99mTc-DPD-SPECT/CT predicts the outcome of imaging-guided diagnostic anaesthetic injections: A prospective cohort study

Kretzschmar, Martin; Wiewiorski, Martin; Rasch, Helmut; Jacob, Augustinus Ludwig; Bilecen, Deniz; Walter, Martin A.; Valderrábano, Víctor

doi:10.1016/j.ejrad.2010.09.013

Cited by 41 publications

(51 citation statements)

References 22 publications

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“…Hence we think that findings in SPECT-CT have a well correlation with the pain generation as it illustrates the bone metabolism. In the present study for treatment decision the metabolic activity was concordantly judged as superior to morphologic changes due to the assumption that severe deformities could be asymptomatic while already little changes with high metabolic activities might be symptomatic [13]. …”

Section: Discussionmentioning

confidence: 99%

Influence on Therapeutic Decision Making of SPECT-CT for Different Regions of the Foot and Ankle

Claaßen

Uden

Ettinger

et al. 2014

BioMed Research International

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Background. Single-photon emission computed tomography and computed tomography (SPECT-CT) has a high impact on diagnosis and treatment decision of different joints. The aim of this study was to evaluate whether there is a different gain of SPECT-CT for different foot regions. Material and Methods. We retrospectively identified 86 patients who received a SPECT-CT of the foot and ankle between April 2011 and December 2012. We divided all patients into the following subgroups: ankle (group 1), subtalar (group 2), Chopart (group 3), and Lisfranc (group 4). The local ethical committee approved the study. Results. The clinical treatment decision was changed based on SPECT-CT results in 64.5% of group 1, 65.2% of group 2, and 75% each of groups 3 and 4. Eighty patients (93%) had pain relief after treatment based on SPECT-CT. The overall SPECT-CT sensitivity was 0.94 and the specificity was 0.57. The positive and negative predictive values were 0.87 and 0.75, respectively. Conclusion. The impact of SPECT-CT on treatment decision is slightly higher in diseases of the Chopart and Lisfranc joints than in the upper ankle and subtalar joints. The additional information has a clinical relevance due to the high rate of pain relief by treatment based on SPECT-CT diagnosis.

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Section: Discussionmentioning

confidence: 99%

Influence on Therapeutic Decision Making of SPECT-CT for Different Regions of the Foot and Ankle

Claaßen

Uden

Ettinger

et al. 2014

BioMed Research International

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“…The patients studied by these authors had, however, not previously received an MRI. In a prospective study, 27/30 (90 %) patients treated by infiltration with local anesthetics of the structures most active on SPECT/CT reported significant pain reduction [62]. Based on the available evidence and their own clinical experience, Mohan et al proposed a diagnostic algorithm for the imaging of patients with chronic foot pain, recommending SPECT/CT as the first tomographic imaging procedure in patients with previous surgery or metal implants and as the second tomographic examination in cases with an inconclusive MRI [32].…”

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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“…62,63 This may help in targeting guided injections. 64 Infection Radiographs, CT, and MRI are commonly used to detect infection in bone. Recently, MRI has taken over from the bone scan in the diagnosis of osteomyelitis owing to its excellent soft tissue contrast and its sensitivity to tissue edema and hyperemia.…”

Section: Ankle and Foot Painmentioning

confidence: 99%