title: Influence on therapeutic decision making of SPECT-CT for different regions of the foot and ankle.
abstract: BACKGROUND
  Single-photon emission computed tomography and computed tomography (SPECT-CT) has a high impact on diagnosis and treatment decision of different joints. The aim of this study was to evaluate whether there is a different gain of SPECT-CT for different foot regions.
  
  
  METHODS
  We retrospectively identified 86 patients who received a SPECT-CT of the foot and ankle between April 2011 and December 2012. We divided all patients into the following subgroups: ankle (group 1), subtalar (group 2), Chopart (group 3), and Lisfranc (group 4). The local ethical committee approved the study.
  
  
  RESULTS
  The clinical treatment decision was changed based on SPECT-CT results in 64.5% of group 1, 65.2% of group 2, and 75% each of groups 3 and 4. Eighty patients (93%) had pain relief after treatment based on SPECT-CT. The overall SPECT-CT sensitivity was 0.94 and the specificity was 0.57. The positive and negative predictive values were 0.87 and 0.75, respectively.
  
  
  CONCLUSIONS
  The impact of SPECT-CT on treatment decision is slightly higher in diseases of the Chopart and Lisfranc joints than in the upper ankle and subtalar joints. The additional information has a clinical relevance due to the high rate of pain relief by treatment based on SPECT-CT diagnosis.
authors: Hannover Medical School, Orthopedic Department, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany.
authors: Leif
authors: 0000-0001-5212-9744
authors: L
authors: Claassen
authors: Hannover Medical School, Orthopedic Department, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany.
authors: Theodor
authors: 0000-0002-4848-5751
authors: T
authors: Uden
authors: Hannover Medical School, Orthopedic Department, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany.
authors: Max
authors: M
authors: Ettinger
authors: Hannover Medical School, Orthopedic Department, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany.
authors: Kiriakos
authors: 0000-0002-9605-6011
authors: K
authors: Daniilidis
authors: Hannover Medical School, Orthopedic Department, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany.
authors: Christina
authors: C
authors: Stukenborg-Colsman
authors: Hannover Medical School, Orthopedic Department, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany.
authors: Christian
authors: 0000-0003-0568-2074
authors: C
authors: Plaass
mesh_terms: D000328:Adult; D000368:Aged; D003657:Decision Making; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010146:Pain / Q000473:pathology; D011859:Radiography; D013639:Tarsal Bones / Q000000981:diagnostic imaging* / Q000473:pathology; D015899:Tomography, Emission-Computed, Single-Photon