Unsuspected osteomyelitis is frequent in persistent diabetic foot ulcer and better diagnosed by MRI than by <sup>18</sup>F‐FDG PET or <sup>99m</sup>Tc‐MOAB

Schwegler, Beat; Stumpe, Katrin D. M.; Weishaupt, Dominik; Strobel, Klaus; Spinas, G A; Schulthess, Gustav K. von; Hodler, Juerg; Böni, Thomas; Donath, M Y

doi:10.1111/j.1365-2796.2007.01877.x

Cited by 74 publications

(45 citation statements)

References 28 publications

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“…In diabetic-foot patients with clinically suspected osteomyelitis, 18 F-FDG PET showed an only slightly lower sensitivity than MRI for the detection of osteomyelitis but a higher specificity (81% and 93% as compared with 91% and 78%, respectively) (14), whereas in diabetic-foot patients without clinical suspicion of osteomyelitis, MRI was clearly superior (13). On the basis of these results, PET seems to be complementary to MRI and may be used as an alternative to MRI after plain radiography as a screening method (14).…”

Section: Imaging Of Infectious Diseases Osteomyelitismentioning

confidence: 81%

“…In diabetic patients, PET with 18 F-FDG may be at a disadvantage because peripheral insulin resistance might cause decreased uptake at the site of inflammation (13). In diabetic-foot patients with clinically suspected osteomyelitis, 18 F-FDG PET showed an only slightly lower sensitivity than MRI for the detection of osteomyelitis but a higher specificity (81% and 93% as compared with 91% and 78%, respectively) (14), whereas in diabetic-foot patients without clinical suspicion of osteomyelitis, MRI was clearly superior (13).…”

Section: Imaging Of Infectious Diseases Osteomyelitismentioning

confidence: 99%

See 1 more Smart Citation

Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

Gotthardt¹,

Bleeker‐Rovers²,

Boerman³

et al. 2010

J Nucl Med

231

165

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Nuclear medicine imaging procedures play an important role in the assessment of inflammatory diseases. With the advent of 3-dimensional anatomic imaging, there has been a tendency to replace traditional planar scintigraphy by CT or MRI. Furthermore, scintigraphic techniques may have to be combined with other imaging modalities to achieve high sensitivity and specificity, and some may require time-consuming labeling procedures. On the other hand, new developments such as combined SPECT/CT increase the diagnostic power of scintigraphy. Also, the advent of PET had a considerable impact on the use of nuclear medicine imaging techniques. In this review, we aim to provide nuclear medicine specialists and clinicians with the relevant information on rational and efficient use of nuclear medicine imaging techniques in the assessment of patients with osteomyelitis, infected vascular prostheses, metastatic infectious disease, rheumatoid arthritis, vasculitis, inflammatory bowel disease, sarcoidosis, and fever of unknown origin.

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Section: Imaging Of Infectious Diseases Osteomyelitismentioning

confidence: 81%

Section: Imaging Of Infectious Diseases Osteomyelitismentioning

confidence: 99%

Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

Gotthardt¹,

Bleeker‐Rovers²,

Boerman³

et al. 2010

J Nucl Med

231

165

View full text Add to dashboard Cite

show abstract

“…The authors concluded that 18 F-FDG PET can be used for diagnosis of diabetes-related infection and that PET/CT enables accurate differentiation between osteomyelitis and softtissue infection (2). Only 1 study, published by Schwegler et al, found disappointing results for 18 F-FDG PET, with MRI being superior to 18 F-FDG PET and to 99m Tc-labeled monoclonal antigranulocyte antibody scintigraphy (19).…”

Section: Discussionmentioning

confidence: 99%

Can Sequential¹⁸F-FDG PET/CT Replace WBC Imaging in the Diabetic Foot?

et al. 2011

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“…Schwegler et al (52). reported that 18 F-FDG PET detected 2 of 7 cases (29% sensitivity) of osteomyelitis.…”

Section: Diabetic Pedal Osteomyelitismentioning

confidence: 99%

Radionuclide Imaging of Musculoskeletal Infection: A Review

Palestro

2016

J Nucl Med

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the principle of combined labeled leukocyte/marrow imaging; (2) at least one advantage of 18 F-FDG PET or PET/CT over MRI for diagnosing spondylodiskitis; and (3) at least one advantage of SPECT/CT over planar imaging in the diagnosis of pedal osteomyelitis in diabetic patients.Financial Disclosure: The author of this article has indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through September 2019.There are numerous imaging tests for diagnosing musculoskeletal infection. Radiographs are routinely performed, because even when not diagnostic, they provide an anatomic overview of the region of interest that could influence subsequent procedure selection and interpretation. MRI is sensitive and provides superb anatomic detail. Bone scintigraphy accurately diagnoses osteomyelitis in bones not affected by underlying conditions. 67 Ga is used primarily for spondylodiskitis. Although in vitro labeled leukocyte imaging is the radionuclide test of choice for complicating osteomyelitis such as diabetic pedal osteomyelitis and prosthetic joint infection, it is not useful for spondylodiskitis. Antigranulocyte antibodies and antibody fragments have limitations and are not widely available. 111 In-biotin is useful for spondylodiskitis. Radiolabeled synthetic fragments of the antimicrobial peptide ubiquicidin are promising infection-specific agents. 18 F-FDG is the radiopharmaceutical of choice for spondylodiskitis. Its role in diabetic pedal osteomyelitis and prosthetic joint infection is not established. Preliminary data suggest 68 Ga may be useful in musculoskeletal infection. 124 I-fialuridine initially showed promise as an infection-specific radiopharmaceutical, but subsequent investigations were disappointing. The development of PET/CT and SPECT/CT imaging systems, which combine anatomic and functional imaging, has revolutionized diagnostic imaging. These hybrid systems are redefining the diagnostic workup of patients with suspected or known infection and inflammation by improving diagnostic accuracy and influencing patient management.

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Unsuspected osteomyelitis is frequent in persistent diabetic foot ulcer and better diagnosed by MRI than by ¹⁸F‐FDG PET or ^99mTc‐MOAB

Cited by 74 publications

References 28 publications

Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

Can Sequential¹⁸F-FDG PET/CT Replace WBC Imaging in the Diabetic Foot?

Radionuclide Imaging of Musculoskeletal Infection: A Review

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Unsuspected osteomyelitis is frequent in persistent diabetic foot ulcer and better diagnosed by MRI than by 18F‐FDG PET or 99mTc‐MOAB

Cited by 74 publications

References 28 publications

Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

Imaging of Inflammation by PET, Conventional Scintigraphy, and Other Imaging Techniques

Can Sequential18F-FDG PET/CT Replace WBC Imaging in the Diabetic Foot?

Radionuclide Imaging of Musculoskeletal Infection: A Review

Contact Info

Product

Resources

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Unsuspected osteomyelitis is frequent in persistent diabetic foot ulcer and better diagnosed by MRI than by ¹⁸F‐FDG PET or ^99mTc‐MOAB

Can Sequential¹⁸F-FDG PET/CT Replace WBC Imaging in the Diabetic Foot?