Javier La Fontaine1, Kavita Bhavan2, Kenrick Lam1, Suzanne Van Asten1, William Erdman3, Lawrence A Lavery1, Orhan K Öz3. 1. Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX. 2. Department of Internal Medicine, Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX. 3. Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX.
Abstract
OBJECTIVE: Magnetic resonance imaging (MRI) is the recommended diagnostic imaging technique for diabetic foot osteomyelitis (DFO), with a reported accuracy of 79%. The gold standard to diagnose osteomyelitis is bone biopsy, with a positive culture and/or histopathology findings consistent with osteomyelitis. The purposes of this study are to assess the accuracy of technetium-99m (Tc-99m) labeled white blood cell (WBC) single-photon emission computed tomography/computed tomography (SPECT/CT) hybrid imaging for diagnosing DFO confirmed by bone biopsy and to compare that to the diagnostic accuracy of an MRI. MATERIALS AND METHODS: The authors performed a retrospective chart review of 166 patients who received a bone biopsy to confirm the diagnosis of a suspected DFO at a large municipal hospital between 2010 and 2013. Patients were selected on the basis of whether they received an MRI or a SPECT/CT. Patients whose scans were not within a clinically relevant time frame of the biopsy were excluded. Imaging results were correlated with probability of osteomyelitis determined by bone biopsy. RESULTS: For inclusion criteria, 110 patients met the study's criteria: 52 SPECT/CT patients and 58 MRI patients. The sensitivity, specificity, positive predictive value, and negative predictive value of SPECT/CT were 89%, 35%, 74%, and 60%, respectively; the corresponding values for MRI were 87%, 37%, 74%, and 58%, respectively. There were no significant differences in accuracy of diagnosing DFO between imaging techniques. CONCLUSION: This data suggests that the diagnostic accuracy of SPECT/CT imaging in DFOs is similar to an MRI.
OBJECTIVE: Magnetic resonance imaging (MRI) is the recommended diagnostic imaging technique for diabetic foot osteomyelitis (DFO), with a reported accuracy of 79%. The gold standard to diagnose osteomyelitis is bone biopsy, with a positive culture and/or histopathology findings consistent with osteomyelitis. The purposes of this study are to assess the accuracy of technetium-99m (Tc-99m) labeled white blood cell (WBC) single-photon emission computed tomography/computed tomography (SPECT/CT) hybrid imaging for diagnosing DFO confirmed by bone biopsy and to compare that to the diagnostic accuracy of an MRI. MATERIALS AND METHODS: The authors performed a retrospective chart review of 166 patients who received a bone biopsy to confirm the diagnosis of a suspected DFO at a large municipal hospital between 2010 and 2013. Patients were selected on the basis of whether they received an MRI or a SPECT/CT. Patients whose scans were not within a clinically relevant time frame of the biopsy were excluded. Imaging results were correlated with probability of osteomyelitis determined by bone biopsy. RESULTS: For inclusion criteria, 110 patients met the study's criteria: 52 SPECT/CT patients and 58 MRI patients. The sensitivity, specificity, positive predictive value, and negative predictive value of SPECT/CT were 89%, 35%, 74%, and 60%, respectively; the corresponding values for MRI were 87%, 37%, 74%, and 58%, respectively. There were no significant differences in accuracy of diagnosing DFO between imaging techniques. CONCLUSION: This data suggests that the diagnostic accuracy of SPECT/CT imaging in DFOs is similar to an MRI.
Authors: Lawrence A Lavery; P Andrew Crisologo; Javier La Fontaine; Kavitha Bhavan; Orhan K Oz; Kathryn E Davis Journal: J Foot Ankle Surg Date: 2019-07 Impact factor: 1.286
Authors: Jeong Won Lee; Shi Nae Yu; Ik Dong Yoo; Min Hyok Jeon; Chang-Hwa Hong; Jai-Joon Shim; Sung-Hae Chang; Sang Mi Lee Journal: Medicine (Baltimore) Date: 2019-03 Impact factor: 1.817
Authors: Ora Israel; O Pellet; L Biassoni; D De Palma; E Estrada-Lobato; G Gnanasegaran; T Kuwert; C la Fougère; G Mariani; S Massalha; D Paez; F Giammarile Journal: Eur J Nucl Med Mol Imaging Date: 2019-07-04 Impact factor: 9.236
Authors: Katie Rubitschung; Amber Sherwood; Andrew P Crisologo; Kavita Bhavan; Robert W Haley; Dane K Wukich; Laila Castellino; Helena Hwang; Javier La Fontaine; Avneesh Chhabra; Lawrence Lavery; Orhan K Öz Journal: Int J Mol Sci Date: 2021-10-26 Impact factor: 5.923