Comparison of SPECT/CT with MRI in Imaging Scoliosis: Does SPECT/CT Provide Superior Diagnostic Information? 

Description

In a recent presentation, Dan Thurston, a registrar from Birmingham, discussed the roles of SPECT-CT and MRI in assessing scoliosis, detailing their comparative effectiveness and clinical implications. He emphasized that SPECT-CT combines structural and functional imaging, which has proven beneficial in postoperative spinal care and degenerative lumbar conditions by identifying pain generators and potentially avoiding unnecessary surgeries. However, he noted a scarcity of literature directly comparing SPECT-CT and MRI for spinal deformities, thereby justifying their study comparing diagnostic strides in a cohort of painful scoliosis patients.



The retrospective review encompassed 115 patients evaluated at a tertiary spinal center over 13 years, all of whom underwent both SPECT-CT and MRI. The analysis delved into demographics, prior spinal surgeries, and how SPECT imaging results influenced management plans. Notably, the study revealed that although a significant percentage of diagnoses were made with both modalities, a mere transformation in management was observed in only about 10% of cases, bringing to light the necessity of prudent application of these imaging methods.



Thurston reported that while MRI remains the primary diagnostic standard for most cases, SPECT-CT proved valuable particularly in scenarios complicated by metal artifacts, where MRI’s efficacy diminishes. Throughout the presentation, he referenced varied cohorts categorized by the type of deformity—idiopathic, congenital, and degenerative—illustrating the implications of imaging findings on subsequent treatments.



The audience engaged with questions regarding the comparative utility of MRI and SPECT-CT concerning management changes and clinical decision-making. Thurston acknowledged that in cases with clear abnormalities, clinical judgment often took precedence, overshadowing imaging results. The discussion highlighted the importance of cautious interpretation of SPECT results and a balanced approach to incorporating advanced imaging in clinical practices, particularly in complex spinal conditions.

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