Thesis

141 Review of the role of bone-SPECT/CT in tarsal coalitions Figure 15. Same patient as Figs 12–14. The amount of uptake can be objectified semiquantitatively by measuring the standardized uptake value (SUV), in case visual assessment alone should remain indiscriminate. Semiquantitatively, the SUVmax at the site of the coalition increased from the initial value of 12.8 (Fig. 11b) to SUVmax 22.0. In another scenario, co-existing or newly developed pathologies (at other sites) can be sensitively detected, such as (secondary) osteoarthritis. [25, 28]. Figure 16 (coronal reconstructions shown), comparing pre- and post-operative bone-SPECT/CT scans of a male patient of 41 years at first imaging, exemplifies this development with uptake in the TCC actually having decreased considerably (red circle) two years after arthrodesis, but a new focus of increased bone turnover at the site of arthrodesis laterally from the TCC has emerged (blue circle), developing new pain complaints. Therefore, in follow-up of TCs, especially with arthrodesis material in situ, boneSPECT/CT may be useful in pinpointing clinically relevant changes in bone turnover in the TC or elsewhere in the foot or ankle. 5

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