Document Detail

Dual-isotope SPECT/CT impact on hospitalized patients with suspected diabetic foot infection: saving limbs, lives, and resources.
MedLine Citation:
PMID:  23839584     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Foot ulcer with suspected infection is one of the most common reasons for hospitalization and a major factor contributing to morbidity and high healthcare-related expenses among diabetic patients. Many patients will require amputation; however, major amputation is associated with an alarmingly high 5-year mortality rate. In this study, we assess the diagnosis and management of suspected foot infection in diabetic patients using dual-isotope (DI) single-photon emission computed tomography/computed tomography (SPECT/CT) compared with conventional imaging.
METHODS: The diagnostic accuracy in and management of 227 patients who had undergone DI SPECT/CT was compared with that of 232 similar patients who had undergone conventional imaging including plain radiography, CT, planar bone scanning, planar indium-111 white blood cell scanning, and MRI. The duration of hospitalization was additionally compared between these two groups of patients after excluding patients with other active comorbidities.
RESULTS: Soft-tissue infection, osteomyelitis with or without soft-tissue infection, and other bony pathologies were more accurately and confidently identified with DI SPECT/CT than with conventional imaging. DI SPECT/CT use was associated with significantly fewer major amputations and more selective bony resection as well as with shorter duration of hospitalization when compared with conventional imaging.
CONCLUSION: In this large population of diabetic patients with suspected foot infection DI SPECT/CT was more accurate in diagnosing and localizing infection compared with conventional imaging. In addition, DI SPECT/CT provided clear guidance and promoted many limb salvage procedures. Of equal importance to health economics, DI SPECT/CT use was associated with considerably reduced length of hospitalization compared with conventional imaging.
Sherif Heiba; Dov Kolker; Leonard Ong; Shalini Sharma; Arlene Travis; Victoria Teodorescu; Sharif Ellozy; Lale Kostakoglu; Ina Savitch; Josef Machac
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nuclear medicine communications     Volume:  34     ISSN:  1473-5628     ISO Abbreviation:  Nucl Med Commun     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-07-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  England    
Other Details:
Languages:  eng     Pagination:  877-84     Citation Subset:  IM    
aDepartment of Radiology, Nuclear Medicine Division bDepartment of Orthopedics cDepartment of Surgery, Vascular Surgery Division, Mount Sinai School of Medicine, New York, New York, USA.
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