Comparison of planar scintigraphy alone and with SPECT for the initial evaluation of femoral neck stress fracture.
OBJECTIVE
The objective of our study was to compare the accuracy of planar scintigraphy alone versus planar scintigraphy with SPECT for the initial evaluation of femoral neck stress fractures in a young military population.


METHODS
We retrospectively identified 38 patients who had undergone planar scintigraphy and 33 patients who had undergone planar scintigraphy and SPECT before MRI of the hips over a 6-month period for evaluation of suspected femoral neck fracture. Data were analyzed regarding the sensitivity and specificity of bone scanning alone and with SPECT for detecting femoral neck stress fracture and grading fractures as low grade (grades I and II) or high grade (grades III and IV).


RESULTS
Twelve fractures were identified in the group who underwent planar scintigraphy alone and 13 in the group who underwent planar scintigraphy with SPECT. The sensitivities of planar scintigraphy alone and with SPECT were 50% and 92.3%, respectively (p = 0.03). The accuracy of each technique for the detection of high-grade fractures was 12.5% and 70%, respectively (p = 0.025).


CONCLUSIONS
Planar scintigraphy with SPECT had a higher sensitivity and accuracy in assessing the grade of femoral neck stress fractures than planar scintigraphy alone. The results of this study suggest that SPECT should be performed with planar bone scintigraphy for the evaluation of patients with suspected femoral neck stress fractures.
Bryant
L Ray
LR
Department of Radiology and Nuclear Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.
Song
Won S
WS
Banks
Kevin P
KP
Bui-Mansfield
Liem T
LT
Bradley
Yong C
YC
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005265:Femoral Neck Fractures / Q000145:classification / Q000000981:diagnostic imaging*; D015775:Fractures, Stress / Q000145:classification / Q000000981:diagnostic imaging*; D015902:Gamma Cameras; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate