| The diabetic foot: initial experience with 18F-FDG PET/CT. | |
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MedLine Citation:
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PMID: 15750157 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Osteomyelitis complicates up to one third of diabetic foot infections, is often due to direct contamination from a soft-tissue lesion, and represents a clinical challenge. Early diagnosis is important since antibiotic therapy can be curative and may prevent amputation. The present study assessed the role of PET/CT using 18F-FDG for the diagnosis of diabetic foot osteomyelitis. METHODS: Fourteen diabetic patients (10 men and 4 women; age range, 29-70 y) with 18 clinically suspected sites of infection underwent PET/CT after the injection of 185-370 MBq of 18F-FDG for suspected osteomyelitis complicating diabetic foot disease. PET, CT, and hybrid images were independently evaluated for the diagnosis and localization of an infectious process. Additional data provided by PET/CT for localization of infection in the bone or soft tissues were recorded. The final diagnosis was based on histopathologic findings and bacteriologic assays obtained at surgery or at clinical and imaging follow-up. RESULTS: PET detected 14 foci of increased 18F-FDG uptake suspected as infection in 10 patients. PET/CT correctly localized 8 foci in 4 patients to bone, indicating osteomyelitis. PET/CT correctly excluded osteomyelitis in 5 foci in 5 patients, with the abnormal 18F-FDG uptake limited to infected soft tissues only. One site of mildly increased focal 18F-FDG uptake was localized by PET/CT to diabetic osteoarthropathy changes demonstrated on CT. Four patients showed no abnormally increased 18F-FDG uptake and no further evidence of an infectious process on clinical and imaging follow-up. CONCLUSION: 18F-FDG PET can be used for diagnosis of diabetes-related infection. The precise anatomic localization of increased 18F-FDG uptake provided by PET/CT enables accurate differentiation between osteomyelitis and soft-tissue infection. |
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Authors:
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Zohar Keidar; Daniela Militianu; Eyal Melamed; Rachel Bar-Shalom; Ora Israel |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 46 ISSN: 0161-5505 ISO Abbreviation: J. Nucl. Med. Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-03-07 Completed Date: 2005-05-03 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 444-9 Citation Subset: IM |
Affiliation:
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Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel. zohar@keidar.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Diabetic Foot / complications, diagnosis* Female Fluorodeoxyglucose F18 / diagnostic use* Foot / radiography*, radionuclide imaging* Humans Male Middle Aged Osteomyelitis / diagnosis*, etiology Pilot Projects Positron-Emission Tomography / methods Radiopharmaceuticals / diagnostic use Reproducibility of Results Sensitivity and Specificity Subtraction Technique* Tomography, X-Ray Computed / methods |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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