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Comparison of skeletal scintigraphy and standing 18 F-NaF positron emission tomography for imaging of the fetlock in 33 Thoroughbred racehorses.

Abstract: This retrospective, methods comparison study aimed to compare skeletal scintigraphy and F-NaF positron emission tomography (PET) for the detection of abnormalities in the fetlocks of Thoroughbred racehorses. Thirty-three horses (72 limbs) imaged with both scintigraphy and F-NaF PET, for investigation of lameness or poor performance related to the fetlock, were included. Seven observers, including experienced racetrack practitioners, surgery and imaging residents, and a board-certified veterinary radiologist, independently reviewed all data for evidence of increased radiopharmaceutical uptake in 10 different regions of interest. The interobserver agreement was higher for PET (Kappa-weighted (K-w) 0.73 (0.51-0.84)) (median (range)) than for scintigraphy (0.61 (0.40-0.77)) (P < 0.0001). When scintigraphy and PET were compared, the agreement was fair (K-w 0.29). More sites of increased uptake were identified using PET compared with scintigraphy. Agreement between the two modalities was higher for the palmar/plantar metacarpal/metatarsal condylar regions (K-w 0.59) than for the proximal sesamoid bones (K-w 0.25). Increased radiopharmaceutical uptake was detected in the medial proximal sesamoid bone in 6.9% and 22.2% of limbs with scintigraphy and PET, respectively. The high interobserver agreement for PET, despite the recent introduction of this technique, demonstrates the ease of clinical interpretation of PET scans. The higher number of lesions detected with PET compared with scintigraphy can be explained by the higher spatial resolution and cross-sectional nature of this modality. Study findings supported using PET in a clinical population of racehorses, in particular for the assessment of the proximal sesamoid bones.
Publication Date: 2022-10-17 PubMed ID: 36250620DOI: 10.1111/vru.13169Google Scholar: Lookup
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  • Journal Article

Summary

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The research study compares the effectiveness of two imaging techniques – skeletal scintigraphy and Fluorine-18-Sodium Fluoride (18 F-NaF) positron emission tomography (PET) – in identifying abnormalities in the fetlock joint of Thoroughbred racehorses. The study suggests that the PET imaging technique showed higher interobserver agreement and identified more lesions compared to skeletal scintigraphy, despite being a relatively newer technique.

Objective and Methodology of the Study

  • The primary objective of this study was to compare the effectiveness of skeletal scintigraphy and 18 F-NaF positron emission tomography (PET) in detecting abnormalities in the fetlock joints of Thoroughbred racehorses.
  • For this retrospective methods comparison study, a total of 33 Thoroughbred racehorses (72 limbs) that had been imaged with both scintigraphy and F-NaF PET for the investigation of lameness or poor performance related to the fetlock were selected.
  • Seven observers (including experienced racetrack practitioners, surgery and imaging residents, and a board-certified veterinary radiologist) independently reviewed all data for evidence of increased radiopharmaceutical uptake in ten different regions of interest.

Main Observations and Findings

  • The study found that the interobserver agreement was higher for PET (with a Kappa-weighted median range of 0.73) compared to scintigraphy (0.61).
  • When directly compared, the agreement between scintigraphy and PET was found to be fair (Kappa-weighted 0.29).
  • PET identified more sites of increased uptake compared to scintigraphy, indicating that PET potentially has a higher sensitivity for identifying abnormalities.
  • The consensus between the two modalities was higher for the palmar/plantar metacarpal/metatarsal condylar regions than for the proximal sesamoid bones.
  • In terms of detecting increased radiopharmaceutical uptake in the medial proximal sesamoid bone, PET was more effective, with detections in 22.2% of limbs compared to scintigraphy’s 6.9%.

Conclusion and Implications

  • The study concludes that despite the PET’s recent introduction, the high interobserver agreement signifies the ease of its clinical interpretation.
  • The higher number of lesions detected with PET can be explained by its superior spatial resolution and cross-sectional imaging compared to scintigraphy.
  • The results of this study support using PET imaging technique for Thoroughbred racehorses, especially for assessing the proximal sesamoid bones.

Cite This Article

APA
Spriet M, Arndt S, Pige C, Pye J, O'Brion J, Carpenter R, Blea J, Dowd JP. (2022). Comparison of skeletal scintigraphy and standing 18 F-NaF positron emission tomography for imaging of the fetlock in 33 Thoroughbred racehorses. Vet Radiol Ultrasound, 64(1), 123-130. https://doi.org/10.1111/vru.13169

Publication

ISSN: 1740-8261
NlmUniqueID: 9209635
Country: England
Language: English
Volume: 64
Issue: 1
Pages: 123-130

Researcher Affiliations

Spriet, Mathieu
  • School of Veterinary Medicine, University of California, Davis, Davis, California, USA.
Arndt, Stefanie
  • School of Veterinary Medicine, University of California, Davis, Davis, California, USA.
Pige, Charlene
  • School of Veterinary Medicine, University of California, Davis, Davis, California, USA.
Pye, Jannah
  • School of Veterinary Medicine, University of California, Davis, Davis, California, USA.
O'Brion, Julie
  • Southern California Equine Foundation, Arcadia, California, USA.
Carpenter, Ryan
  • Southern California Equine Foundation, Arcadia, California, USA.
Blea, Jeff
  • Southern California Equine Foundation, Arcadia, California, USA.
Dowd, Joseph P
  • Southern California Equine Foundation, Arcadia, California, USA.

MeSH Terms

  • Horses
  • Animals
  • Radiopharmaceuticals
  • Retrospective Studies
  • Cross-Sectional Studies
  • Positron-Emission Tomography / veterinary
  • Positron-Emission Tomography / methods
  • Radionuclide Imaging

Grant Funding

  • Grayson Jockey Club Research Foundation
  • Dolly Green Research Foundation

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Citations

This article has been cited 1 times.
  1. Basran PS, McDonough S, Palmer S, Reesink HL. Radiomics Modeling of Catastrophic Proximal Sesamoid Bone Fractures in Thoroughbred Racehorses Using μCT.. Animals (Basel) 2022 Nov 4;12(21).
    doi: 10.3390/ani12213033pubmed: 36359157google scholar: lookup