4D-SPECT/CT in orthopaedics: a new method of combined quantitative volumetric 3D analysis of SPECT/CT tracer uptake and component position measurements in patients after total knee arthroplasty.
Skeletal Radiol
; 42(9): 1215-23, 2013 Sep.
Article
in En
| MEDLINE
| ID: mdl-23695806
ABSTRACT
OBJECTIVE:
The purpose was to evaluate the intra- and inter-observer reliability of combined quantitative 3D-volumetric single-photon emission computed tomography (SPECT)/CT analysis including size, intensity and localisation of tracer uptake regions and total knee arthroplasty (TKA) position. MATERIALS ANDMETHODS:
Tc-99m-HDP-SPECT/CT of 100 knees after TKA were prospectively analysed. The anatomical areas represented by a previously validated localisation scheme were 3D-volumetrically analysed. The maximum intensity was recorded for each anatomical area. Ratios between the respective value and the mid-shaft of the femur as the reference were calculated. Femoral and tibial TKA position (varus-valgus, flexion-extension, internal rotation- external rotation) were determined on 3D-CT. Two consultant radiologists/nuclear medicine physicians interpreted the SPECT/CTs twice with a 2-week interval. The inter- and intra-observer reliability was determined (ICCs). Kappa values were calculated for the area with the highest tracer uptake between the observers.RESULTS:
The measurements of tracer uptake intensity showed excellent inter- and intra-observer reliabilities for all regions (tibia, femur and patella). Only the tibial shaft area showed ICCs <0.89. The kappa values were almost perfect (0.856, p < 0.001; 95 % CI 0.778, 0.922). For measurements of the TKA position, there was strong agreement within and between the readings of the two observers; the ICCs for the orientation of TKA components for inter- and intra-observer reliability were nearly perfect (ICCs >0.84).CONCLUSION:
This combined 3D-volumetric standardised method of analysing the location, size and the intensity of SPECT/CT tracer uptake regions ("hotspots") and the determination of the TKA position was highly reliable and represents a novel promising approach to biomechanics.
Full text:
1
Database:
MEDLINE
Main subject:
Tomography, X-Ray Computed
/
Tomography, Emission-Computed, Single-Photon
/
Technetium Tc 99m Medronate
/
Arthralgia
/
Arthroplasty, Replacement, Knee
/
Knee Joint
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
En
Year:
2013
Type:
Article