Machado Joana do Mar F, Monteiro Marina S, Vieira Victor Fernandes, Collinot Jean-Aybert, Prior John O, Vieira Lina, Pires-Jorge José A
Haute École de Santé Vaud-Filière TRM, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.
Nuclear Medicine Department, Lausanne University Hospital, Lausanne, Switzerland; and.
J Nucl Med Technol. 2015 Jun;43(2):98-102. doi: 10.2967/jnmt.114.145771. Epub 2015 Apr 9.
The foot and the ankle are small structures commonly affected by disorders, and their complex anatomy represents a significant diagnostic challenge. By providing information on anatomic and bone structure that cannot be obtained from functional imaging, SPECT/CT image fusion can be particularly useful in increasing diagnostic certainty about bone pathology. However, because of the lengthy duration of a SPECT acquisition, a patient's involuntary movements may lead to misalignment between SPECT and CT images. Patient motion can be reduced using a dedicated patient support. We designed an ankle- and foot-immobilizing device and measured its efficacy at improving image fusion.
We enrolled 20 patients who underwent SPECT/CT of the ankle and foot with and without a foot support. The misalignment between SPECT and CT images was computed by manually measuring 14 fiducial markers chosen among anatomic landmarks also visible on bone scintigraphy. ANOVA was performed for statistical analysis.
The absolute average difference without and with support was 5.1 ± 5.2 mm (mean ± SD) and 3.1 ± 2.7 mm, respectively, which is significant (P < 0.001).
The introduction of the foot support significantly decreased misalignment between SPECT and CT images, which may have a positive clinical influence in the precise localization of foot and ankle pathology.
足部和踝关节是常见受疾病影响的小结构，其复杂的解剖结构给诊断带来了重大挑战。通过提供功能成像无法获取的解剖和骨骼结构信息，SPECT/CT图像融合在提高骨病理学诊断确定性方面可能特别有用。然而，由于SPECT采集时间较长，患者的不自主运动会导致SPECT和CT图像之间的错位。使用专用的患者支撑装置可以减少患者的运动。我们设计了一种踝关节和足部固定装置，并测量了其在改善图像融合方面的效果。
我们招募了20名接受踝关节和足部SPECT/CT检查的患者，检查时使用和不使用足部支撑装置。通过手动测量在骨闪烁显像中也可见的解剖标志中选择的14个基准标记，计算SPECT和CT图像之间的错位。进行方差分析以进行统计分析。
不使用支撑装置和使用支撑装置时的绝对平均差异分别为5.1±5.2毫米（平均值±标准差）和3.1±2.7毫米，差异具有统计学意义（P<0.001）。
足部支撑装置的引入显著减少了SPECT和CT图像之间的错位，这可能对足部和踝关节病变的精确定位产生积极的临床影响。
