{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:51:06Z","timestamp":1785419466175,"version":"3.56.0"},"reference-count":62,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objective: We sought to assess the diagnostic performance of quantitative bone SPECT\/CT standardized uptake values (SUVs) in diabetic foot osteomyelitis (DFO) and their associations with inflammatory biomarkers. Methods: We retrospectively reviewed 150 consecutive patients who underwent three-phase bone scintigraphy and foot SPECT\/CT (November 2016\u2013December 2024) for DFO before antibiotic treatment; 117 with complete imaging and laboratory data were analyzed. Lesion and contralateral SUVs (SUVmax, SUVmean) were compared. Receiver operating characteristic (ROC) curves were used to determine discrimination and optimal cut-offs (Youden index). Associations with biomarkers (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), CRP\/albumin (ESR \u00d7 CRP) and hematologic\/coagulation indices including mean corpuscular hemoglobin (MCH) and activated partial thromboplastin time (aPTT) were evaluated using Spearman correlations. Results: Lesion uptake and contralateral uptake were SUVmax 10.94 \u00b1 7.36 vs. 3.62 \u00b1 1.70; SUVmean 4.38 \u00b1 3.63 vs. 0.93 \u00b1 0.50. Discrimination was excellent; SUVmax was AUC 0.921 (cut-off 4.47; sensitivity 0.93; specificity 0.75) and SUVmean was AUC 0.961 (cut-off 1.49; sensitivity 0.91; specificity 0.89). CRP and ESR showed weak but consistent positive correlations with SUVs (\u03c1 \u2248 0.25\u20130.30). The ESR \u00d7 CRP value correlated most strongly (e.g., with SUVmean \u03c1 = 0.35), and CRP\/albumin showed a modest positive association. MCH (\u03c1 \u2248 \u22120.20) and aPTT (\u03c1 \u2248 \u22120.37) were inversely related. Conclusions: Quantitative SPECT\/CT provides excellent lesion\u2013contralateral discrimination in DFO. SUVs\u2014particularly SUVmean\u2014track inflammatory burden, supporting their use as practical quantitative adjuncts to clinical and laboratory assessment. Study-specific cut-offs are promising but require local validation.<\/jats:p>","DOI":"10.3390\/diagnostics15222907","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T15:38:09Z","timestamp":1763393889000},"page":"2907","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Quantitative Bone SPECT\/CT in Diabetic Foot Osteomyelitis: Diagnostic Performance Within-Patient Lesion\u2013Contralateral Separation and Associations with Inflammatory Burden"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8857-687X","authenticated-orcid":false,"given":"Hulya Peker","family":"Yalcin","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Gulhane Education and Research Hospital, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6336-3066","authenticated-orcid":false,"given":"P\u0131nar Akkus","family":"Gunduz","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Gulhane Education and Research Hospital, 06010 Ankara, Turkey"},{"name":"Department of Nuclear Medicine, Ankara University, 06560 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Samsum","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Etlik Education and Research Hospital, 06170 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emel Colak","family":"Samsum","sequence":"additional","affiliation":[{"name":"Directorate General of Health Services, Turkish Ministry of Health, 06800 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aysenur","family":"Erol","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Gulhane Education and Research Hospital, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2594-7124","authenticated-orcid":false,"given":"Umut Mert","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Gulhane Education and Research Hospital, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulsah Gedikli","family":"Turgut","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Gulhane Education and Research Hospital, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aysun","family":"Yalci","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Microbiology, Gulhane Educational and Research Hospital, University of Health Sciences, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihal","family":"Yesildag","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Gulhane Education and Research Hospital, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa Fatih","family":"Yalcin","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Gulhane Education and Research Hospital, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesibe Zeynep","family":"Eryavuz","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Gulhane Education and Research Hospital, 06010 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1056\/NEJMra1615439","article-title":"Diabetic foot ulcers and their recurrence","volume":"376","author":"Armstrong","year":"2017","journal-title":"N. 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