Comparison of SPECT bone scintigraphy with MRI for diagnosis of meniscal tears

Between January 2003 and March 2004, sixteen patients were studied with both modalities and the accuracy rates of SPECT scan results, and MRI findings in the diagnosis of meniscal tears were compared. Arthroscopy was the gold standard.The respective sensitivity rate, specificity rate, and positive and negative predictive accuracies of MRI were 89%, 94%, 93%, and 79% and for SPECT those were 78%, 94%, 94%, and 88%. There was good agreement on the presence or absence of tears between two modalities (κ statistic = 0.699).SPECT and MRI are both valuable imaging techniques. SPECT is a useful alternative when MRI is unavailable or unsuitable and it is beneficial when more possible accuracy is desired (such as when MRI results are either inconclusive or conflict with other clinical data).In diagnosing meniscal tears, MRI is a sensitive and specific tool and has become the procedure of choice in these affections. In fact, MRI is the most commonly used noninvasive imaging method for diagnosing meniscal tears, but its limits are also acknowledged [1].On the other hand, although it is not widely carried out in clinical practice, nuclear medicine procedures have also been used in diagnosing meniscal tears and some authors have demonstrated the usefulness of SPECT in the assessment of knee injuries [2-8].In particular, recent data [9] have demonstrated a higher specificity and accuracy for 99mTc MDP SPECT than those for MRI. As a result, scintigraphy has been considered as competitive to MRI, and also it could give complementary informations which are commonly derived from scintigraphy but not available from MRI.There are not so much published works concerning meniscal tears and bone SPECT [10-14]. Only few studies have compared bone scintigraphy and MR imaging and limited data are available on the accuracy of SPECT compared with that of MRI for the assessment of meniscal tears. Therefore, it was emphasized that further work should be undertaken to evaluate the role of SPECT as