Comparison.of Bone Scan and SPECT/CT in detection of Condylar.Hyperplasia

Abstract

Background: Condylar Hyperplasia is a pathology characterized by. abnormal growth. that causes.facial asymmetry. It is an excessive growth of one or both mandibular condyles.that affects ramus, body or neck of the mandible. It can eventually cause facial asymmetry, malocclusion, speech .and masticatory .problems. Aim: To find out the diagnostic efficacy. of Bone Scan and SPECT/CT. in detection of Condylar Hyperplasia. Methods: 33 patients were selected based on the inclusion criteria. Bone Scans were performed. and dynamic study comprising Perfusion & Blood-pool phases were acquired immediately. after intravenous injection of 99Tcm_MDP. SPECT.and CT images were obtained 3-6 hours after the injection. Results: 14 patients (42.4%) were considered positive on planar bone scan due to the hot spots (radiotracer uptake areas) around TMJ, nose and mandibular region. Yet there was no evidence that these patients were confirmed of the pathology. 3D multi slice imaging was required to confirm the pathology. 10 patients (30.3%) were negative with no hot spots showed. 13 patients (27.3%) were remained suspected and required proper image acquisitions. SPECT CT scans were performed and 28 patients (84.8%) were shown negative. No hot spots shown on mandibular condyles and TMJ confirmed that patients had not been detected of condylar hyperplasia. Only 5 patients (15.2%) confirmed condylar hyperplasia with hot spots on condyles and temporomandibular joint. Conclusion: Planar bone scan did not effectively separate mastoid, TM joint in 2D image due to these structures lies in close proximity to each other. Planar bone scan was unable to localize the actual sites of higher uptakes. On contrary SPECT CT had confirmed 5 patients with positive uptake values and confirmed the presence of pathology. Due to multi slice imaging acquisitions and detailed information regarding radiotracer activity, distribution and localization, SPECT CT showed better visualization of the structures and provided better understanding of the pathology. Keywords: Condylar Hyperplasia, Planar Bone Scan, SPECT CT