Depiction of Nidi and Fibrovascular Zones of Osteoid Osteomas Using Gamma-Correction Tc-99m HDP Pinhole Bone Scan and Co
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ORIGINAL ARTICLE
Depiction of Nidi and Fibrovascular Zones of Osteoid Osteomas Using Gamma-Correction Tc-99m HDP Pinhole Bone Scan and Conventional Radiograph, and Correlation with CT, MRI, and PVC Phantom Imaging Yong-Whee Bahk & Sung Hoon Kim & Yong-An Chung & Won-Jong Bahk & Jung Mee Park & You Mee Kang & Woo Hee Choi & Young Ha Park & Hyung Sun Sohn & Byung Ki Kim & Soo Kyo Chung
Received: 31 August 2010 / Accepted: 13 December 2010 / Published online: 11 January 2011 # Korean Society of Nuclear Medicine 2010
Abstract Purpose For the precise imaging diagnosis of osteoid osteoma (OO), the identification of the nidus and fibrovascular zone (FVZ) is essential. However, the latter sign has received little attention because it is difficult to demonstrate. We applied the recently introduced gamma correction (GC) to depict the FVZ on pinhole bone scan (PBS), conventional radiography (CR), and computed tomography (CT). Nongamma correction MRI was also analyzed for reference. Methods Ten patients with histologically proven diagnoses of OO were enrolled in this retrospective study. PBS, CR, and CT were processed by GC to demonstrate the nidi and FVZ as distinct yet integrating components of OO. PBS was performed using a 4-mm pinhole collimator 3 h after iv injection of 925 to 1,110 MBq (25 to 30 mCi) of Tc-99m HDP, and anteroposterior and mediolateral CR and transverse CT
were taken according to the standard technique. MRI sequences included T1- and T2-weighted images. For gamma correction, we utilized the Photo Correction Wizard program of ACD Photo Editor v3.1. A team of three qualified nuclear physician-radiologists, two nuclear physicians, and one MRI specialist read bone scans, radiographs, and MRIs of OO according to each specialty, and orthopaedic aspects and histology were reviewed by one qualified orthopedic surgeon and two qualified pathologists, respectively. Each observer first read the images separately with basic information about the aim of the study given and then in concert. Interpretive disagreement was settled by discussion and consensus. Results On pinhole scan, nidi were presented as areas of intense tracer uptake in all cases, and, importantly after GC, a thin ring-like zone with lower tracer uptake became visible in seven out of ten cases. GCCR also revealed a thin lucent zone
Y.-W. Bahk Department of Nuclear Medicine, Sung-Ae Hospital, Seoul, Korea
Y. M. Kang Department of Pathology, Sung-Ae Hospital, Seoul, Korea
S. H. Kim : Y.-A. Chung : J. M. Park : W. H. Choi : Y. H. Park : H. S. Sohn : S. K. Chung Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea Y.-A. Chung Institute of Catholic Integrative Medicine (ICIM), Incheon St. Mary’s Hospital, Inchon, Korea W.-J. Bahk Department of Orthopaedic Surgery, Euijongboo St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-ob, Korea
B. K. Kim Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
Y.-A. Chung (*) Department of Radiology, In
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