Cic edizioni internazionali
Il Giornale di Chirurgia

Hight resolution mini-gammacamera and 99mTc (HMPAO)- leukocytes
for diagnosis of infection and radioguided surgery in diabetic foot

Original Article, 246 - 250
Tag this article
Abstract
Full text HTML Full text PDF
English version
Discovery of osteitis may be delayed because of late appearance of X-ray signs in patients with diabetic foot. Scintigraphy with labelled leukocytes is able to detect flogosis but often misses bone involvement, due to inadequate resolution of Anger camera, the commonest detector used in nuclear medicine. Radioguided surgery and biopsy with high resolution scintigraphy (HRS) started to be studied since 2000: although this method had never been tested for planning and guiding diabetic foot surgery, in our opinion it can help early diagnosis and surgical treatment of diabetic foot.
Five patients with diabetic foot and suspected infection were studied with standard 99mTc [HMPAO]-leukocyte scan. In the same patients 2 mm spatial resolution HRS was performed 24 hours after administration of labelled wbc, using our inch2 field-of-view portable mini-gammacamera. Operations were done just after the 24h scan and were guided with the portable high resolution device in the four patients who showed positive scan.
Scintigraphy with Anger camera and HRS were positive in four patients. HRS showed a bar-shaped radioactivity corresponding to small phalanges, close to the main inter-digital hot spot. The presence of osteitis on phalanges that had been shown by HRS was confirmed at surgery, that was successfully driven with the high resolution mini-camera.
In conclusion HRS is able to diagnose early osteitis of diabetic foot and to guide diabetic foot surgery.

Versione Italiana
La tecnica illustrata nel presente lavoro riguarda la localizzazione di lesioni osteomielitiche nel piede diabetico mediante l'utilizzo di un nuovo dispositivo scintigrafico da impiegare in sala operatoria. In particolare, viene preventivamente eseguita una scintigrafia mediante somministrazione di leucociti marcati che evidenziano la estensione ed i limiti della lesione. Questa viene visualizzata durante l'intervento operatorio, consentendo la verifica della completa rimozione.
I casi presentati in questo studio pilota dimostrano la validità della tecnica, che necessiterà di ulteriore verifica su una più ampia casistica

Vol XL (No. 4) 2019 July-August

  1. The widespread of Robot-Assisted Surgery: the urologist perspective
    Mearini E., Del Zingaro M., Boni A.
  2. Hyperbaric oxygen therapy in Plastic Surgery practice: case series and literature overview
    Bassetto F., Bosco G., Brambullo T., Kohlscheen E., Tocco Tussardi I., Vindigni V., Tiengo C.
  3. The ERAS Protocol is at the forefront of the peri-operative pathway in colorectal surgery: monocentric clinical study
    Cicardo G., Ursi P., Rossi V., Ceccarelli G., Di Matteo F.M., Panarese A., D'Andrea V.
  4. Retained sponges in abdomen: an analysis of the judgments of the Italian Supreme Court
    Gioia S., Lancia M., Cirocchi R., Suadoni F., Franceschetto L., Santoro A., Palumbo P., Boselli C., Barberini F., Covarelli P., Renzi C., Carlini L.
  5. Nasal flap or cutaneous grafting in basal cell cancer of the nose. Comparison of two reconstructive possibilities
    Vergine M., Frusone F., De Luca A., Aceti V., Marcasciano M., Amabile M.I., Monti M.
  6. Non small cell lung cancer metastasized to the breast and treated with modified radical mastectomy: a case report
    Grigoropoulos P., Mariolis-Sapsakos T., Karantonis I., Kaklamanos I., Karanasiou V., Zografos C.G., Chrysikos D.
  7. Importance of a careful clinical evaluation in the diagnosis of cystic pancreatic tumors
    Di Cataldo A., Bellavia N., Amico A., Latino R., Bosco D., Perrotti S.
  8. Mass of the neck: an extremely rare location of hydatid disease
    Siaperas P., Zoikas A., Ioannidis O., Karanikas I.
  9. Nuck canal cyst involving right femoral vein: management and therapy of a rare clinical case
    Leanza V., D'antoni S., Lo Presti V., Zanghì G., Vecchio R., Leanza G., Basile F.
  10. Small bowel occlusion after trans-abdominal preperitoneal hernia approach caused by barbed suture: case report and review of literature
    Sartori A., De Luca M., Clemente N., De Luca A., Scaffidi G., Piatto G., Noaro G., Campagnaro C.
  11. Bilateral overuse myositis ossificans of the triceps: report of an unusual case
    Georgoulis S., Koutserimpas C.
  12. Dual site intestinal perforation due to toothpick
    Ossola L., Galafassi J.
  13. A rare case of trichilemmal ovarian carcinoma. Case report and review of the literature
    Leanza V., Nobile V., Galvagno C., Di Grazia F.M., Palumbo M., Leanza G.
  14. Gossypiboma in abdomen: retained surgical gauze after a cesarean section
    Bilali V., Bilali S., Mitrushi A., Pirushi R., Nina H., Ktona E.
  15. Encapsulating peritoneal sclerosis: do not be too late for the right diagnosis! Case report and short literature review
    Sinagra E., Buscaglia F., Iacoponelli A., Sciumè C.
  16. Adrenalectomy for benign and malignant adrenal tumors. Experience from Misurata Cancer Center
    Wafa A., Ghellai A., Aboshnaf A., Elfagieh M., Juwid A.
  17. Left colon interposition for esophageal reconstruction after perforation by metal blades ingestion: a case report
    Bizzoca C., Pisicchio S., Torchia G., Vincenti L.
  18. An alternative management of a Littré hernia case: food for thought
    Schizas D., Katsaros I., Koliakos N., Ntomi V., Tsilimigras D.I., Moris D., Misiakos E.P., Zavras N., Bakopoulos A.
  19. Jejunal metastasis of Merkel cell carcinoma: case report
    Mancini S., Solinas L., Leone L., Battaglia B., Notarangelo M.G., Hassan R., Di Cosimo C., Angeloni R., Belardi A., Cosentino L., Bakacs A., Sagnotta A.
  20. CT-guided drainage with percutaneous approach as treatment of E. Faecalis post caesarean section severe abscess: case report and literature review
    Leanza V., Lo Presti V., Di guardo F., Leanza G., Palumbo M.
Last Viewed articles: la lista degli ultimi x visitati.
  1. Hight resolution mini-gammacamera and 99mTc (HMPAO)- leukocytes
    for diagnosis of infection and radioguided surgery in diabetic foot

    Soluri A., Massari R., Trotta C., Stella S., Cavaiola S., Capriotti G., Di Santo G.P., Di Paolo M.L., Mangano A.M., Liberatore M., Micarelli A., Bruzzese A., Pasta V.
credits