Diagnostic Value of Bone SPECT/CT in Patients with Suspected Osteomyelitis/Osteomiyelit Supheli Hastalarda Kemik SPECT/BT'nin Tanisal Degeri

• Published in: Molecular imaging and radionuclide therapy 2019-10, Vol.28 (3), p.89
• Main Authors: Arican, Pelin, Okudan, Berna, Sefizade, Riza, Naldoken, Seniha
• Format: Article
• Language: English
• Subjects: Comparative analysis; Diagnostic imaging; Osteomyelitis; Surgery; Tomography
• ISSN: 2146-1414
• DOI: 10.4274/mirt.galenos.2019.20053

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 Amac: Retrospektif calismamizda osteomiyelitin (OM) degerlendirilmesinde ve hasta yonetiminde tek foton emisyon bilgisayarli tomografi/bilgisayarli tomografi (SPECT/BT) uc fazli kemik sintigrafisi/SPECT'ye katkisi arastirildi. Yontem: OM'den suphelenilen 85 hasta calismaya dahil edildi. OM suphesi bulunan bolgeye Tc-99m MDP uc fazli kemik sintigrafisi ve SPECT/BT yapildi. SPECT/BT bulgulari planar goruntu/SPECT bulgulari ile karsilastirildi. Planar kemik sintigrafisi/SPECT ve SPECT/BT bulgulari iki gruba ayrildi: OM olmayanlar ve OM olanlar. Tum hastalarda sintigrafik tani, klinik takip, laboratuvar, mikroskobik-bakteriyolojik inceleme, radyoloji, cerrahi ve patoloji ile dogrulanmistir. Bulgular: SPECT/BT, 14/85 (%16,5) hastada tani ve tedavi planlamasini degistirdi. SPECT/BT, OM'nin belirlenmesinde planar goruntuler/SPECT goruntulemeye gore anlamli derecede ustun bulundu (kappa degeri planar tarama/SPECT icin 0,626, SPECT/BT icin 0,929). SPECT/BT, k