High-resolution mini gamma camera for diagnosis and radio-guided surgery in diabetic foot infection

The diagnosis of diabetic foot osteomyelitis is often difficult. 99mTc-WBC (White Blood Cell) scintigraphy plays a key role in the diagnosis of bone infections. Spatial resolution of Anger camera is not always able to differentiate soft tissue from bone infection. Aim of present study is to verify if HRD (High-Resolution Detector) is able to improve diagnosis and to help surgery. Patients were studied by HRD showing 25.7×25.7 mm2 FOV, 2 mm spatial resolution and 18% energy resolution. The patients were underwent to surgery and, when necessary, bone biopsy, both guided by HRD. Four patients were positive at Anger camera without specific signs of osteomyelitis. HRS (High-Resolution Scintigraphy) showed hot spots in the same patients. In two of them the hot spot was bar-shaped and it was localized in correspondence of the small phalanx. The presence of bone infection was confirmed at surgery, which was successfully guided by HRS. 99mTc-WBC HRS was able to diagnose pedal infection and to guide the surgery of diabetic foot, opening a new way in the treatment of infected diabetic foot.