Florian Schleich, Presenter: Nothing to Disclose

Martin W Huellner MD, Abstract Co-Author: Research grant, Siemens AG Research grant, Bayer AG

Maja Schuerch, Abstract Co-Author: Nothing to Disclose

Urs Von Wartburg MD, Abstract Co-Author: Nothing to Disclose

Klaus Strobel MD, Abstract Co-Author: Nothing to Disclose

Patrick Veit-Haibach MD, Abstract Co-Author: Research grant, Bayer AG

To evaluate the diagnostic and therapeutic influence of SPECT/CT in a selected patient population with unspecific pain of the hand and wrist.  

51 consecutive patients (31 female, 20 male, mean age 38) with persisting wrist pain after trauma or with chronic wrist / hand pain without trauma were referred by their hand surgeon for evaluation by SPECT/CT. All patients gave written informed consent prior to the examination. All patients received conventional X-ray as well as planar, early-phase and late-phase SPECT/CT imaging. Region-based evaluation on SPECT/CT was carried out by an dual-board certified nuclear medicine physician/radiologist. Diagnostic SPECT/CT results were compared with X-ray alone and X-ray combined with planar bone scan. 21 patients had an additional MRI prior and 1 patient after the SPECT/CT examination.The therapeutic impact was evaluated in consensus with a hand surgeon.    

Fourty eight pathological lesions were detected on plane radiography, 117 lesions on plain scintigraphy and 142 lesions on SPECT/CT. SPECT/CT detected significantly (p<0.05) more lesions than x-ray-imaging, but not significantly more lesions that X-ray combined with planar bone scan. Overall, in 13 patients a change in therapy was initiated based on the SPEC/CT findings (e.g. surgical treatment, revision of arthrodesis, change from surgical to conservative treatment). Additionally, SPECT/CT excluded suspected pathologies in 9 patients. Consequently, planned therapy was avoided.

Hybrid imaging with SPECT/CT increased the diagnostic accuracy in patients with unspecific pain of the hand and wrist. Additionally, SPECT/CT showed important impact on consecutive therapy in this clinically unsatisfying situation in a significant number of patients. Thus, SPECT/CT imaging might be integrated in the clinical work-up of in this selected patient population.  

SPECT/CT can be integrated in the clinical work up of patients with unspecific hand and wrist pain based on the significant impact on therapy decision found in this study.

Schleich, F, Huellner, M, Schuerch, M, Von Wartburg, U, Strobel, K, Veit-Haibach, P, Diagnostic and Therapeutic Impact of SPECT/CT in Patients with Unspecific Pain of the Hand and Wrist Pain.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11007712.html