Comparison of SPECT/CT and MRI in Diagnosing Symptomatic Lesions in Ankle and Foot Pain Patients: Diagnostic Performance and Relation to Lesion Type

PURPOSE: The purpose of this study was to compare the diagnostic performance of SPECT/CT and MRI in patients with ankle and foot pain, with regard to the lesion types. MATERIALS AND METHODS: Fifty consecutive patients with ankle and foot pain, who underwent (99m)Tc-MDP SPECT/CT and MRI, were retrosp...

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Detalles Bibliográficos
Autores principales: Ha, Seunggyun, Hong, Sung Hwan, Paeng, Jin Chul, Lee, Dong Yeon, Cheon, Gi Jeong, Arya, Amitabh, Chung, June-Key, Lee, Dong Soo, Kang, Keon Wook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Research Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323343/
https://www.ncbi.nlm.nih.gov/pubmed/25668182
http://dx.doi.org/10.1371/journal.pone.0117583
Descripción
Sumario:PURPOSE: The purpose of this study was to compare the diagnostic performance of SPECT/CT and MRI in patients with ankle and foot pain, with regard to the lesion types. MATERIALS AND METHODS: Fifty consecutive patients with ankle and foot pain, who underwent (99m)Tc-MDP SPECT/CT and MRI, were retrospectively enrolled in this study. Symptomatic lesions were determined based on clinical examination and response to treatment. On MRI and SPECT/CT, detected lesions were classified as bone, ligament/tendon, and joint lesions. Uptake on SPECT/CT was assessed using a 4-grade system. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of SPECT/CT and MRI were evaluated in all detected lesions and each lesion type. Diagnostic value of uptake grade was analyzed using receiver-operating characteristics (ROC) curve analysis, and diagnostic performance was compared using Chi-square or McNemar tests. RESULTS: In overall lesions, the sensitivity, PPV and NPV of SPECT/CT for symptomatic lesions were 93%, 56%, 91%, and they were 98%, 48%, 95% for MRI. There was no significant difference between SPECT/CT and MRI. However, the specificity of SPECT/CT was significantly higher than that of MRI (48% versus 24%, P = 0.016). Uptake grade on SPECT/CT was significantly higher in symptomatic lesions (P < 0.001), and its area under curve on ROC analysis was 0.787. In the analysis of each lesion type, the specificity of SPECT/CT was poor in joint lesions compared with other lesion types and MRI (P < 0.001, respectively). MRI exhibited lower specificity than SPECT/CT in bone lesions (P = 0.004) and ligament/tendon lesions (P < 0.001). CONCLUSIONS: SPECT/CT has MRI-comparable diagnostic performance for symptomatic lesions in ankle and foot pain patients. SPECT/CT and MRI exhibit different diagnostic specificity in different lesion types. SPECT/CT may be used as a complementary imaging method to MRI for enhancing diagnostic specificity.

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