The added value of SPECT/CT in the painful foot and ankle: A review of the literature

Eelsing, Robin; Hemke, Robert; Schepers, Tim

doi:10.1016/j.fas.2020.09.009

Cited by 12 publications

(6 citation statements)

References 21 publications

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“…Existing literature on the utility of SPECT/CT in foot pain is limited, however, suggests bone scintigraphy SPECT/CT is helpful in identifying pain generators in the foot with high accuracy and can help in appropriate guided management. Mohan et al in their review recommended SPECT/CT in patients with foot pain in postsurgical patients, patients with metal implants, and in patients with unidentified pain generators on MRI [32][33][34]. The advantages and disadvantages of different imaging modalities have been summarized in Table 1.…”

Section: Nuclear Medicinementioning

confidence: 99%

Emerging role of bone scintigraphy single-photon emission computed tomography/computed tomography in foot pain management

Singh

Agrawal

Trıpathy

et al. 2023

Nuclear Medicine Communications

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Foot and ankle joints being weight-bearing joints are commonly subjected to wear and tear and are prone to traumatic and other pathologies. Most of these foot and ankle pathologies present with pain. The diagnosis of pathology and localization of pain generators is difficult owing to the complex anatomy of the foot and similar clinical presentation. This makes the management of foot pain clinically challenging. Conventional anatomical imaging modalities are commonly employed for evaluation of any anatomical defect; however, these modalities often fail to describe the functional significance of the anatomical lesions, especially in presence of multiple lesions which is common in ankle and foot; however, hybrid single-photon emission computed tomography/ computed tomography (SPECT/CT) by virtue of its dual modalities, that is, highly sensitive functional imaging and highly specific anatomical imaging can serve as a problem-solving tool in patient management. This review attempts to describe the role of hybrid SPECT/CT in overcoming the limitation of conventional imaging and describes its potential application in the management of foot and ankle pain.

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Section: Nuclear Medicinementioning

confidence: 99%

Emerging role of bone scintigraphy single-photon emission computed tomography/computed tomography in foot pain management

Singh

Agrawal

Trıpathy

et al. 2023

Nuclear Medicine Communications

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“…107 Ligamente und 19 Muskeln und Sehnen auf engstem Raum vereint, welcher somit eine der komplexesten anatomischen muskuloskelettalen Regionen des Körpers darstellt. Es gibt zahlreiche Varianten wie akzessorische Knochen, Formabweichungen und Verschmelzungen von Fußwurzelknochen (Koalitionen) [ 5 , 14 ]. Unterschiedliche Zug- und Druckkräfte wirken bei jeder Bewegung dreidimensional auf die verschiedenen Knochen und Gelenke.…”

Section: Einleitung Und Hintergrundunclassified

“…Störungen in diesem komplexen Gefüge wie Arthrosen, Arthritiden, kongenitale Fehlbildungen, Osteoporose oder Diabetes, können zu chronischen Beschwerden führen, die für den behandelnden Arzt eine Herausforderung darstellen. Klassische radiologische Verfahren wie Röntgen, Sonographie, CT und MRT haben Grenzen in der Darstellung der Ursache für chronische Schmerzen [ 5 ]. Ein besonderes Problem besteht, wenn gleichzeitig verschiedene Pathologien vorliegen.…”

Section: Einleitung Und Hintergrundunclassified

Radiological-nuclear medicine hybrid diagnostics with SPECT/CT for chronic foot and ankle diseases

et al. 2023

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Zusammenfassung Hintergrund und Ziel der Arbeit Zahlreiche Erkrankungen des Fußes bzw. der Sprunggelenke können mithilfe der SPECT/CT (Single-Photon-Emmissions-Computertomographie/Computertomographie) im Hinblick auf ihre klinische Relevanz mit hoher Genauigkeit (bis > 90 %) diagnostiziert werden. Ziel dieser Übersichtsarbeit ist es, einen aktuellen Überblick über den Stellenwert der SPECT/CT bei ausgewählten Erkrankungen an Fuß- und Sprunggelenken zu geben, insbesondere in Abgrenzung zu MRT (Magnet-Resonanz-Tomographie), CT und Röntgen. Material und Methoden Es erfolgte einer Literaturrecherche in der Datenbank Pubmed mit folgenden Begriffen: SPECT/CT, SPECT, skeletal or bone scintigraphy, CT, computed tomography, foot‑, ankle disease, ankle, tarsal, foot pain. Die Arbeiten wurden im Hinblick auf häufig auftretende Fragestellungen und Diagnosen selektiert. Ausgewählt wurden Arbeiten, die aufgrund der Anwendung der SPECT/CT eine genauere Diagnose verglichen zu alternativen Verfahren mit Änderung der Therapie beschreiben. Ergebnisse In mehreren Studien wurde nachgewiesen, dass ein fokal erhöhter Knochenmetabolismus bei Arthrose und Osteochondrose signifikant mit der Schmerzentstehung korreliert. Die Präsenz von symptomatischen Ossikeln, wie zum Beispiel Os naviculare accessorium Typ II und Os trigonum, können mithilfe der SPECT/CT eindeutig nachgewiesen und mit keinem anderen bildgebenden Verfahren so treffsicher als Symptomquelle zugeordnet werden. Auch knöcherne Reaktionen im Bereich von Koalitionen, Arthrodesen, Osteosynthesen, okkulten Frakturen, Prothesen und beim diabetischen Fuß können mit keiner anderen bildgebenden Methode in vergleichbarer Genauigkeit nachgewiesen werden. Therapiekonzepte wurden bei unklaren Fällen, basierend auf Standardbildgebung inkl. MRT, durch die Zusatzinformation des SPECT/CT in bis zu zwei Drittel der Fälle geändert. Diskussion und Schlussfolgerung Der Nutzen der SPECT/CT ist gegeben, wenn klinisch Unsicherheiten trotz Standardbildgebung bestehen.

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“…Bone-SPECT/CT is an established problem-solving modality in patients with foot and ankle pathology, with high sensitivity for the detection of osteoblastic activity in various bone and joint diseases and with a generally high correlation of osteoblastic activity to pain complaints in many bones and joint disorders [15]. However, specific literature is still limited about findings on bone-SPECT/CT in patients with tarsal coalitions, with one specific case report that we are aware of [17], and the rest being more generalized overviews on foot and ankle pain, without specific focus on tarsal coalitions [15,[18][19][20] or with little consideration of molecular imaging [7,8,14]. The role of bone-SPECT/CT in tarsal coalitions has not yet been described in a review format in relation to other imaging techniques and clinical outcomes.…”

Section: Molecular and Multimodality Imaging In Tarsal Coalitionsmentioning

confidence: 99%

Review of the role of bone-SPECT/CT in tarsal coalitions

Bruggen

Geus‐Oei

Bosmans

et al. 2022

Nuclear Medicine Communications

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Tarsal coalition (TC) is a congenital abnormal connection (fibrous, cartilaginous, or osseous) between two or more bones in the hind and midfoot, mostly consisting of calcaneonavicular or talocalcaneal coalition, and is often asymptomatic. However, TCs may result in foot motion limitation and pain with or without flatfoot (pes planus), arising in adolescents and young adults. Appropriate imaging is needed to pinpoint foot pain in the (suspected) TC, starting with plain radiographs. Still, normal radiographs do not exclude TCs. Computed tomography (CT) and MRI are frequently used advanced imaging techniques. CT alone has known limited sensitivity in cartilaginous and fibrous TCs and correlation between CT abnormalities and pain may be challenging, as solely anatomical changes in TCs are often asymptomatic. MRI can depict soft tissue abnormalities in TC with high accuracy. Nonetheless, after the implantation of metallic osteosynthesis material, MRI is often limited due to image distortion, signal loss, and misregistration. Bone scintigraphy with [99mTc]Tc-diphosphonate single photon emission computed tomography/CT (bone-SPECT/CT) is a known sensitive tool to detect osteoblastic bone pathology. However, the literature concerning bone-SPECT/CT in TC patients is limited. This article reviews bone-SPECT/CT patterns in TCs, how it complements other imaging techniques and their relation to clinical complaints. Bone-SPECT/CT excels in accurate bone pathology characterization in TC, confidently excluding synchronous lesions elsewhere, and offering optimal insight into osseous structures and 3D-localization of bone metabolism for surgery planning. Furthermore, even with implanted osteosynthesis material, bone-SPECT/CT can pinpoint the culprit pain generator, where MRI is either contra-indicated or considerably hampered.

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The added value of SPECT/CT in the painful foot and ankle: A review of the literature

Cited by 12 publications

References 21 publications

Emerging role of bone scintigraphy single-photon emission computed tomography/computed tomography in foot pain management

Emerging role of bone scintigraphy single-photon emission computed tomography/computed tomography in foot pain management

Radiological-nuclear medicine hybrid diagnostics with SPECT/CT for chronic foot and ankle diseases

Review of the role of bone-SPECT/CT in tarsal coalitions

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