Aim: To quantify condylar uptake on bone SPECT to diagnose bilateral TMJ disorders.
Method: Retrospective analysis of skull SPECT images of all 45 patients referred with condylar hyperplasia (CH) over 10 years was performed. Following iterative reconstruction, Butterworth filtering and reorientation, transverse slices covering the condyles were summed. ROIs were drawn around the condyles and sphynoid bone and the average count per pixel recorded. Ratios of right condyle: sphynoid, left condyle: sphynoid and relative right: left condylar uptake was calculated. Data were split into pathological and normal groups according to radiologist reports. Both groups followed a normal distribution.
Results: The range of normal: sphynoid ratio was found to be 56-123% and the range of pathological: sphynoid ratio was found to be 56-144%. 70% of the ratios that were classed as pathological fell within the normal range. The mean relative ratio of pathological condyle was found to be 55, S.D.3%.
Conclusion: The use of the sphynoid as a reference bone was found to be inappropriate because it failed to distinguish adequately between pathological and normal condyles. The range established of the relative ratio supports the current threshold that if the count is greater than 55%, it can be classed as CH.
Killilea K. Is it possible to use ROI analysis in bone SPECT of the skull for the diagnosis of bilateral TMJ Disorders? BNMS Spring Meeting, Edinburgh, 12-14th May 2008. Nucl Med Commun. 2008 May;29(5):491.
Karen Killilea, Darlington Unit. Tel: +44 (0)1325-743-347.
Regional Medical Physics Department, Newcastle General Hospital, Newcastle upon Tyne, NE4 6BE, UK.
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