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High resolution scintigraphy in diagnosis and radioguided surgery of diabetic foot osteomyelitis (Abstract/Poster in atti di convegno)
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- High resolution scintigraphy in diagnosis and radioguided surgery of diabetic foot osteomyelitis (Abstract/Poster in atti di convegno) (literal)
- Anno
- 2006-01-01T00:00:00+01:00 (literal)
- Alternative label
Capriotti, G.;Di Santo, G.;D'Alessandria, C.;Lanzolla, T.;Di Stasio, F.;Anastasia, A.;Massari, R.;Trotta, C.;Soluri, A.;Scopinaro, F. (2006)
High resolution scintigraphy in diagnosis and radioguided surgery of diabetic foot osteomyelitis
in Congress EANM - European Association of Nuclear Medicine 2006, Atene, 30.9-4.10/2006
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- Capriotti, G.;Di Santo, G.;D'Alessandria, C.;Lanzolla, T.;Di Stasio, F.;Anastasia, A.;Massari, R.;Trotta, C.;Soluri, A.;Scopinaro, F. (literal)
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- 1, 2, 3, 4, 5, 6, 9: University \"La Sapienza\", Rome, Italy;
6, 7, 8: Institute of Biomedical Engineering, ISIB-CNR, Rome, Rome, Italy. (literal)
- Titolo
- High resolution scintigraphy in diagnosis and radioguided surgery of diabetic foot osteomyelitis (literal)
- Abstract
- Aim: Osteomyelitis is a heavy complication of diabetic foot and its diagnosis requires an
integrate approach, both for the clinicians and for the specialist imaging. Leukocytes scan
(WBCS) plays a key role in the diagnosis of osteomyelitis. It is performed to reduce the number
of amputation, to improve wound healing and to reduce the mortality of patients. The suboptimal
spatial resolution of Anger cameras (AC) represents a limitation to achieve these goals. Some
studies suggested the role of High Resolution Scintigraphy (HRS) in the diagnosis, radioguided
surgery and biopsy of different diseases. Aim of present study is to verify if WBCS is able to
improve the diagnosis of osteomyelitis and to help surgery with the use of an hand held High
Resolution Detector (HRD),.Materials and Methods: 10 patients, mean age 64 yrs, with forefoot
ulcers, were enrolled. In all patients planar X-ray, MRI and conventional 99mTc-HMPAO-WBCs
were performed. 24h after administration of radiolabelled WBC, each patient was studied by
HRS with HRD. The hand held HRD showed four inch2 FOV, 2 mm spatial resolution, 18%
energy resolution. The patients underwent surgery or bone biopsy using HRS.Results: Three
patients showed negative scan with both devices. They showed an ulcer without infection,
debridement of lesion was sufficient to obtain healing (Table). Seven patients showed positive
scan at AC without bone infection. HRD showed hot spots of radioactivity in the same patients.
In four of them, the hot spot was bar-shaped. This bar-shaped radioactivity was considered as
sign of osteomyelitis. One patient, with positive WBCs, refused surgery. Two patients, with
positive scan and no sign of osteomyelitis at AC as well as at HRD underwent complete
curettage of purulent inflammation using HRD during the surgical treatment. Two of the 4
patients showing infection at HRD were treated by amputation of the two distal phalanges of the
toe because of osteomyelitis. The other patients underwent to radio-guided bone biopsy. Bone
infection was confirmed by culture exam.Conclusions: HRD seems to be able to guide surgical
treatment opening a new way in the therapy of infected foot. It is possible to assess if surgical
removal of purulent inflammation is complete and to precisely guide biopsy or removal of the
bone with osteomyelitis. (literal)
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