Is PET better than scintigraphy for equine fetlock disease?

VRU 64(1): 123-130

May 16, 2023

Study Aim: To compare skeletal scintigraphy and 18 F-NaF PET for detecting abnormalities in fetlocks of Thoroughbred racehorses.

Results: Interobserver agreement was higher for PET than scintigraphy. More sites of increased uptake were identified using PET. Agreement between the two modalities was higher for palmar/plantar metacarpal/metatarsal condylar regions than for proximal sesamoid bones.

Conclusion: The high interobserver agreement for PET demonstrates ease of clinical interpretation of PET scans. The higher number of lesions detected with PET can be explained by its higher spatial resolution and cross-sectional nature. Study findings support using PET in a clinical population of racehorses, particularly for assessing proximal sesamoid bones.

Lateral (A), dorsal (B) and palmar (C) 99mTc-MDP scintigraphic images and lateral (D) and dorsal (E) maximal intensity projection of 18F-NaF PET data of the left front fetlock of a Thoroughbred racehorse. (Lateral is to the right on the dorsal images) Increased radiopharmaceutical uptake was recognized in both metacarpal condyles both on scintigraphy and PET imaging (arrows). Focal IRU was also identified biaxially at the dorsal aspect of the proximal sesamoid bones (arrowheads), which was not detected on scintigraphic images. (Scintigraphic images were obtained with a 60-second acquisition and displayed in an arbitrary window width. The PET data were acquired using a 4-minute acquisition and a 12-cm axial field of view and are displayed here as a maximal intensity projection with a window ranging from 0 to 15 standardized uptake values.)

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