Background: It was the primary purpose of our study to evaluate the inter- and intra-observer reliability of a\nstandardized SPECT/CT algorithm for evaluating patients with painful primary total hip arthroplasty (THA).\nThe secondary purpose was a comparison of semi-quantitative and 3D volumetric quantification method for\nassessment of bone tracer uptake (BTU) in those patients.\nMethods: A novel SPECT/CT localization scheme consisting of 14 femoral and 4 acetabular regions on standardized\naxial and coronal slices was introduced and evaluated in terms of inter- and intra-observer reliability in 37 consecutive\npatients with hip pain after THA. BTU for each anatomical region was assessed semi-quantitatively using a color-coded\nLikert type scale (0-10) and volumetrically quantified using a validated software. Two observers interpreted the SPECT/\nCT findings in all patients two times with six weeks interval between interpretations in random order. Semi-quantitative\nand quantitative measurements were compared in terms of reliability. In addition, the values were correlated using\nPearsons correlation. A factorial cluster analysis of BTU was performed to identify clinically relevant regions, which\nshould be grouped and analysed together.\nResults: The localization scheme showed high inter- and intra-observer reliabilities for all femoral and acetabular\nregions independent of the measurement method used (semiquantitative versus 3D volumetric quantitative\nmeasurements). A high to moderate correlation between both measurement methods was shown for the distal\nfemur, the proximal femur and the acetabular cup. The factorial cluster analysis showed that the anatomical\nregions might be summarized into three distinct anatomical regions. These were the proximal femur, the distal\nfemur and the acetabular cup region.\nConclusions: The SPECT/CT algorithm for assessment of patients with pain after THA is highly reliable independent\nfrom the measurement method used. Three clinically relevant anatomical regions (proximal femoral, distal femoral,\nacetabular) were identified.
Loading....