Abstract
Over the last 5 years, the diagnostic value of combined single-photon emission computerised tomography and conventional computerised tomography (SPECT/CT) has been increasingly recognised in particular in the diagnostics of painful total knee replacement (TKR). Here, the combined assessment of mechanical/anatomical alignment, anatomy, pathologies and remodelling of the bone after TKR is highlighted. Currently, SPECT/CT is not commonly available in every hospital, but the availability of SPECT/CT systems will increase in the next years. Then, SPECT/CT could become an important diagnostic player in the diagnostics of unhappy patients after TKR.
In this chapter, we aim to give you an introduction into the SPECT/CT methodology, the clinical application and its clinical value in patients with pain after TKR. Other nuclear imaging modalities such as PET/CT are only rarely helpful. There is only scarce evidence for its use, and hence it is not covered here.
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Filippi L, Schillaci O. Usefulness of hybrid SPECT/CT in 99mTc-HMPAO-labeled leukocyte scintigraphy for bone and joint infections. J Nucl Med. 2006;47(12):1908–13.
Gratz S, Hoffken H, Kaiser JW, Behr TM, Strosche H, Reize P. Nuclear medical imaging in case of painful knee arthroplasty. Radiologe. 2009;49(1):59–67.
Graute V, Feist M, Lehner S, Haug A, Muller PE, Bartenstein P, Hacker M. Detection of low-grade prosthetic joint infections using 99mTc-antigranulocyte SPECT/CT: initial clinical results. Eur J Nucl Med Mol Imaging. 2010;37(9):1751–9.
Henckel J, Richards R, Lozhkin K, Harris S, Baena FM, Barrett AR, Cobb JP. Very low-dose computed tomography for planning and outcome measurement in knee replacement. The imperial knee protocol. J Bone Joint Surg Br. 2006;88(11):1513–8.
Hirschmann MT, Henckel J, Rasch H. SPECT/CT in patients with painful knee arthroplasty-what is the evidence? Skeletal Radiol. 2013;42(9):1201–7.
Hirschmann MT, Iranpour F, Davda K, Rasch H, Hugli R, Friederich NF. Combined single-photon emission computerized tomography and conventional computerized tomography (SPECT/CT): clinical value for the knee surgeons? Knee Surg Sports Traumatol Arthrosc. 2009;18(3):341–5.
Hirschmann MT, Iranpour F, Konala P, Kerner A, Rasch H, Cobb JP, Friederich NF. A novel standardized algorithm for evaluating patients with painful total knee arthroplasty using combined single photon emission tomography and conventional computerized tomography. Knee Surg Sports Traumatol Arthrosc. 2010;18(7):939.
Hirschmann MT, Konala P, Amsler F, Iranpour F, Friederich NF, Cobb JP. The position and orientation of total knee replacement components: a comparison of conventional radiographs, transverse 2D-CT slices and 3D-CT reconstruction. J Bone Joint Surg Br. 2011;93(5):629–33.
Hirschmann MT, Konala P, Iranpour F, Kerner A, Rasch H, Friederich NF. Clinical value of SPECT/CT for evaluation of patients with painful knees after total knee arthroplasty–a new dimension of diagnostics? BMC Musculoskelet Disord. 2011;12:36.
Hirschmann MT, Wagner R, Rasch H, Henckel J. Standardized volumetric 3D analysis of SPECT/CT imaging in orthopaedics: overcoming the limitations of qualitative 2D analysis. BMC Med Imaging. 2011;12:5.
Horger M, Eschmann SM, Pfannenberg C, Storek D, Vonthein R, Claussen CD, Bares R. Added value of SPECT/CT in patients suspected of having bone infection: preliminary results. Arch Orthop Trauma Surg. 2007;127(3):211–21.
Rasch H, Falkowski AL, Forrer F, Henckel J, Hirschmann MT. 4D-SPECT/CT in orthopaedics: a new method of combined quantitative volumetric 3D analysis of SPECT/CT tracer uptake and component position measurements in patients after total knee arthroplasty. Skeletal Radiol. 2013;42(9):1215–23.
Scharf S. SPECT/CT imaging in general orthopedic practice. Semin Nucl Med. 2009;39(5):293–307.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Hirschmann, M.T., Rasch, H. (2015). 31 Nuclear Medicine Imaging (SPECT/CT) in the “Unhappy” Total Knee Replacement: A Potential for Better Diagnosis!. In: Hirschmann, M., Becker, R. (eds) The Unhappy Total Knee Replacement. Springer, Cham. https://doi.org/10.1007/978-3-319-08099-4_37
Download citation
DOI: https://doi.org/10.1007/978-3-319-08099-4_37
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-08098-7
Online ISBN: 978-3-319-08099-4
eBook Packages: MedicineMedicine (R0)