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Mol Imaging Radionucl Ther. 2019 Sep 6;28(3):89-95. doi: 10.4274/mirt.galenos.2019.20053.

Diagnostic Value of Bone SPECT/CT in Patients with Suspected Osteomyelitis

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1
University of Health Sciences, Ankara Numune Training and Research Hospital, Clinic of Nuclear Medicine, Ankara, Turkey

Abstract

in English, Turkish

Objectives:

The aim of our retrospective study was to evaluate the contribution of single photon emission computed tomography/computed tomography (SPECT/CT) to three phase bone scintigraphy/SPECT for the assessment of osteomyelitis (OM) and patient’s management.

Methods:

Eighty-five patients who were suspected as having OM were included in this study. Tc-99m MDP three phase bone scintigraphy and SPECT/CT were performed to the region of suspected OM. SPECT/CT findings were compared with the findings of planar images/SPECT. Both planar bone scan/SPECT and SPECT/CT findings were divided into two groups: With OM and without OM. In all patients, scintigraphic diagnosis was confirmed by clinical follow up, laboratory findings, microscopic-bacteriological examinations, radiological, surgical, and pathological findings.

Results:

SPECT/CT changed the diagnosis and treatment planning in 14/85 (16.5%) patients. SPECT/CT was significantly superior to planar scan/SPECT imaging for determining OM (kappa value was 0.626 for planar scan/SPECT, 0.929 for SPECT/CT). SPECT/CT was statistically more successful in detection of chronic OM, and useful in differentiating chronic OM from acute OM (kappa value was 0.541 for planar scan/SPECT, 0.944 for SPECT/CT).

Conclusion:

SPECT/CT increases accuracy of the diagnosis in the evaluation of OM when it is compared to three phase bone scintigraphy/SPECT. SPECT/CT can change the diagnosis and management of the patients.

KEYWORDS:

Bone scintigraphy; osteomyelitis; infection; SPECT; SPECT/CT

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