Abstract
Introduction Precise localisation of osteoarthritis is crucial for selective surgical treatment. Single photon emission computed tomography – computer tomography (SPECT-CT) fuses morphologic and biologic information. We hypothesized that SPECT-CT increase intra- and interobserver reliability to localise increased uptake compared to traditional side-by-side evaluation of CT and bone-scans. Material and Methods 20 consecutive patients with pain of uncertain origin at foot and ankle where evaluated with X-rays and SPECT-CT, available as fused SPECT-CT and separate bone-scan and CT images. Five observers evaluated for presence or absence of arthritis. Images were blinded and randomly ordered and evaluated twice with a six weeks interval. Kappa and multi-rater kappa values were calculated. Results Average intraobserver reliability for SPECT-CT was perfect (κ=0.86; CI 0.81 to 0.88) and significant higher as CT & bone-scan. SPECT-CT had significant higher interobserver agreements, especially evaluating naviculocuneiforme and tarsometatarsal joints. Conclusions Our data suggest that SPECT-CT has added value in localizing active arthritis especially in areas where number and configuration of joints is complex.
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