Nuclear Medicine Imaging in Rheumatic Diseases

Abstract

The rapid development of medical imaging technologies has greatly enhanced the utility of nuclear medicine imaging modalities over the last decade. Hybrid imaging technology merging computed tomography (CT) with single-photon emission computed tomography (SPECT) or positron emission tomography (PET) allows superimposing the physiologic data obtained by SPECT or PET on the detailed anatomy of CT, yielding a better understanding of the disease status and improving diagnostic performance. However, the conventional whole body bone scan and three phase bone scan still have their own distinct role as diagnostic imaging, reflecting the changes of bone metabolism in benign and malignant diseases, including rheumatic diseases. A review of each nuclear medicine imaging technique and clinical applications in various conditions of rheumatic diseases will be presented in this article. (J Rheum Dis 2017;24:4-13)

Bone Scan With SPECT/CT Demonstrated C1 to C2 Involvement in Rheumatic Arthritis

“… 15 Therefore, a bone scan is more sensitive in reflecting disease activity than clinical and radiographic evaluations. 16 For focal abnormal uptake lesions detected on a planar bone scan, SPECT/CT may improve the diagnostic accuracy and contribute to the understanding of disease status in rheumatic diseases. 16 Vertical subluxation is also known as cranial settling, basilar impression, atlantoaxial impaction, and superior migration of the odontoid.…”

“… 16 For focal abnormal uptake lesions detected on a planar bone scan, SPECT/CT may improve the diagnostic accuracy and contribute to the understanding of disease status in rheumatic diseases. 16 Vertical subluxation is also known as cranial settling, basilar impression, atlantoaxial impaction, and superior migration of the odontoid. 12 In the sagittal plane, the Clark station criterion divides the odontoid process into 3 equal parts, “stations,” and determines the level at which the anterior arch of C1 falls.…”

“…Advantages of bone scan for evaluating multiple joint problems include its high sensitivity, good accessibility, low cost, and the possibility of whole-body imaging 15 . Therefore, a bone scan is more sensitive in reflecting disease activity than clinical and radiographic evaluations 16 . For focal abnormal uptake lesions detected on a planar bone scan, SPECT/CT may improve the diagnostic accuracy and contribute to the understanding of disease status in rheumatic diseases 16 .…”