Moo seok Lee Department of nuclear medicine, Pusan University Hospital Use of blood pool half body scan in three phase bone in Patients with R/O RSDS (Reflex Sympathetic Dystrophy Sydrome) Moo seok Lee Department of nuclear medicine, Pusan University Hospital

Contents 1 Purpose 2 Materials and Method 3 Results 4 Conclusion

What is Reflex Sympathetic Dystrophy Syndrome? Purpose What is Reflex Sympathetic Dystrophy Syndrome? CRPS (Complex Regional Pain Syndrome) Stage I RSDS is a multi-symptom, multi-system, syndrome usually affecting one or more extremities

Purpose Flow Blood pool delay R L Three phase bone scan of an 76-year- old with RSD

Materials and Method Patients Period Number From October 2007 to September 2009 Period R/O RSD 28 patients in OCS reguest comment Number 15 patients (Male 8, Female 7, Mean age:67.2) confirmed case of RSDS Quantitative Analysis

Quantitative Analysis Materials and Method SCAN Flow : immediately (60 frame, 1sec/frame) Blood pool: 2~4min after injection (200 kcnts) additional half body scan Delay: 3hrs after injection Quantitative Analysis Count ratio of Bilateral Hands (Flow, Blood pool, Delay) ; included an ipsilateral wrist Count ratio of Bilateral Shoulders (Blood pool, Delay) Compared to the count ratios of shoulders in the blood pool ROI (Right/Left count ratio)

Materials and Method Half body scan (blood pool) WB body scan (delay) The uptake Overall increase in unilateral limbs joint (Flow, Blood pool, Delay)

Materials and Method Half body scan (blood pool) WB body scan (delay) Count ratio (right/left) of bilateral shoulders by drawing a ROI in the half body and whole body image. The each ROI is equal in size.

Materials and Method Flow Blood pool Delay Count ratio (right/left) of bilateral hands by drawing a ROI in the three phase images. The Flow image was compressed every frame. The each ROI is equal in size.

Results Right/Left Ratio Flow Blood pool Delay Hands Shoulders 1.09±0.53 1.13±0.47 1.08±0.26 1.24±0.75 1.11±0.31 The values are Mean±SD. Spearman rank correlation , SPSS 12.0 ver.

Results R=0.895 R=0.886 R=0.855 R=0.754 Hands(Flow) Hands(Blood pool) Shoulders(blood pool) Shoulders(blood pool) Hands(Delay) Shoulder(Delay) R=0.855 R=0.754 Shoulders(blood pool) Shoulders(blood pool) Spearman rank correlation , SPSS 12.0 ver. p<0.01

Results False negative L R L R

Results False positive R L R L

Conclusion Diagnosis Besides, Half body scan can lower false negative and false positive Half body scan Existing Scan Only local lesion blood pool scan included in three phase bone scan Half body scan in the blood pool image is helpful in the diagnosis of RSDS

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