Role of 99mTc-MDP SPECT/CT Imaging in Neck and Back Pain

1264 Objectives Neck and back pain are common causes of disability and can greatly affect quality of life. Several imaging modalities are available for evaluating neck and back pain. The appropriate imaging modality usually depends on the suspected abnormality. In patients with a suspected bone or joint abnormality, scintigraphy including single photon emission computed tomography (SPECT) may be considered. Bone scintigraphy can help localize active bone disease. SPECT improves sensitivity over planar imaging with improved anatomic localization. SPECT/CT has been shown to improve sensitivity and specificity in the evaluation of neck and back pain. OBJECTIVE: Demonstrate the role of 99mTc-MDP SPECT/CT in the evaluation of patients with neck and back pain. Methods Educational exhibit of multiple interesting cases of neck and back pain using 99mTc-MDP SPECT/CT. Correlative imaging where appropriate/available is provided. Results Interesting cases of spinal abnormalities and lesions were characterized with 99mTc-MDP SPECT/CT, including active facet joint arthropathy prior to facet joint injection, subtle pars intra-articularis defects, active degenerative disc disease, active Schmorl’s nodes, discitis, post-surgical spine, and other focal lesions. Conclusions Neck and back pain can be a diagnostic challenge. SPECT/CT has been shown to improve sensitivity and specificity in the evaluation of spinal conditions. Appropriate treatment of neck and back pain often depends on accurately identifying the spinal level and anatomic location of abnormal radiotracer accumulation. Anatomical imaging provides useful information; however, hybrid SPECT/CT imaging improves localization by demonstrating focal increased radiotracer activity when multiple disc levels, facet joints and post-surgical changes are involved. SPECT/CT is rapidly becoming a valuable tool in the evaluation of patients with neck and back pain, complementing anatomical imaging such as conventional radiographs and MRI. $$graphic_9D5F3CFB-86C9-45F2-89E5-6C2540D1BC9E$$