Abstract
1521
Objectives: 1. To compare the diagnostic accuracy of conventional three or two-phase bone scan with SPECT/CT in patients with a painful hip replacement. 2. To assess the role of radionuclide bone SPECT/CT in management of patients with painful hip prosthesis.
Methods: 6-year retrospective study of patients who had a bone SPECT/CT investigation for a painful hip replacement. All studies were reported by two consultant radiologists independently. Correlation of reports with subsequent clinical diagnosis and management by orthopaedic surgeons was evaluated.
Results: SPECT/CT provided additional information in addition to planar bone scintigraphy in 45% of patients investigated for painful hip prosthesis.. Bone scan with SPECT/CT findings correlated with clinical diagnosis in 80% of patients for Intrinsic pathologies and this was 47.4% for Extrinsic pathologies. Both were statistically significant . Bone scan SPECT/CT had Sensitivity, Specificity, PPV and NPV of 85.19%, 86.18%, 73.02% and 92.98% respectively in investigation of painful hip prosthesis.
Conclusions: A bone SPECT/CT should replace planar bone scintigraphy in investigating patients with painful hip replacements as it provides additional diagnostic information. SPECT/CT should be available to patients in the investigation of painful hip prosthesis due to its high sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).