scholarly journals Evaluation of the Diagnostic Value of SPECT/CT in Defining Foot and Ankle Pathologies

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0006
Author(s):  
Ippokratis Pountos ◽  
Christel Charpail ◽  
Nazzar Tellisi
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Diagnostic Value ◽  
Emission Computed Tomography ◽  
Imaging Method ◽  
Foot And Ankle ◽  
Diagnostic Specificity ◽  
Ct Guided ◽  
Complex Anatomy

Category: Ankle Arthritis, Hindfoot, Midfoot/Forefoot Introduction/Purpose: The precise localisation of degenerative or inflammatory pathologies in foot and ankle can be difficult due to the complex anatomy of the joints. MRI plays a vital diagnostic role in these scenarios aiding the diagnosis and preoperative planning. Single-photon emission computed tomography combined with computed tomography (SPECT/CT) is a relatively new imaging technology that combines the sensitivity of nuclear medicine examinations with the anatomical detail of CT. The aim of this study is to analyse the diagnostic effectiveness of SPECT/CT in evaluating foot and ankle pathologies. Methods: The authors retrospectively reviewed the medical records of all patients with a foot and/or ankle -related complaint that received SPECT/CT. Exclusion criteria included patients with inadequate follow-up and those that were not initially assessed by a senior foot and ankle surgeon. Collected data included demographic information, results from imaging, clinical progress and outcomes. Results: 272 included in the study comprised of 156 females and 116 males with a mean age of 52,8 years (range 17-92 years). The acquisition of a SPECT/CT changed the initial diagnosis (from either clinical or radiographs or MRI) in 55% of the cases. SPECT/CT finding correlated with MRI only in 34% of the cases. From the remaining cases SPECT/CT partially correlated with MRI in 26% of cases no correlation was noted in 40%. In regards to patients that undergone a USS or CT guided injection following the finding of a SPECT/CT, 86% reported a transient or long-term improvement in the pain. Overall, the SPECT/CT added confidence to the clinical diagnosis in 89% of the cases while reduced the need of further investigations in 93%. Conclusion: SPECT/CT is a valuable tool in depicting foot and ankle pathologies. It was able to provide additional diagnostic value by demonstrating co-existing pathologies as a potential cause of pain. SPECT/CT and MRI exhibit different diagnostic specificity and the limitations of each scan should be taken into consideration. This study strongly supports the use of SPECT/CT as a complementary imaging method to MRI for enhancing diagnostic specificity and outcomes.

scholarly journals Prediction Value of SPECT/CT in Avascular Necrosis of Femoral Head After Femur Neck Fracture

2019 ◽  
Vol 10 ◽  
pp. 215145931987294
Author(s):  
Sung Jun Park ◽  
Bong Seong Ko ◽  
Kyoung Ho Moon ◽  
Minkyung Lee
Keyword(s):  
Computed Tomography ◽  
Femoral Head ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Single Photon ◽  
Photon Emission ◽  
Diagnostic Value ◽  
Emission Computed Tomography ◽  
Neck Fracture ◽  
Photon Emission Computed Tomography

Introduction: The aim of this study was to determine the diagnostic value of single-photon emission computed tomography/computed tomography (SPECT/CT) in prediction of avascular necrosis (AVN) after femoral neck fracture and to evaluate whether photon defect in femoral head as seen in SPECT/CT can be an index for choice of surgical method. Methods: This study was based on 97 patients who took SPECT/CT after femoral neck fracture from November 2012 to November 2017, with 64 patients with femoral intertrochanteric fracture in which chances of AVN is rare as a comparison group. Among 97 patients with femoral neck fracture, osteosynthesis was conducted in 7 patients with less than 15% of photon defect in damaged femoral head and 7 patients who wanted osteosynthesis, despite photon defect more than 15%, and 83 patients with photon defect more than 25% had arthroplasty. Patient with osteosynthesis was followed up with AVN by conducting magnetic resonance imaging (MRI) in 1 year after the surgery. Results: Quantitative analysis of SPECT/CT in 14 patients who had femoral neck osteosynthesis showed that 7 patients with femoral neck fracture showed photon defect of 15% or more, but less than 25% and 3 patients in these were diagnosed with AVN after 1-year follow-up by MRI. Sensitivity and specificity of SPECT/CT in predicting AVN was 100% and 63.6%, respectively, with prediction accuracy of 71.4%. Among 14 patients with femoral neck fracture who had osteosynthesis, photon defect in 3 patients diagnosed with AVN was 19.6% ± 5.2%, but photon defect in 11 patients who was not diagnosed with AVN was 10.7% ± 5.2%, showing statistically significant difference between 2 groups ( P = .001). Conclusion: Single-photon emission computed tomography/CT in patients with femoral neck fracture is considered to have diagnostic value in predicting occurrence of AVN, and percentage of photon defect is considered to be an useful index in determining the operative method.

Image-Guided Right T10 Costotransverse Joint Resection for Costotransversitis: Operative Technique and Nuances: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Gaetano De Biase ◽  
Kelly Gassie ◽  
Kingsley Abode-Iyamah ◽  
Eric Nottmeier
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Preoperative Evaluation ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
X Rays ◽  
Ct Guided ◽  
Image Guided ◽  
Spect Scan ◽  
The Right

Abstract We describe the operative approach and management for costotransverse joint inflammation in a 49-yr-old man with worsening midthoracic pain radiating to the right paraspinal area. He underwent physical therapy with no relief of his symptoms. Thoracic spine magnetic resonance imaging (MRI) revealed severe arthritic changes involving the right T10 costotransverse joint. Scoliosis X-rays showed a dextroconvex curvature in the midthoracic spine, without any significant imbalance. Single-photon emission computed tomography (SPECT) scan revealed focal increased uptake of the right T10 costotransverse joint. T10 costotransverse joint lidocaine injection did not provide any relief. We performed a computed tomography (CT)-guided biopsy, which was negative for malignancy and also cultures were negative. MRI revealed a significant enhancement in this area and the patient's C-reactive Protein was elevated. Decision was made to perform open biopsy and costotransverse joint resection. We present a case of minimally invasive, image-guided costotransverse joint resection, which has not been described in the literature. The right T10 costotransverse joint was dissected out with the image-guided dilator, and tubular retractors were inserted. Under the microscope, using the image-guided drill, the right T10 costotransverse joint was drilled out. The lateral aspect of the right T10 process was drilled out as well as the medial-dorsal aspect of the right T10 rib. The patient recovered from surgery well with abatement of his preoperative thoracic pain, which remained abated at 6-mo follow-up. This case highlights the complex technical nuances of this procedure, and the importance of a thorough preoperative evaluation with a bone SPECT scan to help localize the pain generator. Patient consented for the procedures and for the publication of the video.

Framework for 2D-3D image fusion of infrared thermography with preoperative MRI

2017 ◽  
Vol 62 (6) ◽  
pp. 599-607 ◽  
Author(s):  
Nico Hoffmann ◽  
Florian Weidner ◽  
Peter Urban ◽  
Tobias Meyer ◽  
Christian Schnabel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Fusion ◽  
Coordinate System ◽  
Infrared Thermography ◽  
Single Photon ◽  
Photon Emission ◽  
Infrared Camera ◽  
Diagnostic Value ◽  
Emission Computed Tomography ◽  
3D Mri

AbstractMultimodal medical image fusion combines information of one or more images in order to improve the diagnostic value. While previous applications mainly focus on merging images from computed tomography, magnetic resonance imaging (MRI), ultrasonic and single-photon emission computed tomography, we propose a novel approach for the registration and fusion of preoperative 3D MRI with intraoperative 2D infrared thermography. Image-guided neurosurgeries are based on neuronavigation systems, which further allow us track the position and orientation of arbitrary cameras. Hereby, we are able to relate the 2D coordinate system of the infrared camera with the 3D MRI coordinate system. The registered image data are now combined by calibration-based image fusion in order to map our intraoperative 2D thermographic images onto the respective brain surface recovered from preoperative MRI. In extensive accuracy measurements, we found that the proposed framework achieves a mean accuracy of 2.46 mm.

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