D Zarringam1, D B F Saris2, J E J Bekkers3. 1. Department of Orthopaedics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. 2. Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, MN, USA. 3. Department of Orthopedics, Diakonessenhuis Hospital, Utrecht, The Netherlands.
Abstract
BACKGROUND: Single photon emission computed tomography (SPECT/CT) is a diagnostic option for knee osteoarthritis patients without osteoarthritic features on X-ray; however, the added value of SPECT/CT remains debatable in the diagnostic algorithm. OBJECTIVE: To review the added value of SPECT/CT in the diagnostic algorithm of knee osteoarthritis. STUDY DESIGN: Systematic review. METHODS: A systematic search was carried out in the databases EMBASE, MEDLINE, and the Cochrane collaboration. The retrieved articles were screened for relevance on title and abstract. This was followed by a full-text study quality appraisal of the remaining articles. Finally, a total of 9 trials were included. RESULTS: The use of SPECT/CT might objectify some clinical knee osteoarthritis symptoms. It could correlate with findings on plain radiography and magnetic resonance imaging. Furthermore, there is some evidence SPECT/CT gives additional information compared with these imaging modalities; however, superiority is not proven. The uptake on SPECT could predict the intraoperative macroscopic findings. Yet the clinical relevance remains unclear. CONCLUSION: There is no strong evidence SPECT/CT should play a role in the diagnosing and decision-making processes of knee osteoarthritis. Yet there is evidence suggesting SPECT/CT might give additional information in the diagnosing process. More research would be of added value to answer this research question.
BACKGROUND: Single photon emission computed tomography (SPECT/CT) is a diagnostic option for knee osteoarthritis patients without osteoarthritic features on X-ray; however, the added value of SPECT/CT remains debatable in the diagnostic algorithm. OBJECTIVE: To review the added value of SPECT/CT in the diagnostic algorithm of knee osteoarthritis. STUDY DESIGN: Systematic review. METHODS: A systematic search was carried out in the databases EMBASE, MEDLINE, and the Cochrane collaboration. The retrieved articles were screened for relevance on title and abstract. This was followed by a full-text study quality appraisal of the remaining articles. Finally, a total of 9 trials were included. RESULTS: The use of SPECT/CT might objectify some clinical knee osteoarthritis symptoms. It could correlate with findings on plain radiography and magnetic resonance imaging. Furthermore, there is some evidence SPECT/CT gives additional information compared with these imaging modalities; however, superiority is not proven. The uptake on SPECT could predict the intraoperative macroscopic findings. Yet the clinical relevance remains unclear. CONCLUSION: There is no strong evidence SPECT/CT should play a role in the diagnosing and decision-making processes of knee osteoarthritis. Yet there is evidence suggesting SPECT/CT might give additional information in the diagnosing process. More research would be of added value to answer this research question.
Authors: Penny F Whiting; Marie E Weswood; Anne W S Rutjes; Johannes B Reitsma; Patrick N M Bossuyt; Jos Kleijnen Journal: BMC Med Res Methodol Date: 2006-03-06 Impact factor: 4.615
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