{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:06:08Z","timestamp":1790352368868,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,7,3]],"date-time":"2015-07-03T00:00:00Z","timestamp":1435881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Physio Funct Imaging"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate whether inclusion of quantitative data on blood flow distribution compared with visual qualitative evaluation improve the reliability and diagnostic performance of <jats:sup>99\u00a0m<\/jats:sup>Tc\u2010hydroxymethylene diphosphate three\u2010phase bone scintigraphy (<jats:styled-content style=\"fixed-case\">TPBS<\/jats:styled-content>) in patients suspected for charcot neuropathic osteoarthropathy (<jats:styled-content style=\"fixed-case\">CNO<\/jats:styled-content>) of the foot.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective cohort study of <jats:styled-content style=\"fixed-case\">TPBS<\/jats:styled-content> performed on 148 patients with suspected acute <jats:styled-content style=\"fixed-case\">CNO<\/jats:styled-content> referred from a single specialized diabetes care centre. The quantitative blood flow distribution was calculated based on the method described by Deutsch <jats:italic>et\u00a0al<\/jats:italic>. All scintigraphies were re\u2010evaluated by independent, blinded observers twice with and without quantitative data on blood flow distribution at ankle and focus level, respectively. The diagnostic validity of <jats:styled-content style=\"fixed-case\">TPBS<\/jats:styled-content> was determined by subsequent review of clinical data and radiological examinations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 90 patients (61%) had confirmed diagnosis of <jats:styled-content style=\"fixed-case\">CNO<\/jats:styled-content>. The sensitivity, specificity and accuracy of three\u2010phase bone scintigraphy without\/with quantitative data were 89%\/88%, 58%\/62% and 77%\/78%, respectively. The intra\u2010observer agreement improved significantly by adding quantitative data in the evaluation (Kappa value 0\u00b779\/0\u00b794). The interobserver agreement was not significantly improved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adding quantitative data on blood flow distribution in the interpretation of <jats:styled-content style=\"fixed-case\">TBPS<\/jats:styled-content> improves intra\u2010observer variation, whereas no difference in interobserver variation was observed. The sensitivity of <jats:styled-content style=\"fixed-case\">TPBS<\/jats:styled-content> in the diagnosis of <jats:styled-content style=\"fixed-case\">CNO<\/jats:styled-content> is high, but holds limited specificity. Diagnostic performance does not improve using quantitative data in the evaluation. This may be due to the reference intervals applied in the study or the absence of a proper gold standard diagnostic procedure for comparison.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cpf.12264","type":"journal-article","created":{"date-parts":[[2015,7,4]],"date-time":"2015-07-04T06:21:50Z","timestamp":1435990910000},"page":"30-36","source":"Crossref","is-referenced-by-count":11,"title":["Three\u2010phase bone scintigraphy for diagnosis of Charcot neuropathic osteoarthropathy in the diabetic foot \u2013 does quantitative data improve diagnostic value?"],"prefix":"10.1111","volume":"37","author":[{"given":"M.","family":"Fosb\u00f8l","sequence":"first","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Herlev Hospital Herlev Denmark"},{"name":"Department of Clinical Physiology Nuclear Medicine &amp; PET Rigshospitalet Copenhagen Denmark"},{"name":"Department of Clinical Physiology and Nuclear Medicine Hvidovre Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Reving","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Herlev Hospital Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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