Bone Scans Are Reliable for the Identification of Lumbar Disk and Facet Pathology

Document Type

Article

Publication Date

2014

Keywords

bone scan, CT, image fusion, lumbar, reliability, spine

Digital Object Identifier (DOI)

https://doi.org/10.1055/s-0034-1394298

Abstract

Study Design: Surgeon survey.

Objective: To evaluate the reliability of bone single-photon emission computed tomography (SPECT) versus bone SPECT images co-registered with computed tomography (bone SPECT-CT) by analyzing interobserver agreement for identification of the anatomical location of technetium99m-labeled oxidronate uptake in the lumbar disk and/or facet joint.

Methods: Seven spine surgeons interpreted 20 bone scans: 10 conventional black-and-white tomograms (bone SPECT) and 10 color-graded bone SPECT-CT scans. Each surgeon was asked to identify the location of any diagnostically relevant uptake in the disk and/or facet joint between L1 and S1. Reliability was evaluated using the free-marginal kappa statistic, and the level of agreement was assessed using the Landis and Koch interpretation.

Results: Conventional bone SPECT scans and bone SPECT-CT scans were reliable for the identification of diagnostically relevant uptake, with bone SPECT-CT having higher reliability (kappa = 0.72) than bone SPECT alone (0.59). Bone SPECT and bone SPECT-CT were also reliable in identifying disk pathology, with kappa values of 0.72 and 0.81, respectively. However, bone SPECT-CT was more reliable (0.81) than bone SPECT (0.60) when identifying facet disease.

Conclusions: For the identification of disk pathology, it is reasonable to use either conventional bone SPECT or bone SPECT-CT; however, bone SPECT-CT is more reliable for facet joint pathology.

Was this content written or created while at USF?

Yes

Citation / Publisher Attribution

Global Spine Journal, v. 5, issue 1, p. 23-29

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