title: Bone Scintigraphy in the Diagnosis of Rheumatoid Arthritis: Is There Additional Value of Bone Scintigraphy with Blood Pool Phase over Conventional Bone Scintigraphy?
abstract: We aimed to investigate the value of bone scintigraphy with additional blood pool phase (BSBP), compared with conventional bone scintigraphy (CBS), in the assessment of rheumatoid arthritis (RA). A total of 242 patients (43 males, 199 females; 14-78 years) with arthralgia, and underwent BSBP were retrospectively analyzed. On the first physical examination, active arthritis was found in 128 of the 242 patients. Clinical diagnosis was made by a rheumatologist on the basis of the 1987 American College of Rheumatology (ACR) criteria, which are considered to be the gold standard. The diagnostic performances and prognostic value of BSBP and CBS were analyzed in the total patients with arthralgia and in the patients with arthritis. The sensitivity of BSBP (84.2%, 80/95) were significantly higher than that of CBS (74.8%, 72/95) in the patients with arthralgia (P = 0.039). When BSBP was interpreted with the results of elevated/positive anti-CCP antibody, its accuracy over CBS also became significantly higher (86.0%, 208/242 vs. 83.1%, 201/242 respectively, P = 0.021). The diagnostic odds ratio of BSBP positivity was higher than CBS positivity in the patients with arthralgia (26.0, 12.9-52.4 vs. 21.1, 10.8-41.3) and with arthritis (12.0, 4.9-29.4 vs. 10.0, 4.2-23.4). Both BSBP and CBS appear to provide acceptable accuracy and comparable diagnostic performance for diagnosis of RA. However, in the patients with arthralgia, BSBP was found to be more sensitive than CBS and more accurate when interpreted with the result of anti-CCP antibody. This could help physicians diagnose RA in daily clinical practice.
authors.affiliation: Department of Nuclear Medicine, Hanyang University College of Medicine, Hanyang University Medical Center, Seoul, Korea .
authors.forename: Ji Young
authors.identifier: 0000-0003-2199-4529
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Hanyang University College of Medicine, Hanyang University Medical Center, Seoul, Korea .
authors.forename: Yun Young
authors.identifier: 0000-0002-7535-4343
authors.initials: YY
authors.lastname: Choi
authors.affiliation: Department of Nuclear Medicine, Hanyang University College of Medicine, Hanyang University Medical Center, Seoul, Korea .
authors.forename: Chan Woo
authors.identifier: 0000-0001-9914-313X
authors.initials: CW
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine and the Hospital for Rheumatic Diseases, Hanyang University Medical Center, Seoul, Korea .
authors.forename: Yoon-Kyoung
authors.identifier: 0000-0001-6691-8939
authors.initials: YK
authors.lastname: Sung
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine and the Hospital for Rheumatic Diseases, Hanyang University Medical Center, Seoul, Korea .
authors.forename: Dae-Hyun
authors.identifier: 0000-0002-0643-4008
authors.initials: DH
authors.lastname: Yoo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000150:complications; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis*; D001323:Autoantibodies / Q000097:blood; D001842:Bone and Bones / Q000000981:diagnostic imaging; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010456:Peptides, Cyclic / Q000276:immunology; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013667:Technetium / Q000737:chemistry; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D013667:Technetium
keywords: Additional Blood Pool Phase; Diagnostic Performance; Rheumatoid Arthritis; Whole Body Bone Scan