Early-Phase SPECT/CT for Diagnosing Osteomyelitis: A Retrospective Pilot Study

Korean J Radiol. 2021 Apr;22(4):604-611. doi: 10.3348/kjr.2019.0746. Epub 2020 Nov 30.

Abstract

Objective: The aim of this pilot study was to investigate the potential of early-phase single-photon emission computed tomography (SPECT)/computed tomography (CT) using technetium-99m methyl diphosphonate (99mTc-MDP) for diagnosing osteomyelitis (OM).

Materials and methods: Twenty-one patients with suspected OM were enrolled retrospectively. Three-phase bone scan (TPBS), early-phase SPECT/CT (immediately after blood pool planar imaging), and delayed-phase SPECT/CT (immediately after delayed planar imaging) were performed. The final diagnoses were established through surgery or clinical follow-up for over 6 months. We compared three diagnostic criteria based on (I) TPBS alone, (II) combined TPBS and delayed-phase SPECT/CT, and (III) early-phase SPECT/CT alone.

Results: OM was diagnosed in 11 of 21 patients (nine surgically and two clinically). Of the 11 OM patients, criterion-I, criterion-II, and criterion-III were positive in six, seven, and 10 patients, respectively. Of the 10 non-OM patients, criterion-I, criterion-II, and criterion-III were negative in five, five, and seven patients, respectively. The sensitivity/specificity/accuracy of criterion-I, criterion-II, and criterion-III for diagnosing OM were 54.5%/50.0%/55.0%, 63.6%/50.0%/57.1%, and 90.9%/70.0%/87.5%, respectively.

Conclusion: This pilot study demonstrated the potential of using the early-phase SPECT/CT to diagnose OM. Based on the results, prospective studies with a larger sample size should be conducted to confirm the efficacy of early-phase SPECT/CT.

Keywords: Bone and bones; Radionuclide imaging; Single photon emission computed tomography computed tomography.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Osteomyelitis / diagnosis*
  • Osteomyelitis / diagnostic imaging
  • Pilot Projects
  • Retrospective Studies
  • Sensitivity and Specificity
  • Skull / diagnostic imaging
  • Tibia / diagnostic imaging
  • Tomography, Emission-Computed, Single-Photon*
  • Tomography, X-Ray Computed*