SPET and three-phase planar bone scintigraphy in adult patients with chronic low back pain. Nucl Med Commun 1998 Jan;19(1):13-21
Date
03/27/1998Pubmed ID
9515543DOI
10.1097/00006231-199801000-00004Scopus ID
2-s2.0-15444343986 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
Among adults, low back pain (LBP) persisting for more than 3 months is a common complaint. A variety of imaging modalities including bone scintigraphy have been recommended as appropriate for the investigation of chronic LBP, even when there is no reason to suspect that the pain is due to tumour, infection or inflammatory arthritis. In this chronic LBP population, the diagnostic benefit of bone SPET, together with planar flow study, blood pool and delayed three-phase imaging, was assessed, Altogether, 2108 consecutive adult patients were entered into the chronic LBP bone scintigraphy database. Retrospective exclusion of patients with a history of tumour, infection or inflammatory arthritis reduced the population to 1390, of whom 916 underwent a lumbosacral spine flow study and blood pool imaging in addition to planar and SPET bone scintigraphy. The diagnostic benefit of these imaging studies was tabulated and compared. In addition, a retrospective chart review of the patients with renal and other soft tissue abnormalities identified by a flow study and blood pool imaging was undertaken with a view to documenting any changes in treatment planning over the 6 months following the nuclear medicine studies. Of the lumbosacral spine abnormalities, 44.1% were seen equally well on planar and SPET images, 24.0% better on SPET, 31.4% only seen on SPET, and 0.4% only seen on planar imaging. The distribution of abnormalities identified on SPET images in the lumbar spine was divided between vertebral bodies (36.1%), lamina or pedicles (which included frequent sites of increased uptake in the articular facets and pars interarticularis) (53.8%), spinous processes (8.7%) and transverse processes (1.3%). For the flow study and blood pool imaging, there was a 16.7% rate of positive studies. However, there were no documented changes in treatment planning because of these positive findings. In conclusion, when used to examine adult patients with chronic LBP, SPET detects significantly more scintigraphic abnormalities than planar imaging. The addition of a flow study and blood pool imaging as part of these LBP examinations results in a significant benefit. However, the clinical utility of such flow study and blood pool imaging studies cannot be confirmed.
Author List
Kanmaz B, Collier BD, Liu Y, Uzum F, Uygur G, Akansel G, Gunes I, Krasnow AZ, Hellman RS, Isitman AT, Carrera GMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Back Pain
Bone and Bones
Databases as Topic
Echo-Planar Imaging
Female
Humans
Male
Middle Aged
Spine
Tomography, Emission-Computed, Single-Photon