PURPOSE: The purpose of this study was to introduce a novel standardized algorithm using SPECT/CT, which promises the potential combined assessment of the biology of the joint in particular the bone-graft-fixation complex and the 3D tunnel placement in patients after ACL reconstruction. Its clinical application and inter- and intra-observer reliability should be critically evaluated. METHODS: A novel SPECT/CT localization scheme consisting of 13 tibial, 9 femoral and 4 patellar regions on standardized axial, coronal and sagittal slices is proposed. The tracer activity on SPECT/CT was localized and recorded in 25 consecutive patients using a 3D volumetric and quantitative analysis software. The inter- and intra-observer reliability was assessed for localization and tracer activity. The tunnel position was assessed in 3D-CT using standardized frames of reference. The inter- and intra-observer reliability (OR) of the measured distances were calculated (ICC). RESULTS: The localization scheme for tracer uptake analysis was useful and easily applicable in all 25 knees. It showed very high inter-OR and intra-ORs for all regions (ICC > 0.80). Tibial and femoral tunnel position measurements showed strong agreement between the readings of the two observers; the ICCs for the position, angulation, length and entry point of the femoral tunnel were >0.88 (intra-OR) and >0.86 (inter-OR). The ICC for the position of the tibial tunnel (angulation, length and entry point) was >0.79 (intra-OR) and >0.74 (inter-OR). CONCLUSIONS: The SPECT/CT algorithm presented is highly reliable and clinically feasible. Combining the 3D-mechanical information on tunnel placement and attachment areas and the 3D metabolic data will be helpful in evaluating patients with pain after ACL reconstruction.
PURPOSE: The purpose of this study was to introduce a novel standardized algorithm using SPECT/CT, which promises the potential combined assessment of the biology of the joint in particular the bone-graft-fixation complex and the 3D tunnel placement in patients after ACL reconstruction. Its clinical application and inter- and intra-observer reliability should be critically evaluated. METHODS: A novel SPECT/CT localization scheme consisting of 13 tibial, 9 femoral and 4 patellar regions on standardized axial, coronal and sagittal slices is proposed. The tracer activity on SPECT/CT was localized and recorded in 25 consecutive patients using a 3D volumetric and quantitative analysis software. The inter- and intra-observer reliability was assessed for localization and tracer activity. The tunnel position was assessed in 3D-CT using standardized frames of reference. The inter- and intra-observer reliability (OR) of the measured distances were calculated (ICC). RESULTS: The localization scheme for tracer uptake analysis was useful and easily applicable in all 25 knees. It showed very high inter-OR and intra-ORs for all regions (ICC > 0.80). Tibial and femoral tunnel position measurements showed strong agreement between the readings of the two observers; the ICCs for the position, angulation, length and entry point of the femoral tunnel were >0.88 (intra-OR) and >0.86 (inter-OR). The ICC for the position of the tibial tunnel (angulation, length and entry point) was >0.79 (intra-OR) and >0.74 (inter-OR). CONCLUSIONS: The SPECT/CT algorithm presented is highly reliable and clinically feasible. Combining the 3D-mechanical information on tunnel placement and attachment areas and the 3D metabolic data will be helpful in evaluating patients with pain after ACL reconstruction.
Authors: Allen Lee; Louise Emmett; Hans Van der Wall; Siri Kannangara; Robert Mansberg; Ignac Fogelman Journal: Clin Nucl Med Date: 2008-11 Impact factor: 7.794
Authors: Carola F van Eck; Eric J Kropf; James R Romanowski; Bryson P Lesniak; Michael J Tranovich; C Niek van Dijk; Freddie H Fu Journal: Knee Surg Sports Traumatol Arthrosc Date: 2010-11-18 Impact factor: 4.342
Authors: Dominic T Mathis; Raphael Kaelin; Helmut Rasch; Markus P Arnold; Michael T Hirschmann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-07-15 Impact factor: 4.342
Authors: Stephan N Schön; Faik K Afifi; Helmut Rasch; Felix Amsler; Niklaus F Friederich; Markus P Arnold; Michael T Hirschmann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-10-11 Impact factor: 4.342
Authors: Michael T Hirschmann; Dominic Mathis; Helmut Rasch; Felix Amsler; Niklaus F Friederich; Markus P Arnold Journal: Int Orthop Date: 2012-11-11 Impact factor: 3.075
Authors: Dominic T Mathis; Anna Hirschmann; Anna L Falkowski; Tommi Kiekara; Felix Amsler; Helmut Rasch; Michael T Hirschmann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-05-27 Impact factor: 4.342
Authors: Basil Suter; Enrique Testa; Patrick Stämpfli; Praveen Konala; Helmut Rasch; Niklaus F Friederich; Michael T Hirschmann Journal: BMC Med Imaging Date: 2015-03-20 Impact factor: 1.930
Authors: Armin Mucha; Milos Dordevic; Enrique A Testa; Helmut Rasch; Michael T Hirschmann Journal: J Orthop Surg Res Date: 2013-12-10 Impact factor: 2.359