Korean J Radiol.  2021 Apr;22(4):604-611. 10.3348/kjr.2019.0746.

Early-Phase SPECT/CT for Diagnosing Osteomyelitis: A Retrospective Pilot Study

  • 1Department of Nuclear Medicine, Hanyang University Medical Center, Seoul, Korea
  • 2Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Daegu, Korea


The aim of this pilot study was to investigate the potential of early-phase single-photon emission computed tomography (SPECT)/computed tomography (CT) using technetium-99m methyl diphosphonate ( 99m Tc-MDP) for diagnosing osteomyelitis (OM).
Materials and Methods
Twenty-one patients with suspected OM were enrolled retrospectively. Three-phase bone scan (TPBS), early-phase SPECT/CT (immediately after blood pool planar imaging), and delayed-phase SPECT/CT (immediately after delayed planar imaging) were performed. The final diagnoses were established through surgery or clinical follow-up for over 6 months. We compared three diagnostic criteria based on (I) TPBS alone, (II) combined TPBS and delayed-phase SPECT/ CT, and (III) early-phase SPECT/CT alone.
OM was diagnosed in 11 of 21 patients (nine surgically and two clinically). Of the 11 OM patients, criterion-I, criterion-II, and criterion-III were positive in six, seven, and 10 patients, respectively. Of the 10 non-OM patients, criterion-I, criterion-II, and criterion-III were negative in five, five, and seven patients, respectively. The sensitivity/specificity/ accuracy of criterion-I, criterion-II, and criterion-III for diagnosing OM were 54.5%/50.0%/55.0%, 63.6%/50.0%/57.1%, and 90.9%/70.0%/87.5%, respectively.
This pilot study demonstrated the potential of using the early-phase SPECT/CT to diagnose OM. Based on the results, prospective studies with a larger sample size should be conducted to confirm the efficacy of early-phase SPECT/CT.


Bone and bones; Radionuclide imaging; Single photon emission computed tomography computed tomography
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