Potential role of multislice SPECT/CT in impingement syndrome and soft-tissue pathology of the ankle and foot

Chicklore, Sugama; Gnanasegaran, Gopinath; Vijayanathan, Sanjay; Fogelman, Ignac

doi:10.1097/mnm.0b013e32835c0964

Cited by 51 publications

(32 citation statements)

References 10 publications

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“…[7810] In a small group of 25 patients, Mohan et al . found that the SPECT/CT study provided additional information compared to planar scintigraphy in 20/25 (80%) patients, with more accurate pathology localization in 16/25 (64%) and new abnormalities in 10/25 (40%) patients.…”

Section: Added Value Of Single-photon Emission Computed Tomography/comentioning

confidence: 99%

“…[8] In a cohort of patients with impingement syndromes and soft-tissue pathology, improvement in localization and characterization of uptake with SPECT/CT was reported in 76% (31/43) patients when compared to clinical assessment and conventional two-phase bone scan. [10]…”

Section: Added Value Of Single-photon Emission Computed Tomography/comentioning

confidence: 99%

“…[67891011121617] Mohan et al . reported that SPECT/CT influenced management in 10/19 (53%) patients in whom follow-up data were available.…”

Section: Added Value Of Single-photon Emission Computed Tomography/comentioning

confidence: 99%

“…Common pathologies encountered included impingement syndromes, plantar fasciitis, and tendonitis [Figure 6a and b]. [10] In over half of the cases (24/43), the pathology demonstrated by SPECT/CT was not suspected by the clinician. Although pathological uptake was also apparent on planar scintigraphy in all but one case (42/43) the improved localization and characterization of SPECT/CT provided additional information to the planar study in 76% (31/43) of cases.…”

Section: Soft Tissuementioning

confidence: 99%

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Technetium-99m methylene diphosphonate single-photon emission computed tomography/computed tomography of the foot and ankle

Upadhyay

Beadsmoore

et al. 2017

World J Nucl Med

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The complex anatomy and function of the foot and ankle can make it difficult to determine the cause of symptoms in patients with foot and ankle pathology. Following initial clinical and radiographic assessment, additional imaging with magnetic resonance imaging may be required, which is often seen as the modality of choice. Although sensitive to pathological changes in bone metabolism and vascularity, technetium-99m (Tc-99m) bone scintigraphy often lacks the specificity and resolution required to evaluate the structures of the foot and ankle. Tc-99m methylene diphosphonate single-photon emission computed tomography/computed tomography (SPECT/CT) combines this sensitivity with the superior anatomical detail of CT, enabling better localization of pathological uptake and evaluation of associated structural changes. As a result, SPECT/CT has been growing in popularity for the assessment of patients with foot and ankle pathology where it can provide additional information that may change the initial diagnosis and subsequent management plan. Studies have reported modification of the surgical approach and site of intra-articular local anesthetic injections following SPECT/CT with good results. Interpretation of SPECT/CT studies requires an understanding of the pathological changes that result in increased tracer accumulation in addition to the CT changes that may be seen. This review aims to highlight the advantages of SPECT/CT, potential applications and explain the imaging appearances of common pathologies that may be observed.

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Section: Added Value Of Single-photon Emission Computed Tomography/comentioning

confidence: 99%

Section: Added Value Of Single-photon Emission Computed Tomography/comentioning

confidence: 99%

“…[67891011121617] Mohan et al . reported that SPECT/CT influenced management in 10/19 (53%) patients in whom follow-up data were available.…”

Section: Added Value Of Single-photon Emission Computed Tomography/comentioning

confidence: 99%

Section: Soft Tissuementioning

confidence: 99%

See 2 more Smart Citations

Technetium-99m methylene diphosphonate single-photon emission computed tomography/computed tomography of the foot and ankle

Upadhyay

Beadsmoore

et al. 2017

World J Nucl Med

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“…The accuracy, sensitivity, specificity, and positive and negative predictive values of SPECT/CT in this series was 94 %, 95 %, 83 %, 98 % and 71 %, respectively. Chicklore et al found that SPECT/CT was useful for the evaluation of impingement syndromes and soft-tissue pathologies [48]. SPECT/CT can be used for the postoperative evaluation of the foot after arthrodesis to assess nonunion or the development of osteoarthritis in adjacent joints due to mechanical overload.…”

Section: Footmentioning

confidence: 99%

Clinical applications of SPECT/CT in imaging the extremities

Huellner

Strobel

2013

Eur J Nucl Med Mol Imaging

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Today, SPECT/CT is increasingly used and available in the majority of larger nuclear medicine departments. Several applications of SPECT/CT as a supplement to or replacement for traditional conventional bone scintigraphy have been established in recent years. SPECT/CT of the upper and lower extremities is valuable in many conditions with abnormal bone turnover due to trauma, inflammation, infection, degeneration or tumour. SPECT/CT is often used in patients if conventional radiographs are insufficient, if MR image quality is impaired due to metal implants or in patients with contraindications to MR. In complex joints such as those in the foot and wrist, SPECT/CT provides exact anatomical correlation of pathological uptake. In many cases SPECT increases the sensitivity and CT the specificity of the study, increasing confidence in the final diagnosis compared to planar images alone. The CT protocol should be adapted to the clinical question and may vary from very low-dose (e.g. attenuation correction only), to low-dose for anatomical correlation, to normal-dose protocols enabling precise anatomical resolution. The aim of this review is to give an overview of SPECT/CT imaging of the extremities with a focus on the hand and wrist, knee and foot, and for evaluation of patients after joint arthroplasty.

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The utility of the ankle SPECT/CT scan to predict functional and clinical outcomes in supramalleolar osteotomy patients

Gross

Barfield

Schweizer

et al. 2018

Journal Orthopaedic Research

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Combined single-photon emission computed tomography and conventional computed tomography (SPECT/CT) is a hybrid imaging modality that shows a combination of metabolic and structural information about the ankle, including arthritis. We hypothesize that uptake in specific locations within the ankle joint can be associated with both clinical outcomes and may help predict which patients will have a successful SMO. Eighty-five pre-operative SMO patients with varus (37), valgus (41), or neutral (7) alignment of the hindfoot were assessed using SPECT/CT. The level of activation on SPECT/CT scans was measured. Pre and Post-operative functional scores were recorded. Patients with medial gutter activation had significantly worse (p < 0.05) AOFAS alignment (AOFAS-A) scores pre-operatively. Patients with varus or valgus alignment did not have any difference in VAS pain scores, but those in valgus did have worse AOFAS-P (pain) scores. Those with cystic lesions had a worse FAOS score pre-operatively. Ten patients (12.5%) had a treatment failure. Pre or post-operative alignment did not correlate to a treatment failure. The only statistically significant (p = 0.036) poor prognostic indicator was a bipolar lesion. Pre-operative SPECT/CT evaluation of an ankle before a SMO can be used to clinically correlate patient-specific factors such as pain and function in the pre and post-operative period. We caution against performing a SMO in patients with bipolar activation on a pre-operative SPECT-CT scan. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2015-2021, 2018.

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Potential role of multislice SPECT/CT in impingement syndrome and soft-tissue pathology of the ankle and foot

Abstract: Tc-99m methylene diphosphonate bone SPECT/CT is useful in localizing and characterizing impingement syndrome and soft-tissue pathology in patients with ankle/foot pain. SPECT/CT may complement MRI and ultrasonography in the investigation of impingement syndrome and soft-tissue pathology.

Cited by 51 publications

References 10 publications

Technetium-99m methylene diphosphonate single-photon emission computed tomography/computed tomography of the foot and ankle

Technetium-99m methylene diphosphonate single-photon emission computed tomography/computed tomography of the foot and ankle

Clinical applications of SPECT/CT in imaging the extremities

The utility of the ankle SPECT/CT scan to predict functional and clinical outcomes in supramalleolar osteotomy patients

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