SNM: Dual-tracer SPECT/CT helps diagnose diabetic foot infections
A study presented at SNM's 57th annual meeting last week in San Diego showed that dual-tracer (DT) SPECT/CT can be a valuable tool for accurately diagnosing and determining treatment for a variety of diabetes-associated foot diseases.

"This new imaging technique is proving to be critical for managing diabetes-associated foot infection by providing comprehensive views of both anatomy and specific disease processes in the foot," said study author Sherif Heiba, MD, an associate professor of radiology at Mount Sinai School of Medicine in New York City. "By using this molecular imaging technique with dual-imaging agents, we were able to better diagnose diabetic foot infections and guide physicians to appropriate treatment for these diabetic patients."

During the three-year study, researchers used DT SPECT/CT to identify foot disease in 23 diabetic patients, who underwent a total of 57 studies.

Participants received multiple molecular imaging scans using different imaging agents to evaluate for presence of bone infection, soft tissue infection, a combination of bone and soft tissue infection or other bony diseases. If mid- or hind-foot bone infection was suspected, an additional bone marrow scan was conducted.

Results indicated that dual-agent SPECT/CT was highly accurate for diagnosing foot infection. In 48 (84 percent) of cases, results of the scan determined the course of treatment or therapy. In 8 of remaining 9 scans management was influenced by ischemia/gangrene.

In the 48 image-guided managements, 77 percent of the scans led to conservative management (local tissue debridement), and 21 percent of the scans to limb salvage procedures (partial bony resections & toe amputation), according to the researchers.

“In our diabetic foot infection patients, the recurrent use of DT SPECT/CT was crucial for the distinction between soft tissue infection & osteomyelitis evaluating the extent of osseous or soft tissue involvement and spatially localizing the focus of disease,” concluded Heiba and colleagues.