ABSTRACT
PURPOSE: To identify differences between three-phase bone scan and SPECT/CT (TBS) and WBC SPECT/CT (WS) and compare diagnostic accuracies of each modality in patients with suspicious post-traumatic osteomyelitis (OM).METHODS: Twenty-one patients with suspicious post-traumatic OM were enrolled. All patients performed TBS and WS within 1 week. Foci ofMDP andWBC accumulation were divided into three categories: bone (OM), soft tissue (soft tissue inflammation; STI), negative for inflammation (NI). Confirmative diagnosis was made upon operative pathology or long-term clinical follow-up.RESULTS: Of 21 patients, four OM, eight STI, nine NI were finally diagnosed. TBS diagnosis was correct in three of four positive cases and nine of 17 negative cases. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) of TBS were 75 %, 52.9 %, 57.1 %, 27.3 %, 90 %. WS diagnosis was correct in two of four positive cases and 17 of 17 negative cases. Sensitivity, specificity, accuracy, PPV, NPV were 50 %, 100 %, 81.0 %, 100 %, 89.5 %. Twelve of 21 cases showed agreement between TBS and WS. TBS misdiagnosed nine cases (six STI and two NI as eight OM; one OM as one STI), while WS misdiagnosed four cases (two OM as two STI; two STI as two NI). Combining results from TBS and WS led to better diagnostic accuracy (91.7 %) than either TBS or WS alone.CONCLUSION: TBS and WS showed moderate agreement in assessment of clinically suspected post-traumatic OM. WS better evaluated inflammation than TBS. WS tended to underestimate inflammation whereas TBS tended to overestimate inflammation. Combining TBS and WS enhanced diagnostic accuracy.
Subject(s)
Humans , Diagnosis , Diagnosis, Differential , Follow-Up Studies , Inflammation , Osteomyelitis , Pathology , Sensitivity and Specificity , Sexually Transmitted DiseasesABSTRACT
Bone scan using (99m)Tc-MDP is the most accurate and reliable method for the early detection of fracture, and that is the screening procedure of choice for the demonstration of bone metastases. It is well known that it has superior sensitivity to radiography for this purpose. We report the case of 41 years old man with known primary tumor and metastatic vertebral fracture presenting false negative bone scan finding.
Subject(s)
False Negative Reactions , Mass Screening , Neoplasm Metastasis , Spinal FracturesABSTRACT
A 24 year-old female presented for a (99m)Tc-methylene diphosphonatae (MDP) whole body bone scan due to chronic pain in the bilateral lower extremities that has aggravated since 2002. She was diagnosed with Camurati-Engelmann disease (CED) based on the clinical and radiological findings in 2002, and she re-visited our institute to evaluate disease status at this time. CED is a rare autosomal dominant type of bone dysplasia characterized by progressive cortical thickening of long bones, and narrowing of medullary cavity, and thus presents with typical clinical symptoms and signs such as chronic pain in the extremities, muscle weakness, and waddling gait. On the (99m)Tc-MDP bone scan performed to evaluate disease status, intense increased uptake was seen in the skull, facial bones, bilateral scapulae, bilateral long bones, and bilateral pelvic bones, which clearly demonstrated the extent of CED involvement.
Subject(s)
Female , Humans , Bone Diseases, Developmental , Camurati-Engelmann Syndrome , Chronic Pain , Extremities , Facial Bones , Gait , Lower Extremity , Muscle Weakness , Pelvic Bones , Scapula , SkullABSTRACT
Objective To investigate radionuclide imaging pattern with ~ 99m Tc-MDP in rat arthritis induced by collagen, and the significance of the imaging in the early diagnosis of arthritis. Methods 70 male Wistar rats were divided into normal (n=28) and model group (n=42), both groups were respectively subdivided into 7 groups according to time of treatment. Collagen induced arthritis (CIA) model was reproduced by subcutaneous injection of collagen and adjuvant. For imaging, rats were injected with ~ 99m Tc-MDP through tail vein. The technique of Radome of Interesting (ROI) was used in knee and whole bone, and R value was calculated. The concentration of radionuclide was observed and compared with arthritis index (AI), paw thickness, pathological changes and ?-ray examination. Results Rats in model group showed higher concentration of radionuclide in the knee joint (P
ABSTRACT
This study was to evaluate the clinical usefulness of 99m Tc-MDP bone scintigraphy for assessing vascular ingrowth into the ocular implants after enucleation and evisceration. Twenty four patients(M:F=7:17, mean age:36), with a coralline hydroxyapatite after uncomplicated enucleation or evisceration surgery were studied. Uptake ratio was also calculated by measuring the implants activity(H)and contralateral orbit activity(N). Grading score and uptake ratio were compared with clinical outcome of vascularization. Additionally, we also analyzed the vascularization status as time lapse between primary surgery and scintigraphic study and surgical methods. The degree of grade and uptake ratio were inversely correlated with vascular ingrowth. Higher than grade 2 or greater than 1.56 in H/N ratio seemed to be an indicator for better prognosis. 99m Tc-MDP bone scintigraphy can be a useful method to evaluate the vascularized status of implants. Adequate time for 99m Tc-MDP bone scintigraphy after enucleation and evisceration was 11~20 weeks.