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Skeletal Radiology
Published in: Skeletal Radiology 9/2017

01-09-2017 | Scientific Article

Evaluation of bone viability in patients after girdlestone arthroplasty: comparison of bone SPECT/CT and MRI

Authors: G. Diederichs, P. Hoppe, F. Collettini, G. Wassilew, B. Hamm, W. Brenner, M. R. Makowski

Published in: Skeletal Radiology | Issue 9/2017

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Abstract

Purpose

To test the diagnostic performance of bone SPECT/CT and MRI for the evaluation of bone viability in patients after girdlestone-arthroplasty with histopathology used as gold standard.

Materials and methods

In this cross-sectional study, patients after girdlestone-arthroplasty were imaged with single-photon-emission-computed-tomography/computed-tomography (SPECT/CT) bone-scans using 99mTc-DPD. Additionally, 1.5 T MRI was performed with turbo-inversion-recovery-magnitude (TIRM), contrast-enhanced T1-fat sat (FS) and T1-mapping. All imaging was performed within 24 h prior to revision total-hip-arthroplasty in patients with a girdlestone-arthroplasty. In each patient, four standardized bone-tissue-biopsies (14 patients) were taken intraoperatively at the remaining acetabulum superior/inferior and trochanter major/minor. Histopathological evaluation of bone samples regarding bone viability was used as gold standard.

Results

A total of 56 bone-segments were analysed and classified as vital (n = 39) or nonvital (n = 17) by histopathology. Mineral/late-phase SPECT/CT showed a high sensitivity (90%) and specificity (94%) to distinguish viable and nonviable bone tissue. TIRM (sensitivity 87%, specificity 88%) and contrast-enhanced T1-FS (sensitivity 90%, specificity 88%) also achieved a high sensitivity and specificity. T1-mapping achieved the lowest values (sensitivity 82%, specificity 82%). False positive results in SPECT/CT and MRI resulted from small bone fragments close to metal artefacts.

Conclusions

Both bone SPECT/CT and MRI allow a reliable differentiation between viable and nonviable bone tissue in patients after girdlestone arthroplasty. The findings of this study could also be relevant for the evaluation of bone viability in the context of avascular bone necrosis.
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Metadata
Title
Evaluation of bone viability in patients after girdlestone arthroplasty: comparison of bone SPECT/CT and MRI
Authors
G. Diederichs
P. Hoppe
F. Collettini
G. Wassilew
B. Hamm
W. Brenner
M. R. Makowski
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 9/2017
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-017-2692-8

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