The Effect of Co-Registration of Tc-99m HDP SPECT Bone Scan with Diagnostic Quality CT /MRI Images on Diagnosis and Management of Neurosurgical Spinal Patients
Aim: To investigate the usefulness of high-quality fusion images of nuclear medicine studies with diagnostic quality anatomical images in neurosurgical spinal patients. Spinal pathology and anatomy, especially in the postoperative patient population is complicated, diagnostic quality anatomical images are crucial in patient management.
Methods: We investigated 134 consecutive patients (81 males - age: 22-78Y, mean:51Y and 53 females- age 19-82Y, mean: 57Y ) referred for Tc-99m HDP bone scan who has had anatomical images performed prior or at the time of their bone scans. Siemens ecam advanced fusion program was used for processing. Pathology type (degenerative process, failed fusion, trauma, malignancy, osteoporotic fracture and no obvious pathology); anatomical site and treatment intention were documented before and after performing the Tc-99m HDP bone scan and the fusion images.
Results: Our survey showed that pathological classification changed in 14 (10%) patients, anatomical localisation also changed in 14 (10%) patients while change in treatment intention occurred in 12 (8.6%) patients. Treatment intention was changed markedly in 5 (3.6%) patients.
Conclusion: High quality fusion images of bone scan with diagnostic quality CT/MRI scans give significant additional information and help the decision making process to form accurate management plans. The authors recommend - especially in this complicated patient population - perfoming fusion images with the use of high quality diagnostic CT/MRI as the preferred option as compared to the use of non-diagnostic quality CT images from hybrid SPECT/CT machines.