Use of Gamma Correction Pinhole Bone Scans in Trauma

Abstract

99m Tc-hydroxydiphosphonate (HDP) bone scanning is a classic metabolic nuclear imaging method and the most frequently performed examination. Clinically, it has long been cherished as an indispensable diagnostic screening tool and for monitoring of patients with bone, joint, and soft tissue diseases. The HDP bone scan, the pinhole scan in particular, is known for its ability to detect increased, decreased, or defective tracer uptake along with magnified anatomy. Unfortunately, however, the findings of such uptake changes are not specific in many traumatic bone disorders, especially when lesions are minute and complex. This study discusses the recently introduced gamma correction pinhole bone scan (GCPBS), emphasizing its usefulness in the diagnosis of traumatic bone diseases including occult fractures; cervical sprains; whiplash injury; bone marrow edema; trabecular microfractures; evident, gaping, and stress fractures; and fish vertebra. Indeed, GCPBS can remarkably enhance the diagnostic feasibility of HDP pinhole bone scans by refining the topography, pathologic anatomy, and altered chemical profile of the traumatic diseases in question.The fine and precise depiction of anatomic and metabolic changes in these diseases has been shown to be unique to GCPBS, and they are not appreciated on conventional radiographs, multiple detector CT, or ultrasonographs. It is true that MR imaging can portray proton change, but understandably, it is a manifestation that is common to any bone disease.

Pixelized Measurement of 99mTc-HDP Micro Particles Formed in Gamma Correction Phantom Pinhole Scan: a Reference Study

“…With the recent development of gamma correction pinhole scan (GCPS), many common bone diseases are now diagnosed at the dimension of trabeculae. They include occult fracture [1], trabecular mircofracture [2], and stress fracture, infection, and tumor [3]. To our knowledge, however, a mathematical method for the size quantification of such microscopic 99m Tc-HDP uptake has not been published.…”

“…The aim was to set up an in-vitro model of the size measurement of microscopic 99m Tc-HDP uptake that can be used clinically in in-vivo 99m Tc-HDP bone scan. Thus, the objectives of this study were first to secure the reliable source of microscopic 99m Tc-HDP deposits for micrometric measurement using standard flood phantom and handy small dish phantom; second, to demonstrate individual deposits with high 99m Tc-HDP radioactivity by GCPS [1,2]; and third, to mathematically calculate their size by pixelized measurement [4,5]. Microscopic 99m Tc-HDP deposits were easily formed in both large standard and small house-made dish phantoms, readily processed by GCPS and precisely calculated.…”