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Utility of 99mTc-MDP hybrid SPECT-CT for diagnosis of skull base osteomyelitis: comparison with planar bone scintigraphy, SPECT, and CT

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Abstract

Purpose

To evaluate single photon emission tomography–computed tomography (SPECT-CT) for diagnosis of skull base osteomyelitis (SBO) and to compare this technique with planar bone scintigraphy (BS), SPECT, and CT.

Methods

Data from 13 patients with known/suspected SBO were retrospectively analysed. Planar BS and SPECT images were evaluated by an experienced nuclear medicine physician, CT by and experienced radiologist, and SPECT-CT by the nuclear medicine physician and radiologist in consensus. On the basis of diagnostic confidence a score of 1–5 was given, with 1 being definitely osteomyelitis, 2 being probably osteomyelitis, 3 being equivocal, 4 being probably normal, and 5 being definitely normal. ROC analysis areas under the curves (AUC) were calculated. For diagnostic values a score of ≤2 was taken as positive. Clinical/imaging follow-up/microbiology was taken as reference standard.

Results

AUC was largest for SPECT-CT (0.977) followed by SPECT (0.909), CT (0.886), and planar BS (0.614). However, no significant difference was found between the techniques except for borderline significance between planar BS with SPECT-CT (P = 0.071) and CT (P = 0.072). Accuracy was 46 % for planar BS, 85 % for SPECT, 77 % for CT and 92 % for SPECT-CT.

Conclusion

SPECT-CT seems to be useful, but not superior to planar BS, SPECT, or CT, for diagnosis of SBO.

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Conflict of interest

The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Nuclear Medicine, All India Institute of Medical Sciences, E-81, Ansari Nagar (East), AIIMS Campus, New Delhi, 110029, India

    Punit Sharma, Krishan Kant Agarwal, Harmandeep Singh, Chandrasekhar Bal, Arun Malhotra & Rakesh Kumar

  2. Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India

    Sourav Kumar

Authors
  1. Punit Sharma
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  2. Krishan Kant Agarwal
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  3. Sourav Kumar
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  4. Harmandeep Singh
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  5. Chandrasekhar Bal
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  6. Arun Malhotra
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  7. Rakesh Kumar
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Correspondence to Rakesh Kumar.

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Sharma, P., Agarwal, K.K., Kumar, S. et al. Utility of 99mTc-MDP hybrid SPECT-CT for diagnosis of skull base osteomyelitis: comparison with planar bone scintigraphy, SPECT, and CT. Jpn J Radiol 31, 81–88 (2013). https://doi.org/10.1007/s11604-012-0148-6

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  • DOI: https://doi.org/10.1007/s11604-012-0148-6

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