{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T05:03:32Z","timestamp":1751691812743,"version":"3.40.5"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Wound Repair Regeneration"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Standard non\u2010invasive methods for diagnosing and selecting the best treatment for osteomyelitis in patients with multiple chronic conditions remain to be established. We aimed to evaluate the ability of quantitative<jats:sup>67<\/jats:sup>Ga\u2010citrate single\u2010photon emission computed tomography (<jats:sup>67<\/jats:sup>Ga\u2010SPECT\/CT) to determine the indication for either non\u2010surgical treatment or osteotomy in patients with lower\u2010limb osteomyelitis (LLOM) associated with diabetes mellitus and lower\u2010extremity ischemia, based on monitoring of inflammatory activity in bone tissue. This single\u2010centre prospective study conducted from January 2012 to July 2017 included 90 consecutive patients with suspected LLOM. Regions of interest were drawn on SPECT images during quantification of Ga accumulation. Subsequently, the inflammation\u2010to\u2010background ratio (IBR) was calculated by dividing the maximal accumulated lesion number by the mean number for the distal femur bone marrow of the unaffected side. Osteotomy was performed in 28 of 90 patients (31%). The osteotomy rate was higher for patients with IBR &gt;8.4 (71.4%) than for those with IBR \u22648.4 (5.5%) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, sensitivity: 0.89, specificity: 0.84). In the multivariate Cox regression analysis, IBR &gt;8.4 was an independent risk factor for osteotomy (hazard ratio [HR]: 19.0, 95% confident interval [CI]: 5.6\u201363.9,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Transcutaneous oxygen tension (TcPO<jats:sub>2<\/jats:sub>) was identified as an independent risk factor for lower\u2010limb amputation (HR: 0.96, 95% CI: 0.92\u20130.99,<jats:italic>p<\/jats:italic>\u00a0=\u00a00.01). The current results indicate that quantitative<jats:sup>67<\/jats:sup>Ga\u2010SPECT\/CT is useful for distinguishing patients with LLOM likely to require osteotomy.<\/jats:p>","DOI":"10.1111\/wrr.13075","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T08:12:01Z","timestamp":1677831121000},"page":"384-392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical utility of<scp><sup>67<\/sup>Gallium\u2010SPECT<\/scp>\/<scp>CT<\/scp>for determining osteotomy indication in patients with lower\u2010limb osteomyelitis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3222-491X","authenticated-orcid":false,"given":"Sonoko","family":"Kirinoki\u2010Ichikawa","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9527-5220","authenticated-orcid":false,"given":"Gen","family":"Takagi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nippon Medical School Tokyo Japan"},{"name":"Department of ER and General Medicine Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6224-4914","authenticated-orcid":false,"given":"Yoshimitsu","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Radiology Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7272-6498","authenticated-orcid":false,"given":"Shuhei","family":"Tara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaaki","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichiro","family":"Kumita","sequence":"additional","affiliation":[{"name":"Department of Radiology Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-021-00474-8"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100716664364"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx095"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.139.4.395"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2003.07.027"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/23.2.286"},{"issue":"1","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.3280","article-title":"Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)","volume":"36","author":"Lipsky BA","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2019.05.006"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.836"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2020.109215"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-2108"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.10.003"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.17996\/anc.19-00089"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.115.160937"},{"volume-title":"Hyperbaric oxygen therapy indications. 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