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Archives of Orthopaedic and Trauma Surgery

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01-06-2019 | Magnetic Resonance Imaging | Arthroscopy and Sports Medicine

No added value using SPECT/CT to analyze persistent symptoms after anterior cruciate ligament reconstruction

Authors: Christian Egloff, Lukas Huber, Markus Wurm, Geert Pagenstert

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2019

Abstract

Purpose

To evaluate the diagnostic and clinical value of SPECT/CT compared to the standard algorithm for patients with persistent symptoms after anterior cruciate ligament reconstructions. The standard algorithm uses clinical information, conventional radiographs, MRI and CT scan, while the trial algorithm uses the same information but SPECT/CT in addition.

Methods

In a diagnostic comparative trial three experienced surgeons evaluated 23 consecutive patients with persistent symptoms after ACL reconstruction using first standard and second the trial algorithm with a time interval. Each rater had to establish a diagnosis and therapeutic decision with each algorithm. On MRI, graft continuity, bone marrow edema, chondral and meniscal lesions, femoral notch osteophytes were evaluated. Bone tracer uptake in SPECT/CT was anatomically analyzed and compared with MRI findings. MRI findings and SPECT/CT tracer uptake were correlated using Spearman’s rho test.

Results

Additional SPECT/CT analysis did not change diagnosis in any case and did not correlate with clinical graft integrity. Treatment decisions remained unchanged as well. Chondral lesions, arthritic changes, meniscal lesions, graft impingement are best visualized in MRI and showed correspondent tracer uptake in SPECT/CT. Tunnel position was well classified with standard CT scan and showed no correlation with SPECT/CT tracer uptake.

Conclusion

Information derived by SPECT/CT in addition to the standard algorithm using clinical information, X-rays, MRI, and CT scan did not change the diagnosis or treatment plan. There is currently no justification to implement SPECT/CT for patients with persistent symptoms after anterior cruciate ligament reconstructions.

Level of evidence

Level II: diagnostic comparative study.

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Title: No added value using SPECT/CT to analyze persistent symptoms after anterior cruciate ligament reconstruction
Authors: Christian Egloff
Lukas Huber
Markus Wurm
Geert Pagenstert
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-019-03117-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

No added value using SPECT/CT to analyze persistent symptoms after anterior cruciate ligament reconstruction

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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