Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/152
Title: Co-registration of isotope bone scan with CT scan and MRI in the investigation of spinal pathology.
Epworth Authors: Brazenor, Graeme
Ballok, Zita
Malham, Gregory
Keywords: Bone scan
CT scan
Diagnosis
MR
Pathology
Spine
Treatment
Neurosciences Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Sep-2014
Citation: 2014 Sep;21(9):1617-21
Abstract: Image fusion software enables technetium(99m)-methylene diphosphonate (Tc(99m)-MDP) bone scan images to be co-registered with CT scan or MRI, allowing greater anatomical discrimination. We examined the role of bone scan images co-registered with CT scan or MRI in the investigation of patients presenting with axial spinal pain and/or limb pain. One hundred and thirty-nine consecutive patients were examined, and thereafter investigated with CT scan, MRI, and/or dynamic plain films. At this point diagnosis (pathology type and anatomical site) and treatment intention were declared. The co-registered Tc(99m)-MDP bone scan images were then studied, after which diagnosis (pathology type and anatomical site) and treatment intention were re-declared. This data were then analysed to determine whether the addition of co-registered bone scan images resulted in any change in diagnosis or treatment intention. The most significant change in diagnosis was pathology type (10%). Anatomical site changed markedly without overlap of the pre and post-isotope fields in 5%, and with overlap in 10%. Treatment intention had a major change in 3.6% and minor change in 8.6%. In the two groups where there was (i) no obvious pathology after full pre-isotope investigation, or (ii) a spinal fusion under suspicion, addition of the bone scan information led to a major change in the pathology and/or anatomical localisation in 18% and 19%, respectively. The addition of co-registered Tc(99m)-MDP bone scan images offers significant diagnostic assistance, particularly in the difficult diagnostic groups where a failed spinal fusion may be the suspected pain generator, or when no pain generator can otherwise be found.
URI: http://hdl.handle.net/11434/152
DOI: 10.1016/j.jocn.2013.11.034
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/24798908
ISSN: 0967-5868
Journal Title: Journal of Clinical Neuroscience
Type: Journal Article
Affiliated Organisations: Spine Society of Australia
Neurosurgical Society of Australia
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Diagnostic Services
Neurosciences

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