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The diabetic foot: initial experience with 18F-FDG PET/CT
Zohar Keidar1, Daniela Militianu, Eyal Melamed
1Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel. zohar@keidar.net
Summary
Positron emission tomography/computed tomography (PET/CT) using 18F-FDG accurately differentiates diabetic foot osteomyelitis from soft-tissue infections. This imaging technique aids in early diagnosis and treatment planning for diabetic foot complications.
Area of Science:
- Nuclear Medicine
- Diabetology
- Infectious Diseases
Background:
- Diabetic foot infections frequently lead to osteomyelitis, posing a significant clinical challenge.
- Early diagnosis of diabetic foot osteomyelitis is crucial for effective antibiotic therapy and limb salvage.
Purpose of the Study:
- To evaluate the diagnostic performance of 18F-FDG PET/CT in identifying diabetic foot osteomyelitis.
- To assess the ability of PET/CT to differentiate bone infection from soft-tissue infection in diabetic patients.
Main Methods:
- Fourteen diabetic patients with suspected foot osteomyelitis underwent PET/CT after 18F-FDG injection.
- PET, CT, and fused PET/CT images were independently analyzed for infectious foci.
- Histopathology and bacteriologic assays confirmed the final diagnosis.
Main Results:
- PET/CT identified 14 foci of increased 18F-FDG uptake in 10 patients.
- Osteomyelitis was correctly diagnosed in 8 foci (4 patients) and excluded in 5 foci (5 patients).
- PET/CT distinguished between osteomyelitis, soft-tissue infection, and osteoarthropathy.
Conclusions:
- 18F-FDG PET/CT is a valuable tool for diagnosing diabetes-related foot infections.
- PET/CT provides precise localization, enabling accurate differentiation between osteomyelitis and soft-tissue infections.