Patterns, variants, artifacts, and pitfalls in conventional radionuclide bone imaging and SPECT/CT

Area of Science:

• Nuclear Medicine
• Radiology
• Musculoskeletal Imaging

Background:

• Bone scintigraphy is a cornerstone nuclear medicine investigation for evaluating bone metastases in cancer patients and various benign musculoskeletal conditions.
• Technological advancements, including single-photon emission computed tomography (SPECT) and hybrid imaging (SPECT/CT), have enhanced musculoskeletal disease assessment.

Purpose of the Study:

• To review common patterns, normal variants, artifacts, and pitfalls encountered in conventional planar, SPECT, and SPECT/CT bone imaging.
• To enhance the specificity of bone scans by providing knowledge to avoid misinterpretation.

Main Methods:

• Review of literature and imaging findings related to bone scintigraphy.
• Discussion of interpretive challenges in planar, SPECT, and SPECT/CT bone imaging modalities.

Main Results:

• Bone scans demonstrate high sensitivity but variable or limited specificity.
• Familiarity with normal variants and common patterns is crucial for accurate interpretation.
• Artifacts and pitfalls can lead to misdiagnosis if not recognized.

Conclusions:

• Understanding common patterns, variants, artifacts, and pitfalls in bone scintigraphy is essential for accurate diagnosis.
• Advanced imaging techniques like SPECT/CT offer improved diagnostic capabilities but still require careful interpretation.
• This review aims to improve the diagnostic accuracy of bone imaging in clinical practice.