Assessing SPECT/CT for the Identification of Cartilage Lesions in The Knee Joint: A Systematic Review

Rix, Larissa; Tushingham, Samuel; Wright, Karina; Snow, Martyn

Abstract

Background
Single-photon emission computerised tomography with conventional computer tomography (SPECT/CT) is an emerging technology which may hold clinical value for the identification of cartilage lesions in the knee joint. The intensity and distribution of SPECT/CT uptake tracer may identify physiological and structural information in the absence of structural change on other imaging modalities.

Objectives
To systematically assess the utility of SPECT/CT in the detection of chondral lesions within the knee joint, in patients presenting with knee pain, with or without structural change.

Results
PubMed, Science Direct, Web of Knowledge, and NHS databases were searched for English language articles focusing on the diagnostic value of SPECT/CT for knee chondral lesions and knee pain. Animal studies, cadaver studies, comparator radiological technique other than SPECT/CT or patients with a pathology other than knee chondral lesions were excluded. From the search, 11,982 manuscripts were identified, and screened for relevance. Seven studies were identified and scored low on QUADAS-2 bias review. SPECT/CT correlated with lesions found on other imaging modalities and during intraoperative assessment. Furthermore, in some cases, SPECT/CT out-performed other modalities in the detection of cartilage lesions.

Conclusion
Evidence suggests SPECT/CT may be a useful tool for the detection and localisation of cartilage lesions, particularly in discrepant cases when there is an absence of lesions on other imaging modalities, or a lack of correlation with patients’ symptoms. Further studies are required to confirm the conclusions of this review.

Citation

Rix, L., Tushingham, S., Wright, K., & Snow, M. (in press). Assessing SPECT/CT for the Identification of Cartilage Lesions in The Knee Joint: A Systematic Review. Osteoarthritis and Cartilage Open, 7(1), Article 100577. https://doi.org/10.1016/j.ocarto.2025.100577

• Journal Article Type: Article
• Acceptance Date: Jan 26, 2025
• Online Publication Date: Jan 30, 2025
• Deposit Date: Apr 22, 2025
• Journal: Osteoarthritis and Cartilage Open
• Print ISSN: 2665-9131
• Electronic ISSN: 2665-9131
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 7
• Issue: 1
• Article Number: 100577
• DOI: https://doi.org/10.1016/j.ocarto.2025.100577
• Keywords: Imaging; Diagnostics; Cartilage lesions; Knee pain; SPECT/CT; Nuclear medicine
• Public URL: https://keele-repository.worktribe.com/output/1073093
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S2665913125000135?via%3Dihub