title: Hybrid imaging of peripheral skeletal disease by SPECT/high-resolution flat-panel CT.
abstract: The aim of this study was to determine the impact of high-resolution cone-beam CT with flat-panel detectors on the interpretation of bone SPECT in diseases of the peripheral skeleton.
  
  
  METHODS
  Forty-one consecutive patients with peripheral skeletal disease were examined with a SPECT/high-resolution CT system providing isotropic voxels of 0.33 × 0.33 × 0.33 mm. High-resolution images were retrospectively analyzed by 2 readers and compared with low-resolution images obtained by filtering the high-resolution images to a lower resolution.
  
  
  RESULTS
  SPECT/high-resolution CT demonstrated higher diagnostic confidence scores (1.98 ± 0.27 vs. 1.3 ± 0.45, P < 0.01) and better interobserver agreement (κ = 0.5 vs. 0.2) than SPECT/low-resolution CT. The diagnosis made by SPECT/high-resolution CT was in agreement with the final clinical diagnosis in 95% (reader 1) and 90% (reader 2) of the cases, as compared with 59% (reader 1) and 60% (reader 2) of the cases for SPECT/low-resolution CT (P < 0.01).
  
  
  CONCLUSIONS
  High-resolution flat-panel CT has the potential to significantly improve SPECT/CT imaging in diseases of the peripheral skeleton.
authors.affiliation: Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany. lohrmahnl@mskcc.org
authors.forename: Christian
authors.initials: C
authors.lastname: Lohrmann
authors.forename: Oliver
authors.initials: O
authors.lastname: Hauschild
authors.forename: Philipp T
authors.initials: PT
authors.lastname: Meyer
authors.forename: Michael
authors.initials: M
authors.lastname: Mix
authors.forename: Peter C
authors.initials: PC
authors.lastname: Strohm
authors.forename: Wolfgang A
authors.initials: WA
authors.lastname: Weber
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Rischke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001847:Bone Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D015588:Observer Variation; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: SPECT/CT; flat-panel CT; hybrid imaging; skeletal disease