Registration Bone Scan in the Evaluation of Wrist Pain

Mohamed, Aida; Ryan, P. J.; Lewis, M.; Jarosz, J.; Fogelman, Ignac; Spencer, John David; Clarke, Simon

doi:10.1016/s0266-7681(97)80052-6

Cited by 25 publications

(10 citation statements)

References 8 publications

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“…Coregistration of bone scans with plain radiography has been reported as useful in the evaluation of hand pain/trauma, but the technique is challenging [56] and is not a widely used practice. Huellner et al [57] recently reported a pilot retrospective study of 21 patients with non-specific hand and wrist pain, comparing SPECT-CT with MRI.…”

Section: Applications Of Single Photon Emission Ct-ct In the Upper Limbmentioning

confidence: 99%

SPECT-CT: applications in musculoskeletal radiology

Saha

Burke²,

Desai³

et al. 2013

BJR

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This article reviews the technique, basic science principles and applications of integrated single photon emission CT (SPECT)-CT in musculoskeletal radiology. A review of the current evidence on the topic was undertaken, and selected clinical cases from the authors' institution have been used for illustration. SPECT-CT is a technology with emerging applications that offers technical advantages to image fusion of separately acquired SPECT and CT studies. The prevailing evidence indicates that there may be benefit in adding SPECT-CT to conventional imaging algorithms during the evaluation of some malignant and benign musculoskeletal conditions. SPECT-CT can improve both sensitivity and specificity by reducing equivocal interpretation in comparison to planar scintigraphy or SPECT alone. The evidence base for SPECT-CT in musculoskeletal radiology is still evolving. There is a lack of evidence comparing SPECT-CT with MRI in many key indications, and further research is required in these areas.A wide range of pathological conditions may affect the musculoskeletal system, including infection, trauma and malignant disease. Advances in MRI, multidetector CT (MDCT) and high-frequency ultrasound have provided considerable improvements in imaging musculoskeletal disease over the past decade. There are, however, limitations associated with each of these techniques. MRI image acquisition remains relatively time consuming and, particularly in musculoskeletal radiology, image quality can be degraded significantly by metal artefact from internal fixation and prostheses. MDCT offers exquisite characterisation of bone and can rapidly generate highquality three-dimensional reconstructions; however, the contrast resolution for soft tissues is limited and the modality can also suffer metal-related artefact, although like MRI, imaging parameters can be adjusted to reduce this artefact. High-frequency ultrasound, although operator dependent, provides excellent spatial and contrast resolution for superficial structures but is suboptimal for deeper structures and is unable to penetrate cortical bone.Bone scintigraphy remains an important and highly sensitive tool to the musculoskeletal radiologist but this is frequently criticized for its lack of specificity. Radionuclide imaging, however, may be the only modality to demonstrate pathology before it becomes evident on anatomical imaging. Developments in gamma camera technology now allow high-resolution imaging with shortened scan times, and single photon emission CT (SPECT) imaging has become commonplace in the UK. SPECT is able to increase sensitivity further and improves lesion localisation, but the paucity of anatomical markers on radionuclide imaging remains a constant challenge. Thus, the importance of correlating anatomical and functional imaging has become increasingly recognised [1].Use of a combined SPECT/CT system allows for sequential acquisition of both anatomical and functional information with a high degree of image fusion accuracy.

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Section: Applications Of Single Photon Emission Ct-ct In the Upper Limbmentioning

confidence: 99%

SPECT-CT: applications in musculoskeletal radiology

Saha

Burke²,

Desai³

et al. 2013

BJR

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“…Bone scintigraphy of the peripheral extremities is an excellent tool to detect orthopedic disorders [1][2][3][4][5][6][7][8][9][10][11][12][13][14][29][30][31]. However, the evidence on the value of hybrid imaging of the peripheral extremities is scarce.…”

Section: Discussionmentioning

confidence: 99%

“…Several reports emphasize the high sensitivity of bone scintigraphy [1][2][3][4][5][6][7][8][9][10][11]. However, it is also well known that the specificity of bone scintigraphy is quite low due to the lack of anatomic information, especially in the peripheral extremities, although pinhole SPECT may improve the diagnostic accuracy of imaging the peripheral extremities [12].…”

Section: Introductionmentioning

confidence: 99%

Skeletal SPECT/CT of the peripheral extremities -interdisciplinary approach in orthopaedic disorders-first clinical results

Wuest

Kuwert

Grunewald³

et al. 2007

Open Medicine

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AbstractBone scintigraphy, although quite sensitive to detect skeletal lesions, has a comparatively low specificity. Hybrid-cameras combining single-photon emission computed tomography (SPECT) and spiral-CT offer the opportunity to correlate scintigraphic information with high-quality visualization of morphology in one session. This may lead to an improvement in diagnostic accuracy and anatomic lesion localization. We present 11 patients, who underwent SPECT/CT of the feet (n=10) and hands (n = 1). The examinations were performed due to pain in foot or hand with the following suspected clinical diagnoses: arthrosis (n=1); fracture (n=3); osteomyelitis (n=4); reflex dystrophia (n=1); and, pain of unclear origin (n=2). All patients underwent SPECT/CT hybrid imaging using a dual-headed SPECT camera integrated with a 2-slice spiral CT scanner in one gantry. SPECT, CT, and SPECT/CT were evaluated independently from each other with respect to main diagnosis, anatomic lesion localization, and detection of a possible additional diagnosis. SPECT/CT improved lesion localization in 8 of 11 patients (73%) in comparison to SPECT alone, and in 4 of 11 patients (36%) in comparison to CT alone. Diagnostic accuracy was improved in 4 of 11 patients (36%) in comparison to either SPECT or CT alone. In conclusion, skeletal SPECT/CT improves diagnostic accuracy and lesion localization of orthopedic disorders in the feet and hands. The obtained results encouraged extensive studies to further investigate the potential gain in diagnostic accuracy brought about by SPECT/spiral-CT hybrid imaging in orthopedic disorders of the peripheral extremities.

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“…Bone scintigraphy is frequently used for the diagnostic evaluation of orthopedic disorders because altered bone metabolism can be detected before morphologic changes are detected with planar radiography [8][9][10][11][12][13][14][15][16][17][18]. It is particularly valuable in evaluating prostheses of the hip joints and knees as their loosening leads to periprosthetic augmentation of bone metabolism, which is easily picked up by this technology [19].…”

Section: Introductionmentioning

confidence: 99%

“…Considerable evidence has accumulated with regard to the superiority of SPECT/CT over stand-alone SPECT in staging malignant disease [20][21][22]. Further, several papers have also explored its potential for studying patients with orthopedic disorders [8][9][10][11][12][13][14][15][16][17][18]. However, to the best of our knowledge, a larger trial on the value of this hybrid imaging technology in patients who had undergone lumbar instrumentation is still missing.…”

Section: Introductionmentioning

confidence: 99%