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

Abstract

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.

Extracellular Vesicles: A Potential Biomarker for Quick Identification of Infectious Osteomyelitis

“…However, as these biomarkers are non-specific inflammatory markers, it is difficult to distinguish infectious diseases from non-infectious inflammatory conditions. Image examinations such as magnetic resonance imaging and single-photon emission computed tomography/computed tomography can help distinguish the local bone inflammation from systematic inflammation and can refine the infection region clearly (Arican et al, 2019 ; Mejzlik et al, 2019 ), but their high costs and intricate operation process limit their application. Most importantly, all the tests aforementioned cannot determine the specific pathogenic bacteria to help choose sensitive antibiotics.…”

Incremental Value of Three-Phase Bone Scintigraphy and Single-Photon Emission Computed Tomography–Computed Tomography in a Case of Postpartum PUO in the Wake of The Antibiotic-Resistance Era

“…Arican et al . [ 15 ] in their retrospective study involving 85 patients with suspicion of OM evaluated the contribution of SPECT/CT to three-phase bone scintigraphy for the assessment of OM and patient's management. Their statistical analysis confirmed the superiority of SPECT/CT over planar scan in not only helping in the diagnosis and management of the study population but also differentiating acute from chronic OM.…”

ACR Appropriateness Criteria® Chronic Foot Pain

“…Planar bone scintigraphy has low anatomic resolution and has been shown to be a nonspecific technique to assess the hallucal sesamoids [24]. However, bone scintigraphy with single-photon emission computed tomography (SPECT)/CT increases contrast resolution and anatomic localization of foci with increased osteoblastic activity [25]. Bone scintigraphy may demonstrate increased uptake in pathologic conditions affecting the first metatarsal sesamoids not evident on radiographs.…”

“…When an indeterminate linear lucency is visualized on radiographs, a negative bone scintigraphy suggests sesamoid bipartition [12]. Other conditions that may present positive findings on Tc-99m-methylene diphosphonate (MDP) bone scintigraphy include sesamoiditis, inflammatory or deposition arthropathies, osteoarthritis, and osteonecrosis [25]. In Freiberg's infraction, a photopenic center with a hyperactive collar may be identified on early stages on high-resolution Tc-99m-MDP bone scintigraphy [27].…”