Bone SPECT/CT and Bone PET/CT Scans

I have decided this is the best place to start this discussion!

I am undergoing lots of investigations at a top London hospital because of various spine problems in the cervical, thoracic and lumbar spine.

One of the investigations they have done is a Bone PET / CT scan.  I had only heard of these being done to look for cancer before.  They were actually looking for ongoing metabolic changes in the bone and surrounding tissues.  My neurosurgeon had actually ordered a SPECT / CT scan, but because they required my neck and lumbar spine to be done, they said that a PET / CT scan would be much quicker and I wouldn't have to lie still for so long.  I have been offered facet joint injections in the first instance to see if they will help me.  I decided that I wanted to look ito and research these injections first before deciding what to do.

In my research and reading several research papers, I have learnt about these Nuclear Medicine scans and the information that they can give the doctors.  I suspect that these are going to be used more and more because of the information that they give.  The scans are made up of a CT scan overlaid with the PET Scan.  This clearly shows the levels where there are changes happening in the bone by 'glowing' at those levels.  Research is showing that these glowing levels, which are caused by the radioactive tracer uptake in the bone, are the levels that are very likely to be the pain generating levels.  This helps them to know where to target in the treatment of spinal injections.  Research has shown that MRI  scan will sometimes show worse degeneration at other levels, but it is the glowing levels that respond to injections given to relieve the pain.

I have read in one paper that when facet joint injections are given into the glowing facets, there has been 95% successrate in relieving the pain.  I am almost certain that I am going to decide to give these injections a try.  This must be a very good thing to be pretty sure where the pain generators are to save trial and error.

Has anyone else had any experience of these bone scans?



  • nutcase,

    I do think that these scans will be used more and more to pin point the pain generator.

  • joowee40joowee40 Mississippi Posts: 239

    Jelly-Please let us know how the injections turn out for you. If I understood your post correctly, they will do the scan and inject you while looking at the scan and will see it "cool off"? Or did you mean it will just tell the where and the injection will be later etc?

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  • joowee40,

    No, I just meant that the scan was being used to diagnose which were the pain generating levels.  I had a lot of glowing levels, but they want to do facet joint injections in a couple of left sided facet joints which had intense tracer uptake.

    They also want to do a caudal epidural injection in the hope that it will give relief of the L5/S1, L4/5 and L3/4 levels.  Apparently it won't be able to reach the L2/3 level where I also have stenosis and degeneration.

    We will just be working to control the pain in my lumbar spine at the moment.  I do have ongoing problems in my thoracic and cervical spine too, but I had to choose which level I would like them to treat and my lumbar pain is the most debilitating right now.

  • memerainboltmemerainbolt IndianaPosts: 3,386

    I have had the caudal epidural injections twice and both times they gave me a lot of relief from the nerve pain. And both times it lasted about 3 months. I hope you get the relief I did.

  • Jerome001Jerome001 Cocoa Beach, FloridaPosts: 259

    I have not heard of the Bone PET / CT scans but they sound amazing! Imagine being able to pinpoint the pain source. Sounds like it could take out a lot of the hit/miss aspect of the injections and other nerve treatments. I look forward to hearing your results with targeting the "glowing" spots. Good luck! Jerome

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  • mermerainbolt,

    Thank you and could I ask if you found the caudal epidural painful while they did it?


    I think as hospitals get the machines needed to do these tests, they will become more commonly used.  I am under a teaching hospital in London, which is why I have been able to have this type of scan.

    I have had two left facet joints injected and so far the results are good.  I hardly have any pain on the left leg now, but still have a lot of pain on the right leg and that side of my back.  The right side glowed too, but just not so brightly.  The injections were done seperately so that they could tell which levels have been relieved.

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