Diagnostic Accuracy of 99 MTC Labelled Ubiquicidin (29-41) Spect/Ct for Diagnosis of Osteomyelitis in Diabetic Foot

Hussain, Fida; Dar, Zaigham Salim; Khatoon, Jameela; Ajmal, Saadia; Adil, Muhammad

doi:10.51253/pafmj.v71i3.4102

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…Data on the use of 18F‐FDG PET/CT as a discriminating tool between DFO and CNO still remain limited. Another study with low risk of bias showed 99% positive predictive value, and 57% negative predictive value with 94% diagnostic accuracy of 99mTc labelled Ubiquicidin SPECT/CT for the detection of osteomyelitis in patients with diabetes‐related foot ulcers 92 …”

Section: Resultsmentioning

confidence: 99%

“…Lauri 2017, 76 Ertugrul 2006, 77 Johnson 1996, 78 Nawaz 2010, 79 Newman 1992, 80 Shagos 2015, 81 Blume 1997, 82 Treglia 2013, 83 Rastogi 2016, 84 Abdel Razek 2017, 85 Aslangul 2013, 86 Poirier 2002, 87 Llewellyn 2020, 88 LaFontaine 2021, 89 Sax 2020, 90 Diez 2020, 91 Atif 2021 92 …”

Section: Resultsmentioning

confidence: 99%

“…Another study with low risk of bias showed 99% positive predictive value, and 57% negative predictive value with 94% diagnostic accuracy of 99mTc labelled Ubiquicidin SPECT/CT for the detection of osteomyelitis in patients with diabetes-related foot ulcers. 92 Evidence statement MRI, WBC scintigraphy, and 18F-FDGPET/CT are likely useful for the diagnosis of osteomyelitis in cases where doubt persists after assessing the results of clinical findings and plain X-ray of the foot.…”

Section: Summary Of the Literaturementioning

confidence: 99%

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Diagnosis of infection in the foot of patients with diabetes: A systematic review

Senneville,

Albalawi,

van Asten

et al. 2023

Diabetes Metabolism Res

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BackgroundSecuring an early accurate diagnosis of diabetic foot infections and assessment of their severity are of paramount importance since these infections can cause great morbidity and potential mortality and present formidable challenges in surgical and antimicrobial treatment.MethodsIn June 2022, we searched the literature using PubMed and EMBASE for published studies on the diagnosis of diabetic foot infection (DFI). On the basis of pre‐determined criteria, we reviewed prospective controlled, as well as non‐controlled, studies in English. We then developed evidence statements based on the included papers.ResultsWe selected a total of 64 papers that met our inclusion criteria. The certainty of the majority of the evidence statements was low because of the weak methodology of nearly all of the studies. The available data suggest that diagnosing diabetic foot infections on the basis of clinical signs and symptoms and classified according to the International Working Group of the Diabetic Foot/Infectious Diseases Society of America scheme correlates with the patient's likelihood of the need for hospitalisation, lower extremity amputation, and risk of death. Elevated levels of selected serum inflammatory markers such as erythrocyte sedimentation rate (ESR), C‐reactive protein and procalcitonin are supportive, but not diagnostic, of soft tissue infection. Culturing tissue samples of soft tissues or bone, when care is taken to avoid contamination, provides more accurate microbiological information than culturing superficial (swab) samples. Although non‐culture techniques, especially next‐generation sequencing, are likely to identify more bacteria from tissue samples including bone than standard cultures, no studies have established a significant impact on the management of patients with DFIs. In patients with suspected diabetic foot osteomyelitis, the combination of a positive probe‐to‐bone test and elevated ESR supports this diagnosis. Plain X‐ray remains the first‐line imaging examination when there is suspicion of diabetic foot osteomyelitis (DFO), but advanced imaging methods including magnetic resonance imaging (MRI) and nuclear imaging when MRI is not feasible help in cases when either the diagnosis or the localisation of infection is uncertain. Intra‐operative or non‐per‐wound percutaneous biopsy is the best method to accurately identify bone pathogens in case of a suspicion of a DFO. Bedside percutaneous biopsies are effective and safe and are an option to obtain bone culture data when conventional (i.e. surgical or radiological) procedures are not feasible.ConclusionsThe results of this systematic review of the diagnosis of diabetic foot infections provide some guidance for clinicians, but there is still a need for more prospective controlled studies of high quality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Summary Of the Literaturementioning

confidence: 99%

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Diagnosis of infection in the foot of patients with diabetes: A systematic review

Senneville,

Albalawi,

van Asten

et al. 2023

Diabetes Metabolism Res

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“…107 In patients with a contraindication to MRI, clinicians may choose other imaging techniques (e.g., FDG-PET/CT, HMPAO-labelled leucocyte scintigraphy or 99mTc labelled Ubiquicidin (UBI) SPECT/CT). [107][108][109][110][111][112] Compared to nuclear (e.g., leukocyte) imaging, PET, especially combined with CT scan, offers high spatial resolution, precise anatomic localization, possibly higher sensitivity for chronic infection, easier performance, faster results, and low radiation exposure.…”

Section: Rationalementioning

confidence: 99%

“…A systematic review and meta‐analysis that compared the diagnostic accuracy of imaging tests (plain X‐rays, scintigraphy, MRI, SPECT and PET) for the diagnosis of DFO showed that 18 F‐fluorodeoxyglucose (FDG)–PET and 99 mTc‐ exametazime Hexa Methyl Propylene Amine Oxime labelled WBC scintigraphy offer the highest specificity (0.92 for both) 107 . In patients with a contraindication to MRI, clinicians may choose other imaging techniques (e.g., FDG‐PET/CT, HMPAO‐labelled leucocyte scintigraphy or 99mTc labelled Ubiquicidin (UBI) SPECT/CT) 107–112 …”

Section: Recommendationsmentioning

confidence: 99%

IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes‐related foot infections (IWGDF/IDSA 2023)

Senneville,

Albalawi,

van Asten

et al. 2023

Diabetes Metabolism Res

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The International Working Group on the Diabetic Foot (IWGDF) has published evidence‐based guidelines on the management and prevention of diabetes‐related foot diseases since 1999. The present guideline is an update of the 2019 IWGDF guideline on the diagnosis and management of foot infections in persons with diabetes mellitus.The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was used for the development of this guideline. This was structured around identifying clinically relevant questions in the P(A)ICO format, determining patient‐important outcomes, systematically reviewing the evidence, assessing the certainty of the evidence, and finally moving from evidence to the recommendation. This guideline was developed for healthcare professionals involved in diabetes‐related foot care to inform clinical care around patient‐important outcomes. Two systematic reviews from 2019 were updated to inform this guideline, and a total of 149 studies (62 new) meeting inclusion criteria were identified from the updated search and incorporated in this guideline. Updated recommendations are derived from these systematic reviews, and best practice statements made where evidence was not available. Evidence was weighed in light of benefits and harms to arrive at a recommendation. The certainty of the evidence for some recommendations was modified in this update with a more refined application of the GRADE framework centred around patient important outcomes. This is highlighted in the rationale section of this update. A note is also made where the newly identified evidence did not alter the strength or certainty of evidence for previous recommendations.The recommendations presented here continue to cover various aspects of diagnosing soft tissue and bone infections, including the classification scheme for diagnosing infection and its severity. Guidance on how to collect microbiological samples, and how to process them to identify causative pathogens, is also outlined. Finally, we present the approach to treating foot infections in persons with diabetes, including selecting appropriate empiric and definitive antimicrobial therapy for soft tissue and bone infections; when and how to approach surgical treatment; and which adjunctive treatments may or may not affect the infectious outcomes of diabetes‐related foot problems.We believe that following these recommendations will help healthcare professionals provide better care for persons with diabetes and foot infections, prevent the number of foot and limb amputations, and reduce the patient and healthcare burden of diabetes‐related foot disease.

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IWGDF/IDSA Guidelines on the Diagnosis and Treatment of Diabetes-related Foot Infections (IWGDF/IDSA 2023)

Senneville,

Albalawi,

van Asten

et al. 2023

Clinical Infectious Diseases

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The International Working Group on the Diabetic Foot (IWGDF) has published evidence-based guidelines on the management and prevention of diabetes-related foot diseases since 1999. The present guideline is an update of the 2019 IWGDF guideline on the diagnosis and management of foot infections in persons with diabetes mellitus. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was used for the development of this guideline. This was structured around identifying clinically relevant questions in the P(A)ICO format, determining patient-important outcomes, systematically reviewing the evidence, assessing the certainty of the evidence, and finally moving from evidence to the recommendation. This guideline was developed for healthcare professionals involved in diabetes-related foot care to inform clinical care around patient-important outcomes. Two systematic reviews from 2019 were updated to inform this guideline, and a total of 149 studies (62 new) meeting inclusion criteria were identified from the updated search and incorporated in this guideline. Updated recommendations are derived from these systematic reviews, and best practice statements made where evidence was not available. Evidence was weighed in light of benefits and harms to arrive at a recommendation. The certainty of the evidence for some recommendations was modified in this update with a more refined application of the GRADE framework centred around patient important outcomes. This is highlighted in the rationale section of this update. A note is also made where the newly identified evidence did not alter the strength or certainty of evidence for previous recommendations. The recommendations presented here continue to cover various aspects of diagnosing soft tissue and bone infections, including the classification scheme for diagnosing infection and its severity. Guidance on how to collect microbiological samples, and how to process them to identify causative pathogens, is also outlined. Finally, we present the approach to treating foot infections in persons with diabetes, including selecting appropriate empiric and definitive antimicrobial therapy for soft tissue and bone infections; when and how to approach surgical treatment; and which adjunctive treatments may or may not affect the infectious outcomes of diabetes-related foot problems. We believe that following these recommendations will help healthcare professionals provide better care for persons with diabetes and foot infections, prevent the number of foot and limb amputations, and reduce the patient and healthcare burden of diabetes-related foot disease.

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Diagnostic Accuracy of 99 MTC Labelled Ubiquicidin (29-41) Spect/Ct for Diagnosis of Osteomyelitis in Diabetic Foot

Cited by 3 publications

References 20 publications

Diagnosis of infection in the foot of patients with diabetes: A systematic review

Diagnosis of infection in the foot of patients with diabetes: A systematic review

IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes‐related foot infections (IWGDF/IDSA 2023)

IWGDF/IDSA Guidelines on the Diagnosis and Treatment of Diabetes-related Foot Infections (IWGDF/IDSA 2023)

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