Radiological and Nuclear Medicine Monitoring of the State of Revascularized Autografts Using Hybrid SPECT/CT Technology

Purpose: To determine the relative efficiency of bone scan and SPECT/CT in assessing the viability of the mandibular and maxillary bone fragments in the reconstruction of revascularized autografts.

Material and methods: 37 patients with vascularized autografts were examined. Bone scan and SPECT/CT were performed as monitoring methods after surgery. The viability of autotransplants was judged on the levels of accumulation of radiopharmaceutical on bone scan and SPECT/CT in a transplanted flap.

Results: Bone scan gave a reliable information  on the status of the autograft in 28 out of 37 cases in patients with uncomplicated postoperative course. Additionally SPECT/CT was performed. SPECT/CT showed an increased accumulation of radiopharmaceutical in all patients with uncomplicated postoperative course. If thrombosis of supplying autograft vessels were present, SPECT/CT showed no accumulation of radiopharmaceutical – 5 patients. Thus SPECT/ CT allow to obtain a reliable data in 100 % of clinical cases.

Conclusion: SPECT/CT is recommended  as a method  of choice for early monitoring  of patients undergoing reconstructive surgery with the formation of mandibular and maxillary autografts. SPECT/CT can adequately assess the effectiveness of blood flow and the viability of bone grafts.

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