Incremental value of ^99mTc MDP single photon-emission computed tomography-computed tomography over planar scintigraphy in different skeletal pathologies

To assess the incremental value of single photon-emission computed tomography-computed tomography (SPECT-CT) over planar scintigraphy in different skeletal pathologies. A total of 66 patients were recruited prospectively, having different skeletal pathologies including osteomyelitis (42), prosthesis loosening (6), avascular necrosis (4), myositis ossificans (2), osteoid osteoma (1), graft viability (1), condylar hyperplasia (1), metastasis (1), and others (8). Follow-up was available for 60 patients. All patients underwent planar bone scan initially. Additional SPECT-CT imaging was acquired in 40 patients having equivocal finding on planner scintigraphy. Histopathology/microbiology/clinical imaging/follow-up was used as the reference standard. The average age of the patients was 36.56 years and range is 10-76 years. There were 39 male patients and 21 female patients. Of the 60 patients, the diagnosis was conclusive on planar scintigraphy in 20 patients and 40 patients diagnosis was equivocal on planar scintigraphy. These 40 patients underwent additional SPECT-CT. SPECT-CT was true positive (TP) in 33 patients, true negative (TN) in one patient, false positive in five patients, and false negative in one patient. The accuracy (TP + TN) of SPECT-CT was found to be 85%. SPECT-CT showed an incremental value of about 56% over planar scintigraphy in different skeletal pathologies. SPECT-CT showed an incremental value of about 56% over planar scintigraphy in characterization of different skeletal pathologies