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Imaging in a 79-year-old patient with osteoporotic compression fractures of the spine. a – c CT ( a ), SPECT/CT volume-rendered ( b ) and SPECT/CT ( c ) images obtained 14 days after percutaneous balloon kyphoplasty of Th5 – 7. Kyphoplasties of Th11, L3 and L4 are older than 1 year and do not show signal enhancement. The Th8 endplate is clearly
Source publication
Injuries of the axial skeleton are an important field of work within orthopaedic surgery and traumatology. Most lesions following trauma may be diagnosed by means of conventional plain radiography, computed tomography or magnetic resonance imaging. However, for some aspects SPECT/ CT can be helpful even in a trauma setting. In particular, the combi...
Contexts in source publication
Context 1
... patients report persistent pain following treatment of degenerative or traumatic afflictions of the spine and pelvis with consecutive iliosacral arthrodesis or dorsal spine instrumentation and fusion. Studies have shown that up to 14 % of patients with spinal implants may require an additional operation within 4 years due to persistent pain [58]. Because the results of such a reoperation are inferior to those of a primary operation, the indication must be well-founded [59]. Important questions to be answered by the chosen imaging technique include loosening of pedicle screws, instability of the instrumentation, non-union of spondylodesis, low-grade infection and finally evidence of epifusional and subfusional degeneration. With this knowledge, a well-founded judge- ment can be made as to whether a patient might profit from an additional operation or whether conservative treatment is the better choice. Furthermore, the type of operation can be better planned. As mentioned above, in the postoperative setting following spinal instrumentation, MRI has a much lower diagnostic value in the presence of metal artefacts. When evaluating osseous consolidation or active degenerative changes, SPECT/CT again shows better sensitivity and specificity than CT ( Fig. 4) [60, 61]. Radiological documentation of spinal fusion is usually possible after 6 – 9 months on conventional radiographs or CT scans. However, complete healing may be expected only after 2 years. With the help of nuclear medicine, suspected pseudoarthrosis can be visualized through increased tracer uptake as early as 1 year postoperatively [56, 60]. This in turn may explain persistent pain and warrant additional surgical interventions. Usually a consistent decrease in tracer uptake is recorded beginning within the third postoperative month [61], with the total tracer accumulation being dependent on general bone metabolism. As well as increased tracer uptake within the field of operation in pseudoarthrosis, implant loosening and infection may be detected (Fig. 5). Adjacent segments may show increased uptake as well, as in the presence of epi- or subfusional degeneration with (erosive) osteochondrosis [61]. Whether there is also a signal increase in adjacent segments following percutaneous procedures such as kyphoplasty still remains undetermined (Fig. 3). This would be of great value when estimating the risk of adjacent segment fractures which can consistently be found in a substantial number of patients [62, 63]. Posttraumatic osteonecrosis of the femoral head may occur in up to 14 % of patients with impacted, nondisplaced femoral neck fractures and 50 % of patients following a displaced fracture [64]. SPECT/CT may be helpful in such cases as sensitivity is superior even to that of MRI [65]. Visible changes on CT or MRI due to infection are usually evident only during a late stage and are rather nonspecific in nature. Furthermore, the presence of implant-associated artefacts may lead to a substantial deterioration in image quality. Compared to other nuclear medicine techniques, SPECT/CT not only allows the detection of infection but also its exact location, and is thus of great value in implant-associated infections [66]. The sensitivity and specificity are dependent on the radiopharmaceutical agent used. For this purpose, dicarboxypropandiphosphonate (DPD) scintigraphy combined with radioactively marked leucocytes is considered the gold standard [66]. Antigranulocyte scintigraphy is more pop- ular in Europe and has been proven to be of equal value [67]. Depending on the body region, sensitivity and specificity may vary. This is why FDG PET/CT is currently still considered the standard for diagnosing infections of the spine, but SPECT/CT is superior to PET/CT or MRI for imaging an infection of an extremity [68, 69]. It is also highly sensitive for detection of osteomyelitis and has a higher specificity than planar nuclear medicine techniques [69, 70]. Since a detailed anatomical correlation is possible, it is also helpful in differentiating between osteomyelitis and soft tissue infections [71]. The combination of highly sensitive but nonspecific scintigraphy and nonsensitive but highly specific CT can be very helpful in a trauma setting. Compared to planar scintigraphy, additional insight is possible as anatomical and pathomorphological findings are coupled with metabolic information. This is especially important in anatomically complex regions such as the pelvis and spine [23, 24, ...
Context 2
... spondylolysis, which results from a fractured pars interarticularis of the vertebral body, is frequently not visible on conventional radiographs [29]. Further, CT of the lumbar spine is not sensitive for detecting early acute stress reactions in the pars interarticularis [30, 31]. This lesion is believed to be caused by repetitive axial loading in combination with hyperextension movements of the spine. The resulting increased metabolic turnover in the affected region of the bone can be made visible by SPECT. The sensitivity and specificity are therefore superior even to those of MRI [29]. The lesion can readily be anatomically localized when combined with CT: SPECT/CT [29, 32]. Additionally, acute injuries can be differentiated from chronic injuries [32] and inflammatory changes from degenerative changes. This distinction is of additional value in osteoporotic compression fractures of the spine (Fig. 3). Conventional radiographs as well as CT scans of the spine often reveal multiple spinal deformities such as compression fractures in elderly patients. Since the tracer accumulates in the region of a fresh fracture, SPECT/CT can aid in distinguishing between fresh and old lesions. To assess fracture age it is necessary to acquire three scintigraphic phases normally as spot images (flow , blood-pool and late phases). Further, SPECT/CT of the suspected fracture region is performed to evaluate morpho- logical as well as metabolic changes. During the first 4 weeks after trauma the fracture shows diffuse tracer uptake during the flow and blood-pool phases. During the following 8 weeks the activity is more focused on the late phase images, while activity in flow and blood-pool phase images decreases. Usually, normalization in the flow and blood-pool phases can be observed after 6 months. A decrease in the late phase is visible after 3 – 18 months, and sometimes uptake persists for years. As well as diagnostic benefits, this information is of value when choosing a suitable treatment. For example, many patients with osteoporotic compression fractures of the spine may experience pain reduction following a stabilization pro- cedure such as percutaneous kyphoplasty of a fresh fracture [33 – 36]. In this context, it is crucial that the fracture is not older than 6 weeks, since a reduced therapeutic benefit has been demonstrated when operatively treating such a fracture beyond this time [37, 38]. Information concerning the approx- imate age of the fracture may be obtained either using the short tau inversion recovery sequence (STIR) in MRI or by assessing tracer uptake on SPECT/CT. This makes estimation of the benefit of a planned surgical intervention possible [39, 40]. A clear advantage for SPECT/CT imaging compared to conventional SPECT has been demonstrated as SPECT/CT has shown additional information in 62.5 % of patients [40]. Furthermore, SPECT/CT allows a precise differentiation between malignant and benign compression fractures, which is of key importance in therapy and prognosis [41]. These two entities are usually distinguished using MRI [42]. Compression fractures result in lesions within the bone mar- row which lead to minor signal intensity changes on the T1- weighted sequences and a high signal intensity on the STIR sequence. This however may cause difficulties in distinguishing between malignant and benign processes [43]. Furthermore, MRI is not an option in patients suffering from claustrophobia or patients with a cardiac pacemaker, which is why other equivalent diagnostic methods are necessary. SPECT/CT may be a valuable alternative with proven equal sensitivity and specificity to MRI ...
Similar publications
Objective:
The incidence of pelvic fractures is relatively low compared with other fracture locations. The low incidence is in great contrast to the high morbidity and mortality. Particularly in the elderly, with apparently isolated fractures of the pubic rami, these observations are believed to be due to additional occult lesions of the posterior...
Citations
... Meanwhile, SPECT-CT was reported to be effective in identifying the source of back pain in 92% of cervical spine scans and 86% of lumbar spine scans and in predicting treatment response in chronic LBP 5,12 . Several cases have also reported either the early detection of other spinal lesions or identification of chronic, subtle pathologies through SPECT-CT 13,14,15 . Our case findings are consistent with a previous Canadian case reported by Carstensen and colleagues, in which lumbar facet arthropathy was evident on plain radiographs but was confirmed only through SPECT-CT 16 . ...
Lower back pain (LBP) is a global health concern with increasing prevalence, projected to reach 843 million cases by 2050. Lumbar facet joint (LFJ) syndrome contributes significantly to LBP, impacting patient quality of life. Despite its prevalence, a gold standard for accurate and noninvasive diagnosis of LBP has not yet been established, leading to underdiagnosis and inadequate treatment. This case report presents a 57-year-old woman diagnosed with LFJ syndrome and mild sacroiliitis through single-photon emission computed tomography- computed tomography (SPECT-CT) and quantitative sacroiliac scintigraphy (QSS). The patient presented with persistent LBP and hip pain without history of trauma or surgery. Clinical examination revealed lumbar tenderness, limited mobility, and positive Fortin and STORK tests. Whole body bone scan (WBBS) revealed tracer uptake at the sacroiliac (SI) joints and multiple spinal levels, particularly L3-L4. Hybrid SPECT-CT imaging showed heightened bone activity on lumbar spine, confirming degenerative arthropathy of the L3-L4 facet joints, in contrast with minimal evidence obtained from plain radiography and CT images. Furthermore, combining results from SPECT-CT and borderline sacroiliac indices from QSS indicate the presence of chronic degenerative sacroiliitis. Identifying the source of LBP remains challenging. SPECT-CT emerges as a valuable tool for comprehensive evaluation of LBP by combining anatomical and functional imaging of target tissues, allowing increased foci localization and accuracy of diagnosis. QSS can also be utilized as a complement in identifying the presence of chronic lesions of the SI joints. These promising results open opportunities for more research on the efficacy of combined morphological and functional imaging, as well as sacroiliac indices as a complementary diagnostic tool.
... Its main indication is the diagnosis of occult fractures in posterior vertebral elements such as in the pars interarticularis (traumatic spondylolysis), the vertebral body or pelvic ring. 7,8 The increase in osteogenic activity in a scintigraphic study allows the diagnosis of a fracture within 72 h post-traumatism, with pathological images within a few hours. The scintigraphic appearance of these fractures is directly related to the state of curation and depends on the size and localization. ...
... It has been described that SPECT/CT is able to identify potential foci of pain with a sensitivity of 92% in the cervical column and of 86% in the lumbar spine. 8,11 Pain in the interscapular region is difficult to assess, especially after minor traumatisms, with SPECT/CT being useful to detect fractures (in vertebrae and/or posterolateral elements) and differentiate degenerative alterations in costovertebral and interapophyseal joints in individuals with thoracic pain which is unexplained or non diagnosed by other imaging modalities such as MR or CT. 11 ...
Clinical problems in the human spine are still common in our society, often causing pain and can also limit movement. Back pain is a very common clinical entity, although difficult to diagnose due to its multifactorial nature. There are multiple processes that can alter the structure of the spine, injure vertebrae and/or the surrounding tissue. For the study of the spine, image diagnosis is essential, and within this, molecular hybrid techniques play an important role by providing us with an image of functional and morphological fusion. Among these, SPECT/CT is key in the diagnosis of traumatic and stress pathology, allowing us to locate hidden vertebral fractures, and is also very useful in degenerative and post-surgical pathology. On the other hand, PET/CT with 18F-FDG also plays an important role in the management and monitoring of infectious and oncological processes. This review describes the application of these hybrid techniques in the different pathologies of the spine and the findings of their images, being very useful for the diagnostic assessment and therapeutic management of the patient.
... La mayoría de las lesiones óseas tras un traumatismo pueden diagnosticarse mediante técnicas morfológicas y, aunque las técnicas de MN todavía juegan un papel menor en el proceso diagnóstico postraumático inmediato, la GO siempre con SPECT y en especial el SPECT/TC ha ganado terreno en los últimos años en columna vertebral y pelvis. Su principal indicación es el diagnóstico de fracturas ocultas en elementos posteriores vertebrales como en la pars interarticularis (espondilolisis traumática), el cuerpo vertebral o el anillo pélvico 7,8 . El aumento de la actividad osteogénica en el estudio gammagráfico permite un diagnóstico de la fractura dentro de las 72 h postraumatismo, con imágenes patológicas desde las pocas horas. ...
... La SPECT/TC ha revolucionado la imagen de la columna cervical ya que permite definir un patrón de captación normal, pudiendo tanto identificar la causa de dolor postraumático cervical agudo con una localización precisa del foco hipercaptante, como diferenciar esta lesión de una enfermedad articular degenerativa en articulaciones cigapofisarias y uncovertebrales. Se ha descrito que la SPECT/TC identifica focos potenciales de dolor con una sensibilidad del 92% en columna cervical y del 86% lumbar 8,11 . El dolor en la región interescapular es de difícil valoración, particularmente después de traumatismos menores, siendo la SPECT/TC útil para detectar fracturas (en vértebra y/o elementos posterolaterales) y diferenciarlas de alteraciones degenerativas en articulaciones costovertebrales e interapofisarias en dolores torácicos inexplicados o no diagnosticados por otras modalidades de imagen como RM o TC 11 . ...
Resumen
Los problemas clínicos en la columna vertebral humana siguen siendo frecuentes en nuestra sociedad, con frecuencia provocan dolor y también pueden limitar los movimientos. El dolor de espalda es una entidad clínica muy común, aunque difícil de diagnosticar debido a su naturaleza multifactorial. Existen múltiples procesos que pueden alterar la estructura de la columna, lesionar vértebras y/o el tejido que las rodea. Para el estudio de la columna vertebral, es imprescindible el diagnóstico por imagen y dentro de este las técnicas híbridas moleculares, ya que juegan un papel importante proporcionándonos una imagen de fusión funcional y morfológica, entre ellas, la SPECT/TC es clave en el diagnóstico de la patología traumática y de estrés permitiendo localizar fracturas vertebrales ocultas, también resulta de gran utilidad en la patología degenerativa y postquirúrgica. Por otro, lado la PET/TC con ¹⁸F-FDG también juega un papel importante en el manejo y monitorización sobretodo de procesos infecciosos y oncológicos. En esta revisión se describe la aplicación de estas técnicas híbridas en las diferentes patologías de la columna vertebral y los hallazgos de sus imágenes, siendo de gran utilidad para la valoración diagnóstica y el manejo terapéutico del paciente.
... Schließlich gewinnen knochenszintigraphische Untersuchungstechniken einschließlich SPECT (Single-Photon Emission Computed Tomography) bei der FFP-Detektion an Bedeutung, weil reparative Knochenumbauproprozesse (und damit auch die szintigraphisch nachweisbare Osteoblastenaktivität) bereits sehr früh im Insuffizienzfrakturgeschehen einsetzen [65]. Damit sind diese Radionuklidmethoden nicht nur sehr sensitiv, sondern ermöglichen auch die Erkennung multifokaler Insuffizienzfrakturen innerhalb und außerhalb des knöchernen Beckens [66]. ...
Epidemiology:
Traumatic fractures of the pelvic ring are relatively rare, but are associated with increased risk of mortality. Depending on injury mechanism and main vector of energy impact, a distinction is made between anteroposterior compression, lateral compression, and vertical shear (Young and Burgess classification), while the stability-related classification according to Tile distinguishes between type A (stable), type B (rotationally unstable) and type C (completely unstable). A comprehensive modern classification is given by the AO/OTA.
Radiological fracture diagnosis:
Plain pelvis x‑rays lack sufficient sensitivity but are still used to detect highly unstable pelvic fractures. CT has superior sensitivity and specificity. In addition to fracture classification, CT allows reliable assessment of associated vascular and bladder/urethral injuries and large soft tissue hemorrhage. MRI is unparalleled in showing bone marrow edema, cauda and plexus complications, and peripelvic soft tissue damage. MRI may also prove to be a valuable diagnostic tool for pelvic ring injuries in children, adolescents and young women, provided they are hemodynamically stable. Angiography, ultrasonography and bone scintigraphy are additional important diagnostic and therapeutic options.
Practical recommendations:
Knowledge of basic pelvic trauma mechanisms is important to understand the potential severity of traumatic pelvic fractures and to classify them correctly in terms of stability. Being familiar with typical concomitant injuries in pelvic ring fractures allows reliable diagnosis and their communication with the clinician. CT remains the "diagnostic workhorse". In fragile pelvic fractures, the often prolonged course with fracture progression must be taken into account, which is why MRI is of particular importance herein.
... 36,37 It has also proven value as a problem-solving tool applied to investigating a multitude of other disorders such as bone pain, heterotopic ossification, osteoid osteoma, diabetic foot infections, extraosseous radiotracer uptake, and also in the evaluation of musculotendinous sport injuries and orthopedic conditions. [38][39][40][41] In frostbite-related injuries the tips of the distal phalanges of the hand and feet are challenging to assess with conventional bone scintigraphy due to limited spatial resolution and overall juxtaposition of the phalanges, metacarpal/metatarsal, and carpal/tarsal bones. SPECT/CT provides important anatomic information allowing the interpreter to precisely distinguish the margin of viable and non-viable bone to aid in surgical planning ( Figure 2). ...
Objective::
Frostbite is a localized cold-thermal injury resulting from prolonged exposure of flesh to freezing and near freezing temperatures. The depth and extent of frostbite injuries are not easily assessed, from a clinical standpoint, at the time of injury making it challenging to plan appropriate management and treatment.
Methods::
A review of the literature of management of cold-related injuries and retrospective case review of the imaging and clinical course of frostbite injury.
Results::
Bone scintigraphy with single photon emission computed tomography (SPECT)/CT was performed in the acute and subacute course of frostbite injuries, subsequently leading to earlier definitive management and shorter hospital stay.
Conclusion::
Multiphase technetium-99m-methylenediphosphonate (99mTc-MDP) bone scintigraphy with SPECT/CT can expedite clinical management of frostbite injuries by determining the extent of injury and can accurately predict the level of amputation if needed.
Advances in knowledge::
SPECT/CT is underutilized at many facilities but can have a profound and immediate impact on clinical management of patients with frostbite when used in combination with physiological bone scan imaging.
... On the other hand, radiotracer uptake within the trabecular skeleton, where the hematopoietic bone marrow is located, can present significant interpatient variations [18,19]. As Ra-223 uptake tends to mirror the one of the common bone-seeking tracers [8,20], a higher metabolism in the pretherapeutic bone scintigraphy could entail a greater Ra-223 uptake as well as a longer residence time within the trabecular bone, possibly resulting in an overall higher dose to the bone marrow. ...
... As a matter of fact, the activity rate measured within the trabecular bones was strictly dependent on the entity of the metastatic invasion: the more the intraosseous spaces were occupied by tumor localizations, the higher the activity measured was in the apparently unaffected trabecular tissue. This could reflect either a tendency to instability in a skeleton whose static mechanisms are impaired by the osteoblastic reactions [18,19,35] or, possibly, the presence of microscopic metastatic invasion that cannot yet be demonstrated at morphological imaging [36]. Independently of the pathophysiological considerations, these data suggest that a massive presence of metastases can impair bone marrow function during radionuclide therapy in two ways: by restricting the space available for bone marrow expansion and by indirectly increasing the dose to the unaffected trabecular bone. ...
Rationale
Radium-223-Dichloride (Ra-223) is an alpha-emitter, used to treat bone metastases. Patients with high metastatic burden and/or with increased trabecular bone uptake could present a higher incidence of hematologic toxicity. We hypothesized that these two factors are predictors of bone marrow failure.
Material and Methods
A computer algorithm discriminated between trabecular bone (BVol) and tumor metastases (MVol) within pretherapeutic whole-body skeletal SPECT/CT (N = 47). The program calculated the metastatic invasion percent (INV%) as the MVol/(MVol + BVol) ratio and extracted the BVol mean counts. BVol counts were correlated to % drop of hemoglobin (Hb), leukocytes (WBC), and platelets (PLT) after 3/6 Ra-223 cycles. Patient-specific and computational-derived parameters were tested as predictors of hematologic toxicity with MANOVA.
Results
BVol counts correlated with drop of Hb (R = 0,65, p < 0.01) and PLT (R = 0,45, p < 0.01). Appendicular BVol counts showed a better correlation (p < 0.05, p < 0.01, and p < 0.001 for Hb, WBC, and PLT, resp.). INV% directly correlated with BVol counts (R = 0.68, p < 0.001). At MANOVA, grade III/IV toxicity was predicted by INV% (p < 0.01), by long-bone invasion (p < 0.005), and by BVol counts (p < 0.05).
Conclusions
In patients with significant bone tumor burden, degree of bone invasion and trabecular bone uptake are predictors of subsequent bone marrow failure.
... The SPECT is a functional examination in which the level of OI accumulation is directly proportional to metabolic processes in the bone system. The utilization of scintigraphy, which is sensitive but has low specificity, in combination with computed tomography having high specificity but low sensitivity is most useful in such cases [25]. Before the procedure, the OI activity in vertebral bodies and spinous processes in the area of the implemented stabilizer showed a strong positive correlation with the activity in comparative L2 vertebra, and the observed differences were not statistically significant. ...
Introduction:
Lack of efficacy of pharmacotherapy and physiotherapy in spinal pain syndrome is an indication for intervertebral stabilizer implantation between the processes in the lumbar segment of the spine.
Material and methods:
The group consisted of 32 patients qualified after radioisotopic single-photon emission computed tomography/computed tomography (SPECT/CT) examinations with assessment of bone metabolism and mineral density. For comparative purposes, the L2 vertebra was defined as normal. Parameters defined in the area of operated vertebrae were comparable to L2. Imaging examinations and a pain intensity test were performed before and 12 months after the procedure.
Results:
In SPECT, osteotropic isotope (OI) activity in spinous bodies and processes was close to L2 values. Density assessed in CT of analysed vertebrae was close to L2. In the control examination, activity of OI in spinous bodies and processes was higher in the procedure area. Under the stabilizer, there was a strong positive correlation with the L2 parameters. The differences were statistically significant (p = 0.0002). The increase of OI activity in the elements above the stabilizer was variable. In the control examination, there was higher density of spinous processes and bodies above and under the stabilizer. The difference, compared to the L2 density, was statistically significant.
Conclusions:
The radioisotopic method with SPECT/CT allows for the precise assessment of bone metabolism in the spine. After the procedure, a negative correlation was observed between bone metabolism changes and pain intensity test results.
... In the first few hours after acute trauma, bone scintigraphy may be falsely negative; however, sensitivity is closed to 100 % at 72 h after fracture onset[30].Also, it is important to be familiar with normal skeletal development across different age groups. There are 3 primary ossification centers for a spinal vertebra and a total of 21 for sacrum, and these fuse before puberty (usually by 6–7 years old) and are normally not seen any more in the adolescent age range. ...
Low back pain of various etiologies is a common clinical presentation in young athletes. In this article, we discuss the utility of SPECT/CT bone scintigraphy for the evaluation of low back pain in young athletes. The spectrum of lower spine lesions caused by sports injuries and identifiable on bone scan is presented along with strategies to avoid unnecessary irradiation of young patients. Also covered are pitfalls in diagnosis due to referred-pain phenomenon and normal skeletal variants specific to this age group.
... It is frequently performed with a hybrid SPECT/CT camera that can combine the functional imaging capabilities of SPECT with the precise anatomic overlay of CT images. It provides accurate attenuation-corrected and coregistered images and has been shown to improve sensitivity and specificity in the areas of malignant and benign bone disease (4)(5)(6)(7). ...
Methods:
In this prospective study, enrolled patients underwent bone SPECT/CT with one SPECT acquisition followed by two randomized CT acquisitions: FBP CT (FBP, noise index 25 [NI]) and ASiR CT (70% ASiR, NI 40). Image quality of both attenuation-corrected SPECT and CT images were visually (5-point Likert scale, 2 readers) and quantitatively (contrast ratio [CR], and signal to noise ratio [SNR]) estimated. CT dose index volume (CTDIvol), dose-length product (DLP) and effective dose (E) were compared.
Results:
Seventy-five patients were enrolled in the study. Quantitative attenuation-corrected SPECT evaluation showed no inferiority for CR and SNR issued from FBP CT or ASiR CT (respectively 13.41 ±7.83 vs 13.45 ±7.99 and 2.33 ±0.83 vs 2.32 ±0.84). Qualitative image analysis showed no difference between attenuation-corrected SPECT images issued from FBP CT or ASiR CT for both reader (respectively 3.5 ±0.6 vs 3.5 ±0.6 and 3.6 ±0.5 vs 3.6 ±0.5). Quantitative CT evaluation showed no inferiority for SNR between FBP and ASiR CT images (respectively 0.93 ±0.16 and 1.07 ±0.17). Qualitative image analysis showed no quality difference between FBP and ASiR CT images for both reader (respectively 3.8 ±0.5 vs 3.6 ±0.5 and 4.0 ±0.1 vs 4.0 ±0.2). Mean CTDIvol, DLP and effective dose for ASiR CT (3.0 ±2.0 mGy; 148 ±85 mGy*cm and 2.2 ±1.3 mSv) were significantly lower than for FBP CT (8.5 ±3.7 mGy; 365± 160 mGy*cm and 5.5±2.4 mSv).
Conclusion:
The use of 70% ASiR blending in bone SPECT/CT can reduce CT radiation dose of about 60%, with no sacrifice in attenuation-corrected SPECT and CT images quality, compared to conventional protocol using FBP CT reconstruction technique.
Trial registration number:
NCT01800084.
... [15]. Unter Verwendung sensitiverer Bildgebungsverfahren wie der SPECT/CT, nimmt die Rate detektierter hinterer Beckenringverletzungen noch zu [16,17]. Die «einfache» Schambeinastfraktur ist daher in der Regel nur ein Indiz für eine Verletzung des gesamten Beckenrings. ...
... Die oben genannten konventionellen Röntgenaufnahmen des Beckens (antero-posterior, Inlet und Outlet), sind unserer Meinung nach -ungeachtet einer bereits durchgeführten oder geplanten CT -unentbehrlich zur Beurteilung von Frakturversatz und Stabilität ebenso wie als Referenz für spätere Verlaufskontrollen. In seltenen Fällen unklarer typischer Schmerzen ohne Korrelat in der konventionell-radiografischen oder CT-Bildgebung kann auf sensitivere Verfahren wie die Magnetresonanztomografie [28], die Knochenszintigrafie [28,29] oder die SPECT/CT zurückgegriffen werden [16,17]. Hier bestimmen Anamnese, klinische Untersuchungsbefunde und auch die jeweilige Verfügbarkeit das bevorzugte Verfahren. ...
