title: SPECT-CT imaging in degenerative joint disease of the foot and ankle.
abstract: The precise localisation of osteoarthritic changes is crucial for selective surgical treatment. Single photon-emission CT-CT (SPECT-CT) combines both morphological and biological information. We hypothesised that SPECT-CT increased the intra- and interobserver reliability to localise increased uptake compared with traditional evaluation of CT and bone scanning together. We evaluated 20 consecutive patients with pain of uncertain origin in the foot and ankle by radiography and SPECT-CT, available as fused SPECT-CT, and by separate bone scanning and CT. Five observers assessed the presence or absence of arthritis. The images were blinded and randomly ordered. They were evaluated twice at an interval of six weeks. Kappa and multirater kappa values were calculated. The mean intraobserver reliability for SPECT-CT was excellent (kappa = 0.86; 95% CI 0.81 to 0.88) and significantly higher than that for CT and bone scanning together. SPECT-CT had significantly higher interobserver agreement, especially when evaluating the naviculocuneiform and tarsometatarsal joints. SPECT-CT is useful in localising active arthritis especially in areas where the number and configuration of joints are complex.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Hospital of Basel, Spitalstrasse 21, Basel CH-4031, Switzerland. geert.pagenstert@ukb.uni-bonn.de
authors.forename: G I
authors.initials: GI
authors.lastname: Pagenstert
authors.forename: A
authors.initials: A
authors.lastname: Barg
authors.forename: A G
authors.initials: AG
authors.lastname: Leumann
authors.forename: H
authors.initials: H
authors.lastname: Rasch
authors.forename: J
authors.initials: J
authors.lastname: Müller-Brand
authors.forename: B
authors.initials: B
authors.lastname: Hintermann
authors.forename: V
authors.initials: V
authors.lastname: Valderrabano
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging*; D018450:Disease Progression; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging*; D005534:Foot Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010003:Osteoarthritis / Q000150:complications / Q000000981:diagnostic imaging*; D010146:Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D055815:Young Adult