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First published online June 12, 2009, 10.2967/jnumed.108.059493
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Journal of Nuclear Medicine Vol. 50 No. 7 1042-1046
© 2009 by Society of Nuclear Medicine
doi: 10.2967/jnumed.108.059493

Clinical Investigation

Diabetic Foot Infection: Usefulness of SPECT/CT for 99mTc-HMPAO-Labeled Leukocyte Imaging

Luca Filippi1, Luigi Uccioli2, Laura Giurato2 and Orazio Schillaci3

1 Section of Nuclear Medicine, Ospedale Maggiore, Trieste, Italy; 2 Department of Internal Medicine, University of Rome "Tor Vergata," Rome, Italy; and 3 Department of Biopathology and Diagnostic Imaging, University of Rome "Tor Vergata," Rome, Italy

Correspondence: For correspondence or reprints contact: Orazio Schillaci, viale Mazzini 121, 00195 Rome, Italy. E-mail:orazio.schillaci{at}uniroma2.it

Our aim was to evaluate the role of SPECT/CT for the diagnosis of diabetic foot infection by labeled leukocytes. Methods: Seventeen patients with 19 clinically suspected sites of infection were included. After leukocyte labeling and administration, planar scans were acquired at 30 min, 4 h, and 24 h for 18 consecutive patients. SPECT/CT was obtained at 6 h. The final diagnosis was established by clinical follow-up (24 mo) in all cases and by bone biopsy for 14 sites. Results: Leukocyte scanning was positive in 16 of 19 lesions and negative in 3. SPECT/CT changed the interpretation of the planar and SPECT images for 10 of 19 suspected sites (52.6%): it excluded osteomyelitis in 6 cases, revealed bone infection in 1 case, and revealed both bone and soft-tissue infection in 3 cases. The hybrid device did not significantly contribute to the evaluation of patients with negative scan results. Conclusion: SPECT/CT can be useful for a more accurate diagnosis of diabetic foot infection by labeled leukocyte imaging.

Key Words: diabetic foot • infection • hybrid SPECT/CT • leukocytes

COPYRIGHT © 2009 by the Society of Nuclear Medicine, Inc.


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Copyright © 2009 by the Society of Nuclear Medicine.