Quantitative Bone SPECT/CT Parameters Could Predict the Success of the Conservative Treatment for Symptomatic Basal Joint Arthritis of the Thumb.

Abstract

Purpose: The aim of this study was to evaluate the role of quantitatively assessed bone SPECT/CT parameters for predicting the success of conservative treatment for symptomatic basal joint arthritis of the thumb.

Patients and methods: Seventy-eight patients (128 hands) with symptomatic basal joint arthritis of the thumb who underwent bone SPECT/CT scans within 4 weeks after their initial visit and completed conservative treatment for more than 6 months between April 2019 and April 2023 were retrospectively enrolled. PRWHE (patient-rated wrist/hand evaluation) was evaluated in all patients before and after the treatment. The SUV max from bone SPECT/CT was measured in the 4 peritrapezial joints, and the highest uptake was used for analysis.

Results: On the basis of the minimal clinically important difference in PRWHE scores, 64 hands (50.0% of 128 hands) were classified as the treatment success group and 64 hands (50.0% of 128 hands) were failure group. In multivariate logistic regression analysis, only high SUV max (odds ratio, 1.097; 95% confidence interval, 1.027-1.172; P = 0.006) was a factor significantly associated with the success of conservative treatment. In receiver operating characteristics curve analysis, the area under the curve of SUV max was 0.649 (95% confidence interval, 0.554-0.744; P = 0.002). As a prognostic parameter for the success of conservative treatment, SUV max showed a sensitivity of 56.3% and specificity of 70.3% with a cutoff of 9.52.

Conclusions: High initial SUV max on bone SPECT/CT was significantly associated with the success of conservative treatment for symptomatic basal joint arthritis of the thumb.