Hybrid imaging with 99mTc-WBC SPECT/CT to monitor the effect of therapy in diabetic foot osteomyelitis

Francisco Lazaga; Suzanne Av Van Asten; Adam Nichols; Kavita Bhavan; Javier La Fontaine; Orhan K Oz; Lawrence A Lavery

doi:10.1111/iwj.12433

Hybrid imaging with 99mTc-WBC SPECT/CT to monitor the effect of therapy in diabetic foot osteomyelitis

Int Wound J. 2016 Dec;13(6):1158-1160. doi: 10.1111/iwj.12433. Epub 2015 Apr 8.

Authors

Francisco Lazaga¹, Suzanne Av Van Asten², Adam Nichols², Kavita Bhavan³, Javier La Fontaine², Orhan K Oz¹, Lawrence A Lavery²

Affiliations

¹ Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
² Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
³ Department of Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Abstract

This study sought to assess the utility of monitoring response to treatment of diabetic foot osteomyelitis (DFO) with Tc-99m WBC-labelled single photon emission computed tomography (SPECT/CT) imaging. This is a retrospective cohort study of 20 patients with DFO with sequential Tc-99m WBC-labelled SPECT/CT imaging. Radiologic findings of osteomyelitis were evaluated and imaging results were correlated with clinical outcomes subtracted from chart review. Successful treatment of osteomyelitis was defined by wound healing and/or lack of re-admission for bone infection of the same site within 1 year. The sensitivity, specificity, positive predictive value and negative predictive value of SPECT/CT to determine osteomyelitis treatment remission were 90%, 56%, 69% and 83%, respectively. Tc-99m WBC-labelled SPECT/CT imaging may be useful to help determine treatment outcomes for DFO.

Keywords: Diabetic foot; Imaging; Infection; Osteomyelitis; SPECT/CT.

MeSH terms

Diabetic Foot*
Humans
Multimodal Imaging
Osteomyelitis*
Retrospective Studies
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed