SPECT-CT in total hip arthroplasty

Tam, H.H.; Bhaludin, Basrull; Rahman, Farzana; Weller, Alex; Ejindu, Vivian; Parthipun, Arum

doi:10.1016/j.crad.2013.08.003

Cited by 72 publications

(51 citation statements)

References 73 publications

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“…The Gruen classification is already widely used for assessment of periprosthetic radiolucencies, hence it was decided to adapt this scheme to the biomechanics of the hip reflecting bone remodeling and integration of the prosthetic hip components. It has also been used by others to report BTU findings in SPECT/CT [26, 32]. …”

Section: Discussionmentioning

confidence: 99%

Evaluation of patients with painful total hip arthroplasty using combined single photon emission tomography and conventional computerized tomography (SPECT/CT) – a comparison of semi-quantitative versus 3D volumetric quantitative measurements

Barthassat¹,

Afifi²,

Konala³

et al. 2017

BMC Med Imaging

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BackgroundIt was the primary purpose of our study to evaluate the inter- and intra-observer reliability of a standardized SPECT/CT algorithm for evaluating patients with painful primary total hip arthroplasty (THA). The secondary purpose was a comparison of semi-quantitative and 3D volumetric quantification method for assessment of bone tracer uptake (BTU) in those patients.MethodsA novel SPECT/CT localization scheme consisting of 14 femoral and 4 acetabular regions on standardized axial and coronal slices was introduced and evaluated in terms of inter- and intra-observer reliability in 37 consecutive patients with hip pain after THA. BTU for each anatomical region was assessed semi-quantitatively using a color-coded Likert type scale (0-10) and volumetrically quantified using a validated software. Two observers interpreted the SPECT/CT findings in all patients two times with six weeks interval between interpretations in random order. Semi-quantitative and quantitative measurements were compared in terms of reliability. In addition, the values were correlated using Pearson`s correlation. A factorial cluster analysis of BTU was performed to identify clinically relevant regions, which should be grouped and analysed together.ResultsThe localization scheme showed high inter- and intra-observer reliabilities for all femoral and acetabular regions independent of the measurement method used (semiquantitative versus 3D volumetric quantitative measurements). A high to moderate correlation between both measurement methods was shown for the distal femur, the proximal femur and the acetabular cup. The factorial cluster analysis showed that the anatomical regions might be summarized into three distinct anatomical regions. These were the proximal femur, the distal femur and the acetabular cup region.ConclusionsThe SPECT/CT algorithm for assessment of patients with pain after THA is highly reliable independent from the measurement method used. Three clinically relevant anatomical regions (proximal femoral, distal femoral, acetabular) were identified.

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Section: Discussionmentioning

confidence: 99%

Evaluation of patients with painful total hip arthroplasty using combined single photon emission tomography and conventional computerized tomography (SPECT/CT) – a comparison of semi-quantitative versus 3D volumetric quantitative measurements

Barthassat¹,

Afifi²,

Konala³

et al. 2017

BMC Med Imaging

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“…Although SPECT and SPECT/CT are now standard techniques in bone scintigraphy, as of early 2014, we could not locate any extensive data on the normal range of osteoblastic activity surrounding THA on SPECT. A review of SPECT/CT in THA published in 2014 [2] concluded that 'presently there is no specific literature describing the natural evolution of post-THA tracer uptake using SPECT-CT'. Of note, however, is a study [5] that measured SPECT activity ratios around 18 normal femoral stems and compared it with bone mineral density in the same locations.…”

Section: Introductionmentioning

confidence: 98%

“…Other established cross-sectional imaging methods, stand-alone computed tomography (CT) and MRI, provide structural-only information and are often limited by significant metalrelated artefact [2]. Elevation of osteoblastic activity is often the earliest indicator of prosthetic failure or complication, such as periprosthetic fracture, loosening, infection, heterotopic bone activity, and stress response to abnormal weight force transfer or to metal-bone stiffness mismatch.…”

Section: Introductionmentioning

confidence: 99%

Normal range of osteoblastic activity in total hip arthroplasties on single-photon emission computed tomography bone scintigraphy

Jin

Boktor

Man

et al. 2016

Nuclear Medicine Communications

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Measured activity ratios that fall within our normal range are likely to represent normal periprosthetic osteoblastic activity. Measured activity ratios that fall above the upper cut-offs of our normal range are likely to be abnormal. The cut-offs are robust in clinical practice and have utility in discriminating normal from abnormal stabilized arthroplasties where visual interpretation is ambiguous. Elevated AC/RA under 12 months and FC/RF under 24 months may represent normal periprosthetic activity and should be interpreted with caution.

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“…Several studies have demonstrated positive results in utilizing SPECT-CT in infection diagnostics, given the improvement in localization and defining the extent of disease. Based on current knowledge, it is supposed that the CT component increases sensitivity by accurately localizing the anatomical site of infection due to the detection of morphologic abnormalities that are parallel to sites of increased activity [41]. For example, Filippi et al [42] improved the accuracy of 99m Tc-labeled leukocyte scintigraphy from 64% to 100%.…”

Section: Originalmentioning

confidence: 99%

A retrospective analysis of the accuracy of radioactively labeled autologous leukocytes in patients with infected prosthetic joints

et al. 2017

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SPECT-CT in total hip arthroplasty

Cited by 72 publications

References 73 publications

Evaluation of patients with painful total hip arthroplasty using combined single photon emission tomography and conventional computerized tomography (SPECT/CT) – a comparison of semi-quantitative versus 3D volumetric quantitative measurements

Evaluation of patients with painful total hip arthroplasty using combined single photon emission tomography and conventional computerized tomography (SPECT/CT) – a comparison of semi-quantitative versus 3D volumetric quantitative measurements

Normal range of osteoblastic activity in total hip arthroplasties on single-photon emission computed tomography bone scintigraphy

A retrospective analysis of the accuracy of radioactively labeled autologous leukocytes in patients with infected prosthetic joints

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