J Nucl Med. 2007; 48 (Supplement 2):122P
General Clinical Specialties: Musculoskeletal
SPECT and SPECT/CT |
SPECT-CT in the assessment of bony foot pathology
Babak Langroudi1,
Hosahalli Mohan1,
Gopinath Gnanasegaran1,
Kathryn Adamson1,
Audrey Taylor1,
Martin Klinke2,
Susan Clarke1 and
Ignac Fogelman1
1 Department of Nuclear Medicine; ;
2 Orthopaedics, Guy's Hospital, London, United Kingdom
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Objectives: Accurate localisation of pathology in the foot is limited by its relatively complex anatomy. Although 99mTc-MDP bone scintigraphy provides functional information it is often difficult to localise the site of the abnormality in the foot accurately. The advent of hybrid SPECT-CT systems may provide better localisation of the site and also detect additional coexistent pathology. The aim of this study was to assess the additional value of SPECT-CT compared to conventional planar 2 phase bone scan when evaluating patients with foot abnormalities such as infection, inflammatory and degenerative change. Methods: 16 patients (10 Female, 6 Male, and mean age 45.6 years) with a variety of symptoms affecting the foot were referred from specialist orthopaedic clinic. All patients underwent 99mTc-MDP bone scintigraphy and SPECT-CT using a Philips Precedence SPECT-CT system, which were reported independently. The results of the 2 studies were then compared. Results: SPECT-CT provided additional information in 13(81%) of the 16 patients, but was not helpful in 3(19%) cases. A specific diagnosis was made in 6/13(46%) patients which included mal-union, osteochondral defect, osteomyelitis and inflammatory arthritis. More accurate localisation of degenerative or post surgical changes was observed in the remaining 7 patients. Conclusions: When compared to conventional bone scintigraphy, SPECT-CT provides more specific information as well as allowing more accurate localisation of the abnormalities detected, thus proving superior in the assessment of bony foot pathology.
