SPECT-CT Is Good Predictor of Response to Vertebroplasty

Positive bone SPECT-CT good predictor of clinical improvement after percutaneous vertebroplasty

WEDNESDAY, Jan. 11 (HealthDay News) -- Positive bone single photon emission computed tomography-computed tomography (SPECT-CT) images are useful as predictors regarding which patients will experience clinical improvement following percutaneous vertebroplasty (PV) for vertebral fractures, according to a study published in the December issue of The Spine Journal.

Montserrat Solá, Ph.D., of the Hospital Universitari Germans Trias i Pujol in Badalona, Spain, and colleagues investigated the value of bone SPECT-CT in patient selection, treatment planning, and the prediction of response to PV in a prospective, consecutive case study involving 33 patients; of these, 24 underwent a PV procedure. The SPECT-CT images were compared with magnetic resonance imaging (MRI). Pre- and post-procedure outcomes measurements of pain, mobility, and analgesic use were compared to detect improvement of clinical status.

The researchers found that clinical improvement was predicted in 91 percent of the positive SPECT-CT images. There was 80 percent agreement between SPECT-CT and MRI. In some cases, an alternative cause of pain was identified on SPECT-CT images, including new or multiple coexisting fractures, persisting bone remodeling in a previous cemented vertebra, and degenerative disease. In eight patients who could not receive MRI, SPECT-CT was mandatory, and all patients improved after PV.

"Our study confirms that PV is a highly efficient therapy for the relief of chronic pain because of vertebral fractures. Positive bone SPECT-CT images perform as a good predictor of patient improvement," the authors write.

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