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

Abstract

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. 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. 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. 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.