Tomographic Imaging of the Distal Extremities Using Cone-Beam Collimation

We evaluated the feasibility of cone-beam tomography (SPECT with a converging collimator) for detecting bone pathology of the distal extremities. We examined 11 patients: seven with hand or wrist pain, three with ankle pain and one with tibial pain. Cone-beam tomography was performed using a high-resolution converging collimator with a 45-cm focal length. Tomograms were then compared to high-resolution planar images. Cone-beam tomography was successfully performed in all patients and tomograms were reconstructed in time for inclusion in the clinical report. In five patients, cone-beam tomography identified abnormalities that were equivocal or poorly defined on planar images. All other cone-beam studies provided the same information as the planar images. Tomographic imaging of the distal extremities can be successfully performed by using cone-beam tomography which has been found to be feasible and potentially useful in the clinical setting.