Hybrid Imaging in the Diagnosis of Bone Diseases

Although the use of SPECT/CT, PET/CT, and PET/MR in different bone diseases was discussed in several chapters of this book, a separate chapter putting together the clinical uses and impacts of such important modalities in the diagnosis and follow-up of bone diseases is thought to be warranted given the importance of such modern imaging modalities. The clinical utility and effectiveness of bone scan, planar scan, and SPECT have been proven without CT. In most patients, a bone scan without CT provides sufficient information for the diagnosis. Accordingly, adding CT should only be in select situations when bone scans show lesions of indeterminate nature and/or location. In such situations, CT is added for a limited region of interest to improve the specificity of bone scintigraphy. PET/CT and PET/MR have revolutionized the impact of nuclear medicine in the diagnosis and follow-up of diseases, including bone pathologies, particularly in neoplastic disease.