diagnostic gold standard of medial branch blocks.Results: Facet joint angles and joint diameters were signifi cantly larger in symptomatic patients, who also showed signifi cantly higher grades of degeneration but no difference in joint space distances or shape or signal intensity.The readers were able to correctly identify symptomatic patients with good interrater reliability (kappa 0.5, sensitivity and specifi city 0.87-0.93), positive (LR+= 6.7-7.2) and negative likelihood ratios (LR-=0.15). Conclusions:Contrary to recent publications, we could demonstrate differences between asymptomatic and symptomatic subjects showing the latter to have larger joints and more signs of degeneration.One can conclude from the strong LR+ and LR-values that MRI is a useful investigation to rule in or rule out facet pain.

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Section: Discussionmentioning

confidence: 99%

“…Facet joint activity in SPECT/CT may be discordant from diagnosis [25,26] and CT has been shown to be not helpful [27,28].…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging Can Detect Symptomatic Patients with Facet Joint Pain. A Retrospective Analysis

Freund¹,

Weber²,

Meier³

et al. 2017

J Clin Med Exp Images

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show abstract

“…This primary finding also indicates that further evaluation of the significance of these two imaging findings is needed. Although prior studies purport that 99m Tc-MDP activity predicts facet joint pain, the methods used have additional shortcomings beyond the lack of use of comparative medial branch blocks, which have been detailed previously (5,6,21). It will be useful to evaluate 99m Tc-MDP activity and peri-facet signal change independently in future investigations.…”

Section: Discussionmentioning

confidence: 99%

Comparison of facet joint activity on 99mTc-MDP SPECT/CT with facet joint signal change on MRI with fat suppression

Lehman

Murphy

Schenck

et al. 2016

Diagn Interv Radiol

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“…Additional data on the use of stand-alone SPECT also point in this direction [42][43][44]. In a further publication, however, Lehmann et al [45], in a group of 74 patients, analyzed the relationship between the localization of abnormal tracer uptake in the facet joint and the joint percutaneously treated. In 70 % of these subjects, site of treatment and SPECT/CT abnormality did not coincide.…”

Section: Differential Diagnosis Of Pain Associated With the Musculoskmentioning

confidence: 99%

Skeletal SPECT/CT: a review

Kuwert

2014

Clin Transl Imaging

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Skeletal scintigraphy is one of the most frequent in vivo procedures in the field of nuclear medicine. Visualizing bone metabolism, it exhibits a fairly high sensitivity to detect skeletal lesions, but has limitations in terms of specificity and spatial resolution, even when single-photon emission computed tomography (SPECT) is used. Combining SPECT with X-ray computed tomography helps overcome these limitations. This has, in particular, been shown when diagnosing bone involvement in malignant tumors. Emerging evidence indicates the benefit of hybrid imaging for bone scintigraphy during the workup of painful conditions affecting the back and the extremities. Methodological advances holding considerable promise for further improving its value are the quantitation of skeletal tracer uptake in absolute units, as well as multimodal image reconstruction techniques that have recently become available for use in clinical routine.

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Frequency of Discordance between Facet Joint Activity on Technetium Tc99m Methylene Diphosphonate SPECT/CT and Selection for Percutaneous Treatment at a Large Multispecialty Institution

Cited by 32 publications

References 16 publications

Magnetic Resonance Imaging Can Detect Symptomatic Patients with Facet Joint Pain. A Retrospective Analysis

Magnetic Resonance Imaging Can Detect Symptomatic Patients with Facet Joint Pain. A Retrospective Analysis

Comparison of facet joint activity on 99mTc-MDP SPECT/CT with facet joint signal change on MRI with fat suppression

Skeletal SPECT/CT: a review

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