Purpose@#We aimed to evaluate the performance of
hybrid bone single-photon
emission computed tomography (
SPECT)/computed
tomography (CT) in predicting
bone graft viability after maxillary or
mandibular reconstructive surgery with vascularized
bone grafts. @*
Methods@#We retrospectively reviewed 46
bone planar
scintigraphy and
SPECT/CT images of 45
adult patients taken at 1 week (5–8 days) after maxillary or
mandibular reconstructive surgery with vascularized
bone grafts. By visual
analysis, two
nuclear medicine physicians scored the uptake degrees of each
bone graft segment compared with the
calvarium uptake on planar
bone scintigraphy and
SPECT/CT, respectively (0 = absence of uptake, 1 = less uptake, 2 =
similar uptake, and 3 = more uptake). The imaging results were compared with clinical follow-up for assessing
bone graft viability. @*Results@#During follow-up, five
bone graft segments were surgically removed and confirmed as nonviable—one had a score of 0, although the other four had a score of 1–3 on planar
bone scintigraphy. All five
bone graft segments were scored 0 on
SPECT/CT and eventually confirmed as nonviable. All other
graft segments with a score of > 1 on
SPECT/CT were viable and uneventful.The anatomical CT information on
SPECT/CT images was helpful in discriminating
bone graft uptake from adjacent
bone or soft
tissue uptake. @*Conclusions@#The absence of tracer uptake by the vascularized
bone graft on
bone SPECT/CT at 1 week after maxillary or
mandibular reconstructive surgery can predict
graft failure.
Bone SPECT/CT can be used to predict vascularized
bone graft viability postoperatively.