Thesis

142 Part I Chapter 5 Figure 16. Male patient of 41 years at first bone-SPECT/CT. When comparing preoperative and postoperative bone-SPECT/CT scans (coronal reconstructions shown), the uptake in the TCC has increased considerably (from previous, but a new focus of increased bone turnover has developed at the site of arthrodesis laterally from the TCC (blue circle). CT, computed tomography; TCC, talocalcaneal coalition. Technical considerations The illustrative cases shown in this review comply with the recommendations below, performed on two different bone-SPECT/CT-systems, the Philips BrightView XCT and the Siemens Symbia Intevo system. Acquisition Acquisition of images are advised to accord to the current European Association of Nuclear Medicine practice guidelines for bone scintigraphy [16], combined with additional tailored acquisition details specifically for the foot and ankle as described by Kampen, et al. [15]. This means that slice thickness should not exceed 1-1.5 mm and multiplanar reconstruction of the Computed Tomography (CT) images, which may be helpful to get better images and clarity along with proper envision of the smaller joints. Injected activity should be reduced in children according to the latest standards adjusted to body weight [32]. Acquisition of the early ‘blood pool’ images started between 2 and 10 minutes post injection (p.i.) with an acquisition time of 2-5 minutes for planar images to image co-existing tendinopathy or other inflammatory pathology in soft tissues or the bone [33].

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