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Skeletal scintigraphy with SPECT/CT in benign pediatric bone conditions

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Abstract

Benign bone diseases present an ongoing challenge for pediatricians. Most of them are not life threatening, but may be associated with significant morbidity. Benign space occupying lesions are a source of pain and/or pathological fractures. Their symptoms may raise concern for malignancy and require a complex diagnostic workup. Late or inadequate treatment of bone infections may result in bone and joint destruction and lifelong functional impairment especially in young children. Bone damage due to altered blood supply or due to minor trauma can be difficult to identify. MRI is a cornerstone in modern assessment of pediatric bone disease, but bone scintigraphy remains a useful tool in this clinical field. Unlike MRI, bone scans are widely available, provide whole body rather than focused exploration, are less affected by metallic implants or devices and combined with CT in hybrid SPECT/CT systems, allow visualization of bone morphology and metabolism in a single imaging session. The clinical indication and imaging technique of skeletal SPECT/CT in children are still evolving although the benefit of this technique in evaluation of children with bone pain and/or serendipitously found bone lesions seems ascertained. Improvements in gamma camera technology allow the obtaining of high quality images with either shorter acquisition times and /or reduced radiopharmaceutical administered activities. Sedation is required much less for bone scans than for MRI.

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Authors and Affiliations

  1. Nuclear Medicine Unit, Circolo Hospital and Macchi Foundation, Viale L. Borri 57, 21100, Varese, Italy

    Diego De Palma

  2. Division of Nuclear Medicine, Department of Radiology, British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada

    Helen R. Nadel

  3. Department of Nuclear Medicine, Schneider Children’s Medical Center, 14 Kaplan Street, Petach Tikva, 49202, Israel

    Zvi Bar-Sever

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  1. Diego De Palma
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  2. Helen R. Nadel
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  3. Zvi Bar-Sever
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Correspondence to Diego De Palma.

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All the authors (Diego De Palma, Zvi Bar-Sever, Helen R. Nadel) declare no conflict of interest.

This article does not contain any studies with human or animal subjects performed by the any of the authors.

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De Palma, D., Nadel, H.R. & Bar-Sever, Z. Skeletal scintigraphy with SPECT/CT in benign pediatric bone conditions. Clin Transl Imaging 4, 191–201 (2016). https://doi.org/10.1007/s40336-016-0169-8

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