Incremental values of 99Tcm-MDP bone scan in postmenopausal women with osteoporotic thoracolumbar vertebral fractures

Abstract

Objective To assess incremental values of 99Tcm-MDP SPECT/CT bone scan imaging by semi-quantitative analysis indexes for osteoporotic thoracolumbar vertebral fractures in postmenopausal women. Methods This retrospective study enrolled 81 postmenopausal women patients diagnosed and treated for back pain from November 2012 to October 2016. All patients were diagnosed with osteoporotic thoracolumbar vertebral compression fractures. All patients underwent 99Tcm-MDP SPECT/CT bone imaging, and techniques for ROI were repeatedly applied to draw sagittal imaging sites of regional uptake in ROI, to record the number of radioactive counting of lesions (T) and adjacent normal vertebral sagittal imaging (NT), and to calculate T/NT ratio. Patients were divided into two groups. One group was treated by vertebroplasty or kyphoplasty after 99Tcm-MDP SPECT/CT bone imaging, and the other was treated with conservative treatment. T/NT ratios of the two groups were statistically analyzed. Results A total of 110 vertebral fractures were treated by vertebroplasty or kyphoplasty after 99Tcm-MDP SPECT/CT bone imaging, and 70 vertebral fractures were treated with conservative treatment. T/NT ratio of fractures reached 2.44±0.84 and 1.04±0.14, respectively (t=13.654, P<0.05), after treatment with vertebroplasty or kyphoplasty; and conservative treatment. Some concurrent lesions which were absent in X-ray or MRI were detected by SPECT/CT, for example, 29 rib fractures and 2 sacrum fractures. Conclusion 99Tcm-MDP SPECT/CT bone imaging by semi-quantitative analysis can effectively guide treatment of vertebral compression fractures. Key words: Osteoporosis, postmenopausal; Thoracic vertebrae; Lumbar vertebrae; Technetium Tc 99m medronate; Tomography, emission-computed, single-phton; Tomography, X-ray computed; Verte-bral fracture