Your Donations in Action: Maryam Soltanolkotabi, MD

Osteoarthritis (OA) is a prevalent, debilitating disease with a complex pathophysiology that significantly impacts quality of life. Current imaging modalities often fail to detect OA in its earliest stages, limiting opportunities for timely intervention. 

Quantitative single-photon emission computed tomography/computed tomography (SPECT/CT) offers a promising solution through its visualization of osteoblastic activity and inflammation before irreversible structural changes occur. This early insight may allow more targeted treatment at an earlier stage. Recent advances in reconstruction algorithms now enable standardized uptake value (SUV) measurements in bone SPECT/CT, similar to those used in PET/CT.

For her 2023 RSNA Research Scholar Grant, “Quantitative Bone SPECT/CT and Its Role in Osteoarthritis Imaging & Management: A Pilot Study on the Hand & Wrist,” Maryam Soltanolkotabi, MD, assistant professor of radiology and imaging sciences at the University of Utah in Salt Lake City, and colleagues conducted a prospective pilot study to evaluate the reliability of quantitative SPECT/CT and its correlation with clinical presentation in the early stages of hand and wrist OA. 

The researchers analyzed 180 joints from nine individuals (mean age 49) with radiographically occult OA who were candidates for intra-articular injections. Two musculoskeletal radiologists independently measured mean and maximum SUVs.

Results demonstrated excellent reproducibility, with intraclass correlation coefficients ranging from 0.95 to 0.99 for both inter- and intra-rater reliability. Higher SUVmax values correlated significantly with greater pain intensity and reduced grip and pinch strength.  QuickDASH scores and SF-12 correlations trended in expected directions of improvement but were not significant.  

“This work suggests that quantitative SPECT/CT can help bridge the gap between symptoms and traditional structural imaging by detecting early metabolic changes associated with painful OA,” Dr. Soltanolkotabi said. “SUV measurements may help identify which joints are biologically active and therefore more likely to benefit from image-guided interventions.”

According to Dr. Soltanolkotabi, the RSNA Research Scholar Grant made it possible to standardize imaging protocols, rigorously test reproducibility and gather paired imaging and clinical data. “These foundational findings now serve as the basis for a larger validation study and upcoming NIH proposals focused on metabolically guided precision imaging in osteoarthritis,” she concluded. 

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