Author/Editor		Buscombe, JR; Cwikla, JB; Xing-Dang, L; Dave, PK; Dougall, P; Fettich, J; Fettich-Seliger, M; Frangos, S; van Heerden, BB; Kanmaz, B
Title		Bone SPECT in lower nack pain: results of an IAEA coordinated research project
Type		članek
Source		World J Nucl Med Print
Vol. and No.		Letnik 2, št. 3
Publication year		2003
Volume		str. 199-205
Language		eng
Abstract		The aim of this study was to determine if it would be possible to use spinal bone single photon emission computed tomography (SPELT) in patients with unexplained back pain in varied clinical backgrounds and to determine if a positive or negative study had any prognostic value. The study was co-ordinated by the International Atomic Energy Agency (IAEA) and involved 8 centres in 7 countries. A total of 174 patients (mean age 42 years, range 15-80 years) were screened and found to have no obvious cause for their back pain at the time of the SPELT scan. All patients had a CT, and planar radiology. There was clinical, follow-up data for 6 months without active treatment (such as surgery) in 147 patients. A panel of 9 specialists in nuclear medicine, radiology and orthopaedics reviewed all images and histories. Final assessment determined that 141 patients had skeletal causes for their back pain. SPELT was abnormal in 64% of these patients as compared to 58% with CT and 18% with planar radiology. CT was most likely to be diagnostic in disc degeneration (sensitivity 92%). SPECT was most diagnostic in facet joint disease (sensitivity 96%). In the 43 patients without any skeletal disease the specificity of SPECT was 79%, compared to 65% for CT. Follow-up of patients at 6 months showed that on average 71% had improvement of symptoms, suggesting a benign cause for their backpain, with the exception of patients with pure facet joint disease, identified on SPECT but with no treatment. Spinal skeletal SPECT can be applied in a wide range of social and clinical settings. Results compare well with CT, providing additional information in 30% of patients, especially in facet joint disease where a positive SPECT study, suggests a worse clinical outcome at 6 months.
Descriptors		LOW BACK PAIN SPINE TOMOGRAPHY, EMISSION-COMPUTED, SINGLE-PHOTON