The Value of SPECT/CT for Knee Osteoarthritis: A Systematic Review

Background Single photon emission computed tomography (SPECT/CT) is a diagnostic option for knee osteoarthritis patients without osteoarthritic features on X-ray; however, the added value of SPECT/CT remains debatable in the diagnostic algorithm. Objective To review the added value of SPECT/CT in the diagnostic algorithm of knee osteoarthritis. Study Design Systematic review Methods A systematic search was carried out in the databases EMBASE, MEDLINE, and the Cochrane collaboration. The retrieved articles were screened for relevance on title and abstract. This was followed by a full-text study quality appraisal of the remaining articles. Finally, a total of 9 trials were included. Results The use of SPECT/CT might objectify some clinical knee osteoarthritis symptoms. It could correlate with findings on plain radiography and magnetic resonance imaging. Furthermore, there is some evidence SPECT/CT gives additional information compared with these imaging modalities; however, superiority is not proven. The uptake on SPECT could predict the intraoperative macroscopic findings. Yet the clinical relevance remains unclear. Conclusion There is no strong evidence SPECT/CT should play a role in the diagnosing and decision-making processes of knee osteoarthritis. Yet there is evidence suggesting SPECT/CT might give additional information in the diagnosing process. More research would be of added value to answer this research question.