Magnetic resonance imaging versus bone scintigraphy in suspected scaphoid fracture

1996 ◽  
Vol 23 (8) ◽  
pp. 971-975 ◽  
Author(s):  
M. M. C. Tiel-van Buul ◽  
W. Roolker ◽  
B. W. B. Verbeeten ◽  
A. H. Broekhuizen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Bone Scintigraphy ◽  
Scaphoid Fracture ◽  
Resonance Imaging ◽  
Suspected Scaphoid Fracture

Rationale and design of the SMaRT trial: A randomised, prospective, parallel, non-blinded, one-centre trial to evaluate the use of magnetic resonance imaging in acute setting in patients presenting with suspected scaphoid fracture

2018 ◽  
Vol 15 (2) ◽  
pp. 120-129 ◽  
Author(s):  
Tiago Rua ◽  
Sanjay Vijayanathan ◽  
David Parkin ◽  
Vicky Goh ◽  
Paul McCrone ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
National Health Service ◽  
Magnetic Resonance ◽  
Primary Outcome ◽  
Scaphoid Fracture ◽  
Resonance Imaging ◽  
Acute Setting ◽  
Scaphoid Fractures ◽  
The United Kingdom ◽  
Suspected Scaphoid Fracture

Background Wrist injury is a common presentation to the Emergency Department in the United Kingdom. Among these injuries, the scaphoid is the most common fractured carpal bone. However, given the limited ability of conventional radiography to accurately diagnose a suspected scaphoid fracture on presentation, its diagnosis and management remain challenging. Despite the vast clinical evidence supporting the superior accuracy of magnetic resonance imaging, there is little to no evidence around the real-world clinical and economic impact of immediate magnetic resonance imaging in the management of suspected scaphoid fractures. Methods Review of design and implementation challenges associated with the identification and subsequent recruitment of eligible patients, implementation of a novel clinical pathway in an acute setting, rationale behind the primary and secondary outcomes selected and measurement of the primary outcome. Results The Scaphoid Magnetic Resonance Imaging in Trauma trial is a single-site prospective, randomised, non-blinded, parallel design trial that aims to evaluate the use of immediate magnetic resonance imaging in the management of patients presenting to the acute setting with suspected scaphoid fractures. The primary outcome is the total 3-month cost per patient associated with the diagnosis and treatment of suspected scaphoid fractures. It is hypothesised that the immediate use of magnetic resonance imaging, a more accurate but expensive imaging modality, in patients with negative findings in the initial four-view radiography, will reduce the overall National Health Service costs by promoting definitive care and avoiding unnecessary diagnostic and treatment procedures. Other rationale design considerations in the recruitment, randomisation, data acquisition and intervention implementation are also discussed. Several of these challenges derive from real-world operational issues associated with the provision of magnetic resonance imaging in an intrinsically complex acute setting. Staff engagement during the trial’s planning phase, combined with an extensive training programme rolled out prior to the trial’s launch, were essential to raise staff awareness and engagement. Given the acute nature of the clinical condition, the latter was deemed essential as the eligibility assessment, recruitment, randomisation and treatment allocation processes all need to happen in a very tight time frame. Limitations Findings from the Scaphoid Magnetic Resonance Imaging in Trauma trial might not be generalisable to other National Health Service hospitals, foreign healthcare systems nor patient presentations outside normal magnetic resonance imaging working hours. Conclusion The Scaphoid Magnetic Resonance Imaging in Trauma trial was designed to evaluate the costs, patient satisfaction and clinical outcomes around the management of suspected scaphoid fractures and ultimately provide solid evidence on which to base the United Kingdom and international clinical practice. This article discusses the steps considered in the design of this novel trial, with particular emphasis on the issues and lessons learned during the planning and implementation stages.

A Comparison of Magnetic Resonance Imaging to Bone Scintigraphy in Early Traumatic Ischemia of the Femoral Head

1992 ◽  
Vol &NA; (285) ◽  
pp. 30???34 ◽  
Author(s):  
LOUIS J. RULAND ◽  
GWO-JAW WANG ◽  
CHARLES D. TEATES ◽  
SPENCER GAY ◽  
ARIE RIJKE
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Femoral Head ◽  
Bone Scintigraphy ◽  
Resonance Imaging

scholarly journals Magnetic resonance imaging and bone scintigraphy in bone metastasis detection: A comparative study

2010 ◽  
Vol 67 (6) ◽  
pp. 453-458 ◽  
Author(s):  
Silvija Lucic ◽  
Katarina Nikoletic ◽  
Andrea Peter ◽  
Milos Lucic ◽  
Dusan Jovanovic
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Bone Metastasis ◽  
Bone Scintigraphy ◽  
Regions Of Interest ◽  
Diagnostic Methods ◽  
Whole Body ◽  
Resonance Imaging ◽  
Mutual Correlation ◽  
Diagnostic Potential

Background/Aim. Bone scintigraphy is well-known method for the detection of neoplastic lesions with a high sensitivity and, at the same time, a lower specificity. On the other hand magnetic resonance imaging (MRI) is previously established noninvasive imaging method regarding its diagnostic specificity. The aim of this study was to determine the possibilities and to correlate two different diagnostic methods - bone scintigraphy and MRI in the detection of bone metastasis in the spine and pelvic bones. Methods. A total of 123 patients who underwent both bone scintigraphy and spine and pelvic MRI on 1.5 T MR imager were enrolled in this study. Scans were subsequently analyzed in total and divided in regions of interest (cervical, upper, middle and lower thoracic, upper and lower lumbar and pelvic region, which includes sacral spinal segment); afterwards the total number of 585 matching regions were compared and statistically analyzed. Results. The statistical analysis demonstrated significant correlation between the findings of both methods in total. Divided by regions of interest, significant degrees of correlation were demonstrated in all of them, except in the cervical spine region where the r-value was in the range of low correlation. Conclusion. Having a high mutual correlation, bone scintigraphy and MRI are to be considered as the complementary diagnostic methods in the detection of bone metastases. Still, increased diagnostic potential of MRI may highlights negative bone scintigraphy findings in the patients with solitary metastatic lesions or diffuse vertebral infiltration. Advances in the bone scintigraphy (single photon emission tomography - SPECT, SPECTcomputed tomography - SPECT-CT) and MRI (whole body MRI, diffusion MRI), make it possible the diagnostic potential of both methods will result in a further improvement in bone metastasis detection.

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