Back pain is a burden for most people at some point in their lifetime, but pinpointing the reason for the pain can be tricky. Researchers presenting during the recent Society of Nuclear Medicine and Molecular Imaging 2014 Annual Meeting in St. Louis have found that SPECT/CT in addition to conventional bone scan gets straight to the point of pain and leads to much higher pain relief following intervention.

Suruchi Jain, co-author of the study conducted at the Sanjay Gandhi Institute of Medical Sciences in Lucknow, India, suggested that SPECT/CT provides more clinical certainty about etiologies, such as inflammation and infection, which could mean improved patient treatment selection.

“Conventional radiological modalities [X-ray, CT and MRI] provide only the anatomical details of the spine but quite frequently the structures that show abnormal morphology are not the cause of low back pain,” noted Jain. “Patients in whom the clinical diagnosis is not clear, interventions are performed according to a low back pain management algorithm. The algorithmic approach usually translates into multiple procedures, which cause discomfort to the patient and at the same time lead to loss of valuable working hours. Findings of this research study reveal that inclusion of bone scan with SPECT/CT in workup of low backache patients might obviate these problems.”

For this randomized, double-blind study, researchers compared pain relief after treatment for 80 patients aged 20 to 80 years split into two groups. Conventional bone scans with additional SPECT/CT was performed for one group and a control group received no advanced imaging. Pain relief was given as a percentage compared to baseline pain level before treatment.

Results of the study revealed how 28 patients who underwent SPECT/CT and bone scan achieved between 70 and 100 percent pain relief. In fact, those who had 50 percent or more pain relief had a much better chance of being in the group that underwent bone scanning. This was in stark contrast to the 10 subjects who achieved 70 or greater percent improvement in the control group. Clinical decision-making was changed in 23 out of 40 scanned patients, with three new conditions unveiled as a result of the bone scan.

With further study, this research could lead to new standards of care for patients suffering from low back pain and more access to SPECT/CT imaging for these patients.