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Title: Bone scans are reliable for the identification of lumbar disk and facet pathology.
Epworth Authors: Malham, Gregory
Ballok, Zita
Other Authors: Goss, Ben
Diwan, Ashish
Uribe, Juan
Parker, Rhiannon
Keywords: CT
Bone Scan
Image Fusion
Single-Photon Emission Computed Tomography (SPECT)
Bone SPECT Images Co-Registered With Computed Tomography (Bone SPECT-CT)
Disk Pathology
Facet Joint Pathology
Neurosciences Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Feb-2015
Citation: Global Spine J. 2015 Feb;5(1):23-30
Abstract: To evaluate the reliability of bone single-photon emission computed tomography (SPECT) versus bone SPECT images co-registered with computed tomography (bone SPECT-CT) by analyzing interobserver agreement for identification of the anatomical location of technetium(99m)-labeled oxidronate uptake in the lumbar disk and/or facet joint. Seven spine surgeons interpreted 20 bone scans: 10 conventional black-and-white tomograms (bone SPECT) and 10 color-graded bone SPECT-CT scans. Each surgeon was asked to identify the location of any diagnostically relevant uptake in the disk and/or facet joint between L1 and S1. Reliability was evaluated using the free-marginal kappa statistic, and the level of agreement was assessed using the Landis and Koch interpretation. Results Conventional bone SPECT scans and bone SPECT-CT scans were reliable for the identification of diagnostically relevant uptake, with bone SPECT-CT having higher reliability (kappa = 0.72) than bone SPECT alone (0.59). Bone SPECT and bone SPECT-CT were also reliable in identifying disk pathology, with kappa values of 0.72 and 0.81, respectively. However, bone SPECT-CT was more reliable (0.81) than bone SPECT (0.60) when identifying facet disease. Conclusions For the identification of disk pathology, it is reasonable to use either conventional bone SPECT or bone SPECT-CT; however, bone SPECT-CT is more reliable for facet joint pathology.
DOI: 10.1055/s-0034-1394298
PubMed URL:
ISSN: 2192-5682
Journal Title: Global Spine Journal
Type: Journal Article
Affiliated Organisations: NuVasive Australia and NZ Pty Ltd, Melbourne, Australia
Department of Orthopaedic Surgery, St. George Private Hospital, University of New South Wales, Sydney, Australia
Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States
Type of Clinical Study or Trial: Reliability Study
Appears in Collections:Diagnostic Services

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