Initial experience of SPECT/CT in the diagnosis of occult scaphoid fracture

Author:

de Zwart Andele D1,Beeres Frank JP2,Rietbergen Daphne DD3,Krijnen Pieta1,Schipper Inger B1

Affiliation:

1. Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands

2. Department of Surgery, Luzerner Kantonsspital, Lucerne, Switzerland

3. Department of Nuclear Medicine, Leiden University Medical Centre, Leiden, The Netherlands

Abstract

Background *Equal contributors. Planar bone scintigraphy (PBS) is often advocated for diagnosing occult scaphoid fractures. PBS is a sensitive diagnostic modality, but lacks specificity, which may result in over-diagnosis. Purpose To examine, in a pilot study, the potential additional value of single photon emission computed tomography (SPECT) combined with low dose computed tomography (CT) for the diagnosis of an occult scaphoid fracture. Material and Methods Ten patients that underwent combined PBS and SPECT/CT for a clinically suspected scaphoid fracture, where radiographs could not detect a fracture, were included in this pilot study. The PBS and SPECT/CT results were independently and separately evaluated by a nuclear physician for scaphoid fractures and other injuries. Results PBS was positive for a scaphoid fracture in four patients and diagnosed three other fractures. SPECT/CT showed five scaphoid fractures and one other fracture. SPECT/CT – PBS had discrepant results in three patients. In two patients PBS diagnosed a trapezoid fracture where SPECT/CT showed a scaphoid fracture. The other patient was diagnosed with a scaphoid fracture on PBS, whereas SPECT/CT showed bone bruise of other carpal bones. Conclusion SPECT/CT has the potential to be more accurate than PBS as it uses anatomical information of the CT to discriminate between the scaphoid, other carpal bones, and bone bruises. Larger studies with an independent reference standard are needed for confirmation of these preliminary data.

Publisher

SAGE Publications

Cited by 5 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Hand and Wrist: Fracture Nonunion;Clinical Atlas of Bone SPECT/CT;2023

2. Hand and Wrist: Fracture Nonunion;Clinical Atlas of Bone SPECT/CT;2023

3. Occult capitate fracture through a bone island – SPECT/CT arthrography imaging;European Journal of Hybrid Imaging;2018-11-05

4. SPECT/CT: an update on technological developments and clinical applications;The British Journal of Radiology;2018-01

5. Bone SPECT–CT: An additional diagnostic tool for undiagnosed wrist pain;Journal of Plastic, Reconstructive & Aesthetic Surgery;2016-10

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