Dual-isotope SPECT/CT impact on hospitalized patients with suspected diabetic foot infection: saving limbs, lives, and resources.

Background: Foot ulcer with suspected infection is one of the most common reasons for hospitalization and a major factor contributing to morbidity and high healthcare-related expenses among diabetic patients. Many patients will require amputation; however, major amputation is associated with an alarmingly high 5-year mortality rate. In this study, we assess the diagnosis and management of suspected foot infection in diabetic patients using dual-isotope (DI) single-photon emission computed tomography/computed tomography (SPECT/CT) compared with conventional imaging.

The optimized evaluation of diabetic foot infection by dual isotope SPECT/CT imaging protocol.

Sequential Tc-99m hydroxymethylene-diphosphonate (HDP) 3-phase bone (BS) and In-111 leukocyte scanning (WBCS) have been frequently used to evaluate the diabetic foot, as nonosteomyelitis BS uptake is repeatedly observed and osteomyelitis (OM) in WBCS is often uncertain without BS correlation. Additionally, both modalities are limited in lesion localization because of low resolution and lack of anatomic details. We investigated a method that combined BS/WBCS, and if needed, WBCS/bone marrow scanning (BMS) using SPECT/CT to accurately diagnose/localize infection in a practical protocol.

Demonstration of post-traumatic bile leak using technetium-99m DISIDA.

A 25-year-old miner was admitted with an acute abdomen and marked pallor following a crush injury to the abdomen. CT showed an irregular, patchy appearance of the posterosuperior portion of the liver with a coefficient of density appreciably less than the rest of the liver, consistent with the presence of a hepatic hematoma. The patient was treated conservatively.

The clinical value of scintigraphic brain scanning. Experience at the Hillbrow Hospital, Johannesburg, South Africa.

Patients were referred to the Department of Nuclear Medicine for brain scintigraphy to be screened for possible intracranial pathology. These referrals were made in order to reduce the heavy load on the transmission computerized tomography (TCT) facilities. Great clinical importance, therefore, has been attached to scintigraphic findings; this emphasizes the need for an accurate assessment of the predictive value of this procedure.

Technetium-99m glucoheptonate as a scanning agent in hepatocellular carcinoma.

Technetium-99m glucoheptonate (Tc-99m GH) is concentrated in pulmonary and cerebral tumors. The purpose of this study was to assess the uptake of this radionuclide by hepatocellular carcinoma. Its concentration by the primary tumor was compared with that in the non-neoplastic hepatic tissue in 31 patients who showed obvious defects on a colloid scan, and its uptake by pulmonary metastases was examined in six patients with x-ray evidence of this complication.

A patient data storage and retrieval system.

A patient data storage and retrieval system has been developed for a microcomputer used in a nuclear medicine department. The advantages of coding clinical information and the problems encountered in coding are highlighted. The application of the stored patient data is briefly discussed.

The use of technetium-99m-di-isopropyl-iminodiacetic acid imaging in the demonstration of a biliary-bronchial fistula.

A case is described in which technetium-99m-di-isopropyl-iminodiacetic acid imaging was used to trace the passage of bile from its site of leakage into an amoebic liver abscess, through a fistulous tract connecting the liver abscess with an abscess in the right lower lobe of the lung, and into the upper respiratory tract.

Radiocolloid liver imaging in tuberculous hepatitis.

Twenty of 22 patients with tuberculous hepatitis had abnormal Tc-99m tin colloid liver scans. However, in the majority of the patients the changes were mild and nonspecific. The most frequent scintigraphic picture was a decreased uptake of the radiocolloid by the liver, with shunting to the spleen and bone marrow.

Uptake of Tc-99m di-isopropyliminodiacetic acid by hepatocellular carcinoma: concise communication.

Uptake of Tc-99m di-isopropyliminodiacetic acid (DISIDA) by hepatocellular carcinoma was assessed in 30 patients showing obvious liver defects on a Tc-99m tin colloid image. In none of these patients was there complete "filling in" of the defects, and even partial "filling in" occurred in only 11 (36.7%).