title: Blood-pool SPECT in addition to bone SPECT in the viability assessment in mandibular reconstruction.
abstract: BACKGROUND
  The assessment of the postoperative viability of vascularized and non-vascularized grafts used in the reconstruction of mandibular defects due to trauma and surgical reasons is a major problem in maxillofacial surgery.
  
  
  OBJECTIVE
  In the present study, we evaluated the feasibility and image quality of blood-pool SPECT, which is used for the first time in the literature here in the assessment of mandibular reconstruction, in addition to non-invasive bone scintigraphy and bone SPECT. We also evaluated whether it would be useful in clinical prediction.
  
  
  METHODS
  Micro-vascularized and non-vascularized bone grafts were used in 12 Syrian men with maxillofacial trauma. Between days 5-7 after surgery, three-phase bone scintigraphy, blood-pool SPECT and delayed bone SPECT scans were performed. After month 6, the patients were assessed by control CT scans.
  
  
  RESULTS
  Of the non-vascularized grafts, one graft was reported as non-viable at week one. At month 6, graft resorption was demonstrated on the CT images. The remaining non-vascularized grafts and all of the micro-vascularized grafts were considered to be viable according to delayed bone SPECT and blood-pool SPECT images. However, only the anterior and posterior ends could be clearly assessed on delayed SPECT images, while blood-pool SPECT images allowed the clear assessment of the entire graft.
  
  
  CONCLUSIONS
  The combined use of blood-pool and delayed SPECT scans could allow for better assessment of graft viability in the early period, and can provide more detailed information to clinicians about prognosis in the follow-up of patients undergoing mandibular graft reconstruction.
authors.affiliation: Department of Nuclear Medicine, Otolaryngology Department of Head and Neck Surgery; Mustafa Kemal University, Faculty of Medicine, Hatay, Turkey. drfusunay@yahoo.com  
authors.forename: F
authors.initials: F
authors.lastname: Aydogan
authors.forename: E
authors.initials: E
authors.lastname: Akbay
authors.forename: C
authors.initials: C
authors.lastname: Cevik
authors.forename: E
authors.initials: E
authors.lastname: Kalender
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D005240:Feasibility Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging* / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D013593:Syria; D013997:Time Factors; D014022:Tissue Survival; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals