Ujwal Bhure1, Urs Hug2, Martin W Huellner1, Hannes Grünig1, Andrea Zander1, Maria Del Sol Pérez Lago1, Klaus Strobel3. 1. Nuclear Medicine and Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland. 2. Department of Hand and Plastic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland. 3. Nuclear Medicine and Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland. klaus.strobel@ksl.ch.
Abstract
PURPOSE: To assess the value of SPECT/CT in patients with carpal boss (CB). METHODS: In 24 wrists with CB (18 right-sided, 6 left-sided) in 21 patients, planar images and SPECT/CT images were obtained. Three patients had bilateral CB. The grade of uptake (0 absent, 1 low, 2 moderate, 3 high) on planar imaging and SPECT/CT was assessed and compared with CT findings, clinical symptoms and follow-up findings. RESULTS: CB affected carpometacarpal joint II in 4 wrists, carpometacarpal joint III in 17 wrists and both carpometacarpal joints II and III in 3 wrists. Of the 24 CB, 12 (50 %) were active (i.e. increased radionuclide uptake) on planar images and 18 (75 %) on SPECT/CT images. Of the 17 symptomatic CB, 10 (59 %) were active on planar images and 14 (82 %) were active (mean grade 1.9, range 1 - 3) on SPECT/CT images. Of the 7 asymptomatic CB, 2 were active on planar images and 4 were active (mean grade 1.25, range 1 - 2) on SPECT/CT images. CT alone showed CB in all patients and an accessory ossicle (os styloideum) in 8 wrists. MR imaging was available in 7 patients and positive for CB in 5 (sensitivity 71 %). Plain radiographs were available in 17 patients and positive in 10 (59 %). Therapeutic infiltration of the CB was performed in 9 patients, and resection of the CB in 7 patients. CONCLUSION: SPECT/CT provides important morphological and metabolic information for the clinical assessment of CB, but because SPECT/CT tends to overestimate the clinical importance of CB, we recommend that planar images should still be obtained.
PURPOSE: To assess the value of SPECT/CT in patients with carpal boss (CB). METHODS: In 24 wrists with CB (18 right-sided, 6 left-sided) in 21 patients, planar images and SPECT/CT images were obtained. Three patients had bilateral CB. The grade of uptake (0 absent, 1 low, 2 moderate, 3 high) on planar imaging and SPECT/CT was assessed and compared with CT findings, clinical symptoms and follow-up findings. RESULTS: CB affected carpometacarpal joint II in 4 wrists, carpometacarpal joint III in 17 wrists and both carpometacarpal joints II and III in 3 wrists. Of the 24 CB, 12 (50 %) were active (i.e. increased radionuclide uptake) on planar images and 18 (75 %) on SPECT/CT images. Of the 17 symptomatic CB, 10 (59 %) were active on planar images and 14 (82 %) were active (mean grade 1.9, range 1 - 3) on SPECT/CT images. Of the 7 asymptomatic CB, 2 were active on planar images and 4 were active (mean grade 1.25, range 1 - 2) on SPECT/CT images. CT alone showed CB in all patients and an accessory ossicle (os styloideum) in 8 wrists. MR imaging was available in 7 patients and positive for CB in 5 (sensitivity 71 %). Plain radiographs were available in 17 patients and positive in 10 (59 %). Therapeutic infiltration of the CB was performed in 9 patients, and resection of the CB in 7 patients. CONCLUSION: SPECT/CT provides important morphological and metabolic information for the clinical assessment of CB, but because SPECT/CT tends to overestimate the clinical importance of CB, we recommend that planar images should still be obtained.
Authors: Klaus Strobel; Isabelle Steurer-Dober; Angela J Da Silva; Martin W Huellner; Maria del Sol Pérez Lago; Elvira Bodmer; Urs von Wartburg; Patrick Veit-Haibach; Katharina Tornquist; Urs Hug Journal: Eur J Nucl Med Mol Imaging Date: 2013-11-01 Impact factor: 9.236
Authors: Martin W Huellner; Alexander Bürkert; Florian S Schleich; Maja Schürch; Urs Hug; Urs von Wartburg; Klaus Strobel; Patrick Veit-Haibach Journal: Eur J Nucl Med Mol Imaging Date: 2012-01-12 Impact factor: 9.236
Authors: Florian S Schleich; Maja Schürch; Martin W Huellner; Urs Hug; Urs von Wartburg; Klaus Strobel; Patrick Veit-Haibach Journal: EJNMMI Res Date: 2012-09-28 Impact factor: 3.138
Authors: Martin W Huellner; Alexander Bürkert; Klaus Strobel; María del Sol Pérez Lago; Lennart Werner; Urs Hug; Urs von Wartburg; Burkhardt Seifert; Patrick Veit-Haibach Journal: PLoS One Date: 2013-12-30 Impact factor: 3.240
Authors: Ujwal Bhure; Justus E Roos; Maria Del Sol Pérez Lago; Isabelle Steurer; Hannes Grünig; Urs Hug; Klaus Strobel Journal: Br J Radiol Date: 2017-11-16 Impact factor: 3.039