REVIEW  BLOOD POOL PHASE SPECT: THE MISSING LINK OF BONE SCINTIGRAPHY Free access

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2023 September;67(3):191-201

DOI: 10.23736/S1824-4785.23.03503-3

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Blood pool SPECT: rheumatological and orthopedic focus, a pictorial essay

Jules ZHANG-YIN ¹ ✉, Nicolas ICARD ², Elkheir ATTIA ², Thanh B. TANG ¹, Etienne MAUEL ³, Renée AHOND-VIONNET ⁴, David MORLAND ^{5, 6, 7}

¹ Department of Nuclear Medicine, South Clinic of Luxembourg, Vivalia, Arlon, Belgium; ² Department of Nuclear Medicine, Yves Le Foll Hospital Center, Saint-Brieuc, France; ³ Department of Surgery, South Clinic of Luxembourg, Vivalia, Arlon, Belgium; ⁴ Department of Nuclear Medicine, Hospital Center Agglomération of Nevers, Nevers, France; ⁵ Department of Nuclear Medicine, Godinot Institute, Reims, France; ⁶ CReSTIC, EA 3804, University of Reims Champagne-Ardenne, Reims, France; ⁷ Unit of Nucleart Medicine, GSTeP Radiofarmacia, TracerGLab, Department of Radiology, Radiotherapy and Hematology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy

Single photon emission computed tomography (SPECT) has revolutionized delayed bone scan acquisitions and promises to bring the same benefits to early acquisitions, especially in areas of complex anatomy. To date, however, only a few studies have been published about the utility of blood pool SPECT. The accurate assessment of inflammatory processes can be an indisputable added value to the diagnosis. We present here a series of clinical cases illustrating the utility of blood pool SPECT in various clinical situations in rheumatology and orthopedics. We grouped the cases according to three patterns that facilitate clinical reasoning: inflammatory osseous pathology (pattern A), inflammatory para-osseous pathology (pattern B) and inflammatory extra-osseous pathology (pattern C). A total of seventeen clinical cases are presented. This new semiology requires time and effort to be mastered but expands the diagnostic range offered by bone scintigraphy. More prospective studies on blood pool SPECT will be needed, especially those aiming to clarify its role.

KEY WORDS: Gated blood-pool imaging; Tomography, emission-computed, single-photon; Rheumatology; Orthopedics