Bone Scintigraphy General Principles

Bone scintigraphy is a frequently requested and widely available method of diagnosing a variety of bony lesions of the spine. Bony lesions have predictable patterns of increased tracer uptake that are characteristic of the underlying disease process. Single photon emission computed tomography (SPECT) of the spine shows greater lesion contrast than planar studies (1). SPECT images are also easier to correlate with other tomographic-based studies, such as magnetic resonance imaging (MRI) or computed tomography (CT).

Comparison of SPECT bone images with planar images is useful in identifying the correct vertebral level. When available, radiographic correlation is useful in identifying normal variants, such as six lumbar vertebrae or sacralization of the lumbar spine (2).

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