RT Journal Article
SR Electronic
T1 Clinical Significance of Knee SPECT/CT in the Evaluation of Patellofemoral Joint of Patients with Chronic Anterior Knee Pain
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1909
OP 1909
VO 57
IS supplement 2
A1 Jihyun Kim
A1 Yu Kyeong Kim
A1 So Won Oh
A1 Jee Won Chai
YR 2016
UL http://jnm.snmjournals.org/content/57/supplement_2/1909.abstract
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.