Bone SPECT/CT of the Spine, Foot, and Ankle: Evaluation of Surgical Patients

Radionuclide bone scanning has been used routinely in the evaluation of bone pathology for decades. The greatest strength of the procedure is its extreme sensitivity for bone metabolism, allowing it to distinguish between active and inactive bony abnormalities. The downside of this reliance on abnormal bone turnover is the relative lack of anatomical detail compared with ever-improving CT and MRI technology. Fusion imaging using SPECT/CT (SCT), PET/CT, and PET/MRI offers an opportunity to combine the sensitivity of nuclear medicine examinations with the anatomical detail of CT and MRI. This fusion of technologies is especially important in situations where anatomical imaging modalities alone provide insufficient diagnostic information. In this review, we highlight the utility of SPECT/CT bone imaging in the pre- and postoperative evaluation of patients undergoing procedures of the spine, foot, and ankle.