Bone Scintigraphy: A Review of Technical Aspects and Applications in Orthopedic Surgery

Krumme, John; Lauer, M.; Stowell, Justin T; Beteselassie, Nebiyu M; Kotwal, Suhel

doi:10.3928/01477447-20181120-05

Cited by 12 publications

(6 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 22 23 ] Even in the diagnosis of occult lesions, a bone scan with SPECT/CT is very helpful. [ 24 ] Krumme et al [ 25 ] in their study concluded that bone scan is an “underused tool” in the evaluation and management of orthopedic patients including those presenting with IFs and the authors concur with that.…”

Section: Discussionmentioning

confidence: 88%

Technetium-99m methylene diphosphonate bone scan in evaluation of insufficiency fractures – A pictorial assay and experience from South India

et al. 2021

View full text Add to dashboard Cite

Insufficiency fractures (IFs) can be challenging to diagnose due to varied presentations, and sometimes, it changes the course of treatment, as in cancer patients in whom it has to be differentiated with metastatic disease. We present the role of Technetium 99m methylene diphosphonate ( 99m Tc-MDP) bone scan, which is a low-cost, simple to perform, whole body diagnostic investigation in the diagnosis of IFs. This is a retrospective analysis of all patients who underwent a 99m Tc-MDP bone scan in a tertiary care teaching hospital during 2013–2017 and were diagnosed as having an IF on bone scan. The bone scans were performed on a dual-head gamma camera using low-energy high-resolution collimators. Of all the bone scan performed during 2013–2017, a total of 138 patients with a mean age of 57.5 ± 14.7 years were diagnosed as having IFs based on bone scan and final clinical diagnosis. Among them, the most common complaint was regional bony pain in 62% of patients, while the most common cause was osteoporosis in 47% of patients, both postmenopausal and senile osteoporosis. In all, 265 sites of fractures were identified with a fracture average of 1.9/patient, the most common site being dorsolumbar vertebrae, followed by ribs and lower limb bones. Many unusual sites were also identified such as talus, sternum, clavicle, and scapula. 99m Tc-MDP bone scan, being noninvasive whole-body imaging, is a useful investigation for evaluation of IFs and in correlation with biochemical analysis and other imaging can be used to determine the etiology of IF.

show abstract

Section: Discussionmentioning

confidence: 88%

Technetium-99m methylene diphosphonate bone scan in evaluation of insufficiency fractures – A pictorial assay and experience from South India

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In 99m Tc-MDP bone scintigraphy, the tracer uptake reflects the vascular supply of bone and the living network of osteocytes; thus, it was originally used to assess the properties of primary bone lesions 24 . Bone metastasis, recurrence, and postoperative complications of the bone, including infection, fracture, or nonunion, can also be detected by 99m Tc-MDP bone scintigraphy 25 . In addition, bone scintigraphy can be used to evaluate the viability of devitalized bone, because it is more sensitive for monitoring the revascularization and revitalization process, in comparison to roentgenography, CT, and MRI, especially in cases with ferromagnetic effects due to the use of composite implants 24 .…”

Section: Textmentioning

confidence: 99%

“…24 Bone metastasis, recurrence, and postoperative complications of the bone, including infection, fracture, or nonunion, can also be detected by 99m Tc-MDP bone scintigraphy. 25 In addition, bone scintigraphy can be used to evaluate the viability of devitalized bone, because it is more sensitive for monitoring the revascularization and revitalization process, in comparison to roentgenography, CT, and MRI, especially in cases with ferromagnetic effects due to the use of composite implants. 24 The postoperative course of incorporation and revascularization of pasteurized autografts, as well as extracorporeally irradiated autografts, has also been evaluated by bone scintigraphy.…”

Section: Textmentioning

confidence: 99%

A Viability Analysis of Tumor-Bearing Frozen Autograft for the Reconstruction After Resection of Malignant Bone Tumors Using 99mTc-MDP Scintigraphy

et al. 2022

View full text Add to dashboard Cite

Purpose of the Report: Several methods are used to reconstruct bony defects after malignant tumor excision. Tumor-bearing frozen autograft reconstruction is a biological procedure in which tumor-bearing bone is reused after devitalization with liquid nitrogen to kill tumor cells. The viability of frozen autografts has not been fully evaluated over time. We therefore aimed to evaluate the viability of devitalized bone grafts, using 99m Tc-MDP scintigraphy. Patients and Methods: Seventy-four patients who underwent frozen autograft reconstruction after the excision of a malignant bone tumor were enrolled. Two hundred forty-two postoperative 99m Tc-MDP scans were reviewed. For a quantitative analysis, the region of interest on the frozen bone segment and a symmetric region of interest on the contralateral normal area were manually set. The radioactive tracer uptake ratio was calculated by dividing the count density of the frozen bone segment by that of the contralateral normal area in each image. An uptake ratio of 0.9 to 1.1 was defined as a normalization of tracer uptake. Results: Normalization of tracer uptake was achieved in 95% to 97% of the cases by 60 months postoperatively, and earlier in the middle zone and peripheral zone in the pedicle freezing group in comparison to the free freezing group (both P = 0.03). Fracture and nonunion was associated with a low uptake ratio, whereas infection was associated with a high uptake ratio before the occurrence of the event.Conclusions: The calculation of the uptake ratio using 99m Tc-MDP scans was an objective and accurate evaluation method. The period to normalization of tracer uptake in the pedicle frozen bone was significantly earlier than that in the free frozen bone. The postoperative complications can be also predicted.

show abstract

“…Gallium 67 scintigraphy has higher specificity than does triple-phase bone scanning. Thus, these two examinations are often combined (5). Labeled leukocyte scintigraphy and fluorine 18 fluorodeoxyglucose PET/CT may be used to successfully diagnose spinal infection.…”

Section: Imagingmodalitiesmentioning

confidence: 99%

Postoperative Spinal CT: What the Radiologist Needs to Know

Ghodasara

Clark

et al. 2019

RadioGraphics

View full text Add to dashboard Cite

During the past 2 decades, the number of spinal surgeries performed annually has been steadily increasing, and these procedures are being accompanied by a growing number of postoperative imaging studies to interpret. CT is accurate for identifying the location and integrity of implants, assessing the success of decompression and intervertebral arthrodesis procedures, and detecting and characterizing related complications. Although postoperative spinal CT is often limited owing to artifacts caused by metallic implants, parameter optimization and advanced metal artifact reduction techniques, including iterative reconstruction and monoenergetic extrapolation methods, can be used to reduce metal artifact severity and improve image quality substantially. Commonly used and recently available spinal implants and prostheses include screws and wires, static and extendable rods, bone grafts and biologic materials, interbody cages, and intervertebral disk prostheses. CT assessment and the spectrum of complications that can occur after spinal surgery and intervertebral arthroplasty include those related to the position and integrity of implants and prostheses, adjacent segment degeneration, collections, fistulas, pseudomeningoceles, cerebrospinal fluid leaks, and surgical site infections. Knowledge of the numerous spinal surgery techniques and devices aids in differentiating expected postoperative findings from complications. The various types of spinal surgery instrumentation and commonly used spinal implants are reviewed. The authors also describe and illustrate normal postoperative spine findings, signs of successful surgery, and the broad spectrum of postoperative complications that can aid radiologists in generating reports that address issues that the surgeon needs to know for optimal patient management.©RSNA, 2019.

show abstract

Bone Scintigraphy: A Review of Technical Aspects and Applications in Orthopedic Surgery

Cited by 12 publications

References 81 publications

Technetium-99m methylene diphosphonate bone scan in evaluation of insufficiency fractures – A pictorial assay and experience from South India

Technetium-99m methylene diphosphonate bone scan in evaluation of insufficiency fractures – A pictorial assay and experience from South India

A Viability Analysis of Tumor-Bearing Frozen Autograft for the Reconstruction After Resection of Malignant Bone Tumors Using 99mTc-MDP Scintigraphy

Postoperative Spinal CT: What the Radiologist Needs to Know

Contact Info

Product

Resources

About