ISSN 1305-3825 | E-ISSN 1305-3612
Musculoskeletal Imaging - Original Article
Comparison of facet joint activity on 99mTc-MDP SPECT/CT with facet joint signal change on MRI with fat suppression
1 Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA  
2 Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA  
3 Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Immunology, Mayo Clinic, Rochester, Minnesota, USA  
Diagn Interv Radiol ; : -

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Purpose: We compared signal change on magnetic resonance imaging (MRI) with fat suppression and bone scan activity of lumbar facet joints to determine if these two imaging findings are correlated.


Methods: We retrospectively identified all patients who underwent imaging of the lumbar spine for pain evaluation using both technetium Tc 99m methylene disphosphonate single-photon emission computed tomography/computed tomography (99mTc‑MDP SPECT/CT) and MRI with at least 1 fat-suppressed T2 or T1 sequence with gadolinium enhancement, within a 180-day interval, at our institution between 1 January, 2008, and 19 February, 2013. Facet joint activity on 99mTc‑MDP SPECT/CT and peri-facet signal change on MRI were rated as normal or increased. Agreement between the 2 examination types were determined with the k and prevalence-adjusted bias-adjusted k (PABAK) statistics.


Results: This study included 60 patients (28 male [47%]), with a mean ± SD age of 49 ±19.7 years (range, 12-93 years). The k value indicated no agreement between 99mTc‑MDP SPECT/CT and MRI (k=–0.026; 95% confidence interval = –0.051, 0.000). The PABAK values were fair to high at each spinal level, which suggests that relatively low disease prevalence lowered the k values. Together, the k and PABAK values indicate that there is some degree of intermodality agreement, but that it is not consistent.


Conclusions: Overall, facet joint signal change on fat-suppressed MRI did not always correlate with increased 99mTc‑MDP SPECT/CT activity. MRI and 99mTc‑MDP SPECT/CT for facet joint evaluation should not be considered interchangeable examinations in clinical practice or research. 

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