PT  - JOURNAL ARTICLE
AU  - Jihyun Kim
AU  - Yu Kyeong Kim
AU  - So Won Oh
AU  - Jee Won Chai
TI  - Clinical Significance of Knee SPECT/CT in the Evaluation of Patellofemoral Joint of Patients with Chronic Anterior Knee Pain
DP  - 2016 May 01
TA  - Journal of Nuclear Medicine
PG  - 1909--1909
VI  - 57
IP  - supplement 2
4099  - http://jnm.snmjournals.org/content/57/supplement_2/1909.short
4100  - http://jnm.snmjournals.org/content/57/supplement_2/1909.full
SO  - J Nucl Med2016 May 01; 57
AB  - 1909Objectives Single photon emission computed tomography and computed tomography (SPECT/CT) is a useful imaging tool in the evaluation of musculoskeletal diseases utilizing combination of anatomical and functional information. Patellofemoral (PF) joint was evaluated in patients with chronic anterior knee pain using SPECT/CT.Methods From 2011 March to 2012 February, 118 patients (M: F=50:68, Age=49.7 ± 1.3) who underwent SPECT/CT with 99mTc-hydroxydiphosphoate due to chronic anterior knee pain were retrospectively enrolled for the study. Intensity, location, and pattern of tracer uptake in the PF joint were analyzed on SPECT/CT. Diffuse uptake in the whole patella or PF groove was considered as chondromalacia patellae (CP), and diffuse uptake localized in the anterior aspect of the patella was considered as patellar enthesopathy (PE). Osteoarthritis (OA) was given when osteoarthritis was overt on SPECT/CT. SPECT/CT findings were compared with knee magnetic resonance imaging (MRI), as the gold standard for PF joint pathology.Results SPECT/CT showed that CP was 39.0% (n= 46 /118), PE 34.7% (n= 41 /118), OA 4.2 % (n= 5 /118), respectively. In addition, no lesion was identified in 16.9% (n=20/118) of patients on both SPECT/CT and MRI. However, in PE lesions, no structural abnormality was identified on MRI, except tracer uptake that was matched with enthesophytes on CT. Otherwise, PF lesions based on SPECT/CT were significantly correlated with MRI (p <0.001). Diagnostic accuracy of SPECT/CT in detecting PF joint lesion were sensitivity of 87.5%, specificity of 20.0%, positive predictive value of 42.9%, and negative predictive value of 70.0%.Conclusions Knee SPECT/CT showed relatively high sensitivity and high negative predictive value in detecting PF joint lesions. In particular, Knee SPECT/CT could be useful in patients complain of chronic knee pain without structural abnormality.