II. Indications (with normal L-Spine XRay)

  1. Osteomyelitis
  2. Bony neoplasm or metastases
  3. Occult Vertebral Fracture

III. Mechanism

  1. Radiographic tracer compounds taken up by new bone
    1. Technetium Tc 99m Phosphate
    2. Gallium 67 Citrate
  2. Incorporated into hydroxyapatite crystals
  3. Increased uptake indicates areas of high bone turnover

IV. Advantages

  1. Sensitive for bony neoplasm
    1. Test Sensitivity in spinal metastases: 85%
  2. Sensitive for infection

V. Disadvantages: Non-specific

  1. False positives in 33% older patients (Osteoarthritis)
  2. False negatives
    1. Diffuse bony metastases
    2. Multiple Myeloma

VI. Protocols

  1. Technetium Tc 99m Phosphate
  2. Gallium 67 Citrate
    1. Most accurate imaging in infectious spondylitis (95%)
  3. Single-Photon Emission Computed Tomography (SPECT)
    1. Three dimensional bone scan imaging
    2. Lesions of Vertebral pedicles suggests malignancy

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Ontology: Radionuclide bone imaging of lumbar spine (C2315396)

Concepts Diagnostic Procedure (T060)
SnomedCT 432850003
English Radionuclide bone imaging of lumbar spine, Radionuclide bone imaging of lumbar spine (procedure)
Spanish estudio radioisotópico óseo de la columna vertebral lumbar, estudio por imágenes radioisotópicas de columna vertebral lumbar, estudio radioisotópico óseo de la columna vertebral lumbar (procedimiento), estudio por imágenes radioisotópicas de columna vertebral lumbar (procedimiento)