Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep;14(7):1997-2003.
doi: 10.1177/21925682231163812. Epub 2023 Mar 20.

A Comparison of Magnetic Resonance Imaging and SPECT-CT Imaging in Complex Spine Pathology: Does SPECT-CT Provide Additional Diagnostic Information Over Magnetic Resonance Imaging?

Daniel Thurston  1 , Patrick Hurley  1 , Falaq Raheel  1 , Steven James  1 , Rakesh Gadvi  1 , Rajesh Botchu  1 , Adrian C Gardner  1 , Jwalant S Mehta  1
Affiliations

A Comparison of Magnetic Resonance Imaging and SPECT-CT Imaging in Complex Spine Pathology: Does SPECT-CT Provide Additional Diagnostic Information Over Magnetic Resonance Imaging?

Daniel Thurston et al. Global Spine J. 2024 Sep.

Abstract

Study design: Retrospective cohort study.

Objective: Magnetic Resonance Imaging (MRI) is often regarded as the gold standard for spinal pathology, as it provides good structural visualisation. SPECT-CT, however, provides combined structural and functional information. There is a paucity of literature comparing SPECT-CT with MRI in the spine. Our aim was to determine whether SPECT-CT provides additional information to MRI in individuals with complex spinal pathology, including deformity, which altered management.

Methods: We conducted a retrospective review of all individuals seen at our tertiary spinal unit that were investigated with both MRI and SPECT-CT of the spine between 2007-2020. We reviewed imaging reports, and collated diagnoses, surgical treatment and the relative contributions of MRI and SPECT-CT to management decisions.

Results: 104 individuals identified, with a mean age of 30 years (89 females and 15 males). Diagnostic categories were adolescent, adult, and congenital deformity, degenerative pathology, and miscellaneous pathology. MRI returned positive findings in 58 (55.8%), and SPECT-CT in 41 (39.4%) cases. SPECT-CT identified 10 cases of facet joint degeneration, 5 of increased uptake around metalwork suggestive of loosening, 1 pseudoarthrosis, 1 partial failure of fusion and 1 osteoid osteoma which were not reported on MRI, all in individuals who had previously undergone spinal instrumentation. Despite this, SPECT-CT only altered management for 6 individuals (5.8%).

Conclusion: MRI is less useful in the setting of previous instrumentation due to metal artefact. Where MRI is inconclusive, particularly in individuals with previous spinal instrumentation, SPECT-CT may provide a diagnosis, but is not recommended as primary imaging.

Keywords: bone scan; deformity; degenerative; magnetic resonance imaging.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(A) Coronal SPECT-CT image demonstrating increased uptake around facet joints. (B) Coronal SPECT-CT image demonstrating increased uptake around facet joints. (C) Sagittal SPECT-CT image demonstrating increased uptake around facet joints.
Figure 2.
Figure 2.
Sagittal T2 MRI (A) and SPECT-CT (B) imaging; SPECT-CT demonstrates increased uptake confirming pseudoarthrosis proximally (P) as well as facet joint degeneration (F) distal to construct.
See this image and copyright information in PMC

References

    1. Maus T. Imaging the back pain patient. Phys Med Rehabil Clin. 2010;21(4):725-766. - PubMed
    1. Gnanasegaran G, Paycha F, Strobel K, et al. Bone SPECT/CT in Postoperative Spine. Semin Nucl Med. 2018;48(5):410-424. - PubMed
    1. Nömayr A, Römer W, Strobel D, Bautz W, Kuwert T. Anatomical accuracy of hybrid SPECT/spiral CT in the lower spine. Nucl Med Commun. 2006;27(6):521-528. - PubMed
    1. Sharma P, Sharma S, Ballal S, Bal C, Malhotra A, Kumar R. SPECT-CT in routine clinical practice: increase in patient radiation dose compared with SPECT alone. Nucl Med Commun. 2012;33(9):926-932. - PubMed
    1. Strobel K, Burger C, Seifert B, Husarik DB, Soyka JD, Hany TF. Characterization of focal bone lesions in the axial skeleton: performance of planar bone scintigraphy compared with SPECT and SPECT fused with CT. AJR Am J Roentgenol. 2007;188(5):W467-W474. - PubMed

LinkOut - more resources