{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T09:16:09Z","timestamp":1782551769239,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,4,23]],"date-time":"2014-04-23T00:00:00Z","timestamp":1398211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Diabetic foot osteomyelitis is an important risk factor of lower limb amputation. Antibiotic therapy is often effective in preventing surgery. However, the duration of antibiotic therapy is difficult to define in the absence of a marker to diagnose osteomyelitis remission at the end of the treatment. In this study, we assessed the diagnostic performance of white blood cell SPECT\/CT imaging for evaluating osteomyelitis remission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Twenty\u2010nine out of 42 episodes of diabetic foot osteomyelitis seen between December 2009 and April 2012 had radiographs, a three\u2010phase bone scintigraphy and a white blood cell SPECT\/CT at the end of antibiotic therapy. They were treated with antibiotics alone and considered in clinical remission. White blood cell SPECT\/CT results were considered positive when abnormal uptake in the osteomyelitis location was identified. Osteomyelitis remission was defined by the absence of an osteomyelitis relapse after 12\u00a0months\u2019 follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A negative white blood cell SPECT\/CT was seen for 22 episodes of osteomyelitis. All of them were in remission. A positive white blood cell SPECT\/CT was observed for seven episodes. A relapse occurred in five episodes (71.5%) after a median duration of 4\u00a0months (2\u20137\u00a0months). Sensitivity, specificity, positive predictive value and predictive negative value in predicting osteomyelitis relapse after the discontinuation of antibiotic treatment were, respectively, for radiographs 80%, 33%, 20% and 89%; for three\u2010phase bone scintigraphy 100%, 12.5%, 15.5% and 100%; and for the white blood cell SPECT\/CT 100%, 91.5%, 71.5% and 100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Negative uptake on white blood cell SPECT\/CT is a good marker for diagnosis of diabetic foot osteomyelitis remission and might be very useful in guiding antibiotic therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12445","type":"journal-article","created":{"date-parts":[[2014,3,21]],"date-time":"2014-03-21T16:25:07Z","timestamp":1395419107000},"page":"1093-1099","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Assessing diabetic foot osteomyelitis remission with white blood cell <scp>SPECT<\/scp>\/<scp>CT<\/scp> imaging"],"prefix":"10.1111","volume":"31","author":[{"given":"J.","family":"Vouillarmet","sequence":"first","affiliation":[{"name":"Department of Endocrinology Diabetes and Nutrition Oullins France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Morelec","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Hospices Civils de Lyon Centre Hospitalier Lyon\u2010Sud Pierre B\u00e9nite Oullins France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Thivolet","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Diabetes and Nutrition Oullins France"},{"name":"Inserm U1060 Facult\u00e9 de Medecine Lyon sud Oullins France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02581290"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0989"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(07)60001-5"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/383271"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis346"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(199706)14:6<487::AID-DIA373>3.0.CO;2-Q"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.8.851"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/48.6.927"},{"key":"e_1_2_9_10_1","first-page":"31","article-title":"Conservative management of diabetic foot ulcers complicated by osteomyelitis","volume":"14","author":"Yadlapalli N","year":"2002","journal-title":"Wounds"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602701003"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0976-1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1744"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(97)80057-9"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002590050205"},{"key":"e_1_2_9_16_1","first-page":"485","article-title":"Diagnosis of osteomyelitis in the diabetic foot with a 99mTc\u2010HMPAO leucocyte scintigraphy combined with a 99mTc\u2010MDP bone scintigraphy","volume":"28","author":"Poirier JY","year":"2002","journal-title":"Diabetes Metab"},{"key":"e_1_2_9_17_1","first-page":"1908","article-title":"Usefulness of hybrid SPECT\/CT in 99mTc\u2010HMPAO\u2010labeled leukocyte scintigraphy for bone and joint infections","volume":"47","author":"Filippi L","year":"2006","journal-title":"J Nucl Med"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.108.059493"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2010.07.010"},{"key":"e_1_2_9_20_1","first-page":"110","article-title":"Predicting the cure of osteomyelitis under treatment: concise communication","volume":"24","author":"Graham GD","year":"1983","journal-title":"Nucl Med"},{"key":"e_1_2_9_21_1","first-page":"1015","article-title":"Indium\u2010111\u2010labeled white blood cells in the detection of osteomyelitis complicated by a pre\u2010existing condition","volume":"29","author":"McCarthy K","year":"1988","journal-title":"J Nucl Med"},{"key":"e_1_2_9_22_1","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1177\/107110070102200906","article-title":"Prognostic value of 99mTc leukocyte scintigraphy in diabetic pedal osteomyelitis","volume":"22","author":"Wall H","year":"2001","journal-title":"Foot Ankle Int"},{"key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1001\/jama.1991.03470090080036","article-title":"Unsuspected osteomyelitis in diabetic foot ulcers. 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