Abstract
Background: Diagnosing diabetic foot infection is often difficult, despite several available diagnostic methods. Amongst these, several imaging modalities exist to evaluate the diabetic foot in case of a suspected osteomyelitis. Nuclear Medicine, in particular, offers a variety of radiopharmaceuticals and techniques. Nowadays the gold standard radionuclide procedure, when an osteomyelitis is suspected, is represented by the use of radiolabelled leukocytes with either 99mTc-HMPAO or 111In-oxine.
Methods: In this review, we describe the correct acquisition and interpretation of white blood cell scintigraphy and we provide an overview of the existing literature data of the use of this technique in the infected diabetic foot. If images are correctly acquired, displayed and interpreted, this modality reaches very high diagnostic accuracy (>95%) in detecting osteomyelitis and it allows the differential diagnosis with a soft tissue infection or inflammation. Single-photon emission computed tomography/computed tomography (SPECT/CT) in addition to planar images is mandatory to determine the extent and exact location of the infective process in both fore foot and midhint foot. With the addition of bone marrow scintigraphy using radiolabelled nanocolloids, radiolabelled white blood cell scintigraphy is also able to differentiate between Charcot neuroarthropathy and osteomyelitis, which is a challenge in the evaluation of diabetic foot. Radiolabelled anti-granulocyte monoclonal antibodies and their fragments can also be used instead of white blood cells although there is a limited experience on their usefulness in diabetic foot infection.
Keywords: Diabetic foot, WBC scintigraphy, radiolabelled leukocytes, nuclear medicine, infection, osteomyelitis, diagnosis.
Current Pharmaceutical Design
Title:Leukocyte Imaging of the Diabetic Foot
Volume: 24 Issue: 12
Author(s): Chiara Lauri, Andor W.J.M. Glaudemans and Alberto Signore*
Affiliation:
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, ,Italy
Keywords: Diabetic foot, WBC scintigraphy, radiolabelled leukocytes, nuclear medicine, infection, osteomyelitis, diagnosis.
Abstract: Background: Diagnosing diabetic foot infection is often difficult, despite several available diagnostic methods. Amongst these, several imaging modalities exist to evaluate the diabetic foot in case of a suspected osteomyelitis. Nuclear Medicine, in particular, offers a variety of radiopharmaceuticals and techniques. Nowadays the gold standard radionuclide procedure, when an osteomyelitis is suspected, is represented by the use of radiolabelled leukocytes with either 99mTc-HMPAO or 111In-oxine.
Methods: In this review, we describe the correct acquisition and interpretation of white blood cell scintigraphy and we provide an overview of the existing literature data of the use of this technique in the infected diabetic foot. If images are correctly acquired, displayed and interpreted, this modality reaches very high diagnostic accuracy (>95%) in detecting osteomyelitis and it allows the differential diagnosis with a soft tissue infection or inflammation. Single-photon emission computed tomography/computed tomography (SPECT/CT) in addition to planar images is mandatory to determine the extent and exact location of the infective process in both fore foot and midhint foot. With the addition of bone marrow scintigraphy using radiolabelled nanocolloids, radiolabelled white blood cell scintigraphy is also able to differentiate between Charcot neuroarthropathy and osteomyelitis, which is a challenge in the evaluation of diabetic foot. Radiolabelled anti-granulocyte monoclonal antibodies and their fragments can also be used instead of white blood cells although there is a limited experience on their usefulness in diabetic foot infection.
Export Options
About this article
Cite this article as:
Lauri Chiara, Glaudemans W.J.M. Andor and Signore Alberto *, Leukocyte Imaging of the Diabetic Foot, Current Pharmaceutical Design 2018; 24 (12) . https://dx.doi.org/10.2174/1381612824666180227094116
DOI https://dx.doi.org/10.2174/1381612824666180227094116 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Heart Failure in Acute Ischemic Stroke
Current Cardiology Reviews A Diabetes Treatment Strategy to Reduce the Risk of Cardiovascular Events: Clinical Benefits and Potential of Linagliptin
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Subfractions and Subpopulations of HDL: An Update
Current Medicinal Chemistry Potential Replication of Induced Pluripotent Stem Cells for Craniofacial Reconstruction
Current Stem Cell Research & Therapy Vascular Endothelial Growth Factor (VEGF) Signaling in Tumour Vascularization: Potential and Challenges
Current Vascular Pharmacology Cardiovascular Complications in Diabetes: Lessons from Animal Models
Current Medicinal Chemistry MicroRNA Biogenesis in Hypoxia
MicroRNA Metabolic Activation of Herbal and Dietary Constituents and Its Clinical and Toxicological Implications: An Update
Current Drug Metabolism Lipoprotein-Associated Phospholipase A2: How Effective as a Risk Marker of Cardiovascular Disease and as a Therapeutic Target?
Inflammation & Allergy - Drug Targets (Discontinued) Resveratrol as a Chemopreventive Agent: A Promising Molecule for Fighting Cancer
Current Drug Targets Apolipoprotein E Knockout Models
Current Pharmaceutical Design Metabolic Syndrome Components in Murine Models
Endocrine, Metabolic & Immune Disorders - Drug Targets Cancer Gene Therapy with Tissue Inhibitors of Metalloproteinases (TIMPs)
Current Gene Therapy Demonstration of the Efficacy of Statins in Resolution of Plaque Inflammation by Serial FDG Imaging
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Effect of Aging On Angiogenesis and Arteriogenesis
Current Cardiology Reviews Depression has a Strong Relationship to Alterations in the Immune, Endocrine and Neural System
Current Psychiatry Reviews subject Index To Volume 1
Current Drug Targets - Infectious Disorders The Importance of Novel Inflammatory Biomarkers in Renal Disease
Current Medicinal Chemistry Hyper-Coagulable Profile with Elevated Pro-Thrombotic Biomarkers and Increased Cerebro- and Cardio-Vascular Disease Risk Exist Among Healthy Dyslipidemic Women
Current Neurovascular Research Global Trends of Computational Fluid Dynamics to Resolve Real World Problems in the Contemporary Era
Current Biochemical Engineering (Discontinued)