scholarly journals New Imaging Tracers for the Infected Diabetic Foot (Nuclear and Optical Imaging)

2018 ◽  
Vol 24 (12) ◽  
pp. 1287-1303 ◽  
Author(s):  
Alfred O. Ankrah ◽  
Hans C. Klein ◽  
Philip H. Elsinga
Keyword(s):  
Nuclear Medicine ◽  
Optical Imaging ◽  
Diabetic Foot ◽  
Imaging Techniques ◽  
Healthcare Systems ◽  
Nuclear Medicine Imaging ◽  
Adequate Treatment ◽  
Diabetic Foot Infections ◽  
Hybrid Tracer

Diabetic Foot Infections (DFIs) are associated with increased morbidity, an economic burden on patients, their families and healthcare systems and increased mortality. Early diagnosis with prompt, appropriate and adequate treatment of the infected diabetic foot is crucial. The determination of DFIs, however, may be quite perplexing and invasive. Imaging is useful in the evaluation of certain cases of DFIs, especially in suspected instances with no overt clinical features, or in the diagnosis of osteomyelitis. Nuclear medicine imaging is currently used in the evaluation of DFIs; however, like all the imaging techniques now available, it has its limitations. Several radiopharmaceuticals presently available play useful roles in the management of DFIs, while new ones are being evaluated. Optical imaging techniques have recently demonstrated promising results in the evaluation of many infections including DFIs. Using the same molecule, a tracer can be labeled with a radioisotope or an optical imaging dye. This enables infections to be evaluated both pre- and intra-operatively when surgery is required in their management. In some cases, tracers have been simultaneously labeled with both a radioisotope and an optical imaging dye to produce a hybrid tracer. These new tracers potentially provide powerful and new opportunities in the management of DFIs. In this review, we briefly examine tracers that have been used in the evaluation of the infected diabetic foot. We then explore the potential of new imaging tracers currently under development for infection that may be useful in the management of DFIs.

scholarly journals Immuno-Imaging to Predict Treatment Response in Infection, Inflammation and Oncology

2019 ◽  
Vol 8 (5) ◽  
pp. 681 ◽  
Author(s):  
Alberto Signore ◽  
Chiara Lauri ◽  
Sveva Auletta ◽  
Kelly Anzola ◽  
Filippo Galli ◽  
...  
Keyword(s):  
Decision Making ◽  
Nuclear Medicine ◽  
Treatment Response ◽  
Fungal Infections ◽  
Inflammatory Diseases ◽  
Imaging Techniques ◽  
Nuclear Medicine Imaging ◽  
Tumour Immunology ◽  
Therapy Decision

Background: Molecular nuclear medicine plays a pivotal role for diagnosis in a preclinical phase, in genetically susceptible patients, for radio-guided surgery, for disease relapse evaluation, and for therapy decision-making and follow-up. This is possible thanks to the development of new radiopharmaceuticals to target specific biomarkers of infection, inflammation and tumour immunology. Methods: In this review, we describe the use of specific radiopharmaceuticals for infectious and inflammatory diseases with the aim of fast and accurate diagnosis and treatment follow-up. Furthermore, we focus on specific oncological indications with an emphasis on tumour immunology and visualizing the tumour environment. Results: Molecular nuclear medicine imaging techniques get a foothold in the diagnosis of a variety of infectious and inflammatory diseases, such as bacterial and fungal infections, rheumatoid arthritis, and large vessel vasculitis, but also for treatment response in cancer immunotherapy. Conclusion: Several specific radiopharmaceuticals can be used to improve diagnosis and staging, but also for therapy decision-making and follow-up in infectious, inflammatory and oncological diseases where immune cells are involved. The identification of these cell subpopulations by nuclear medicine techniques would provide personalized medicine for these patients, avoiding side effects and improving therapeutic approaches.

scholarly journals Multidisciplinary Approach for the Management and Treatment of Diabetic Foot Infections with a Resorbable, Gentamicin-Loaded Bone Graft Substitute

2020 ◽  
Vol 9 (11) ◽  
pp. 3586
Author(s):  
Christine Whisstock ◽  
Antonio Volpe ◽  
Sasa Ninkovic ◽  
Mariagrazia Marin ◽  
Marco Meloni ◽  
...  
Keyword(s):  
Bone Graft ◽  
Diabetic Foot ◽  
Multidisciplinary Approach ◽  
Calcium Sulphate ◽  
Bone Graft Substitute ◽  
Diabetic Patients ◽  
Ulcer Formation ◽  
Adequate Treatment ◽  
Diabetic Foot Infections ◽  
Increased Risk

Diabetic patients are at increased risk of developing foot ulcers which may cause bone infections associated with a high probability of both amputation and mortality. Therefore, prompt diagnosis and adequate treatment are of key importance. In our Diabetic Foot Unit, effective multidisciplinary treatment of osteomyelitis secondary to diabetes involves the application of a gentamicin-eluting calcium sulphate/hydroxyapatite bone graft substitute to fill residual bone voids after debridement. The data of all patients treated with the gentamicin-eluting calcium sulphate/hydroxyapatite bone graft substitute for diabetic foot infections with ulcer formation and osteomyelitis at metatarsals, calcaneus and hindfoot at our institute from July 2013 to September 2016 were retrospectively collected and evaluated. A total of 35 patients were included in this retrospective single-arm case series and were either continuously followed up for at least one year or until healing was confirmed. Nineteen lesions affected the distal row of tarsus/talus, ten the calcaneus and a further six were located at the metatarsals. While all of the metatarsal lesions had healed at 1-year follow-up, the healing rate in the hindfoot region was lower with 62.5% at the calcaneus and 72.2% at the distal tarsus and talus at 12 months, respectively. The overall cure rate for ulcerous bone infection was 81.3%. In two calcaneal lesions (25%) and two lesions of distal tarsus/talus (11.1%) amputation was considered clinically necessary. Promising results were achieved in the treatment of diabetic foot infections with soft tissue ulcers by a multidisciplinary approach involving extensive debridement followed by adequate dead space management with a resorbable gentamicin-eluting bone graft substitute.

scholarly journals Recent applications of nuclear medicine in diagnostics: II part

2013 ◽  
pp. 159-166
Author(s):  
Giorgio Treglia ◽  
Ernesto Cason ◽  
Giorgio Fagioli
Keyword(s):  
Nuclear Medicine ◽  
Single Photon ◽  
Imaging Techniques ◽  
Photon Emission ◽  
Cellular Level ◽  
Accurate Information ◽  
Emission Computed Tomography ◽  
Nuclear Medicine Imaging ◽  
Positron Emission ◽  
Artery Disease

Introduction: Positron-emission tomography (PET) and single photon emission computed tomography (SPECT) are effective diagnostic imaging tools in several clinical settings. The aim of this article (the second of a 2-part series) is to examine some of the more recent applications of nuclear medicine imaging techniques, particularly in the fields of neurology, cardiology, and infection/inflammation. Discussion: A review of the literature reveals that in the field of neurology nuclear medicine techniques are most widely used to investigate cognitive deficits and dementia (particularly those associated with Alzheimer disease), epilepsy, and movement disorders. In cardiology, SPECT and PET also play important roles in the work-up of patients with coronary artery disease, providing accurate information on the state of the myocardium (perfusion, metabolism, and innervation). White blood cell scintigraphy and FDG-PET are widely used to investigate many infectious/inflammatory processes. In each of these areas, the review discusses the use of recently developed radiopharmaceuticals, the growth of tomographic nuclear medicine techniques, and the ways in which these advances are improving molecular imaging of biologic processes at the cellular level.

Diagnosis of pathological conditions in laboratory animals by using advance nuclear medicine imaging techniques

2019 ◽  
Vol 43 (2) ◽  
pp. 109
Author(s):  
Yogita Pawar ◽  
Uma Bhartiya ◽  
Sutapa Rakshit ◽  
Saikat Nandy ◽  
N. Lakshminarayanan ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Imaging Techniques ◽  
Laboratory Animals ◽  
Nuclear Medicine Imaging ◽  
Pathological Conditions

scholarly journals Antimicrobial Peptides as Infection Imaging Agents: Better Than Radiolabeled Antibiotics

2012 ◽  
Vol 2012 ◽  
pp. 1-19 ◽  
Author(s):  
Muammad Saeed Akhtar ◽  
Muhammad Babar Imran ◽  
Muhammad Afzal Nadeem ◽  
Abubaker Shahid
Keyword(s):  
Nuclear Medicine ◽  
Antimicrobial Peptides ◽  
Imaging Techniques ◽  
Whole Body ◽  
Whole Body Imaging ◽  
Nuclear Medicine Imaging ◽  
Human Immune System ◽  
Large Member ◽  
Infection And Inflammation ◽  
Radiolabeled Compounds

Nuclear medicine imaging techniques offer whole body imaging for localization of number and site of infective foci inspite of limitation of spatial resolution. The innate human immune system contains a large member of important elements including antimicrobial peptides to combat any form of infection. However, development of antibiotics against bacteria progressed rapidly and gained popularity over antimicrobial peptides but even powerful antimicrobials failed to reduce morbidity and mortality due to emergence of mutant strains of bacteria resulting in antimicrobial resistance. Differentiation between infection and inflammation using radiolabeled compounds with nuclear medicine techniques has always been a dilemma which is still to be resolved. Starting from nonspecific tracers to specific radiolabeled tracers, the question is still unanswered. Specific radiolabeled tracers included antibiotics and antimicrobial peptides which bind directly to the bacteria for efficient localization with advanced nuclear medicine equipments. However, there are merits and demerits attributed to each. In the current paper, radiolabeled antibiotics and radiolabeled peptides for infection localization have been discussed starting with the background of primitive nonspecific tracers. Radiolabeled antimicrobial peptides have certain merits compared with labeled antibiotics which make them superior agents for localization of infective focus.

scholarly journals PET and SPECT Imaging of Tumor Micro-Environment: A Systematic Review of the Last 20 Years

2021 ◽  
Author(s):  
Valeria Stati ◽  
Chiara Lauri ◽  
Michela Varani ◽  
Martina Conserva ◽  
Alberto Signore
Keyword(s):  
Systematic Review ◽  
Nuclear Medicine ◽  
Solid Tumors ◽  
Imaging Techniques ◽  
Clinical Information ◽  
Preclinical Studies ◽  
Nuclear Medicine Imaging ◽  
Cancer Treatments ◽  
Great Cost

Background: Molecular nuclear medicine, due to hybrid imaging camera systems and new tailored radiopharmaceuticals, has been gained a clinical relevance for diagnosis, therapy and follow-up of solid tumors. Despite numerous literature studies, many new radiopharmaceuticals for imaging tumor microenvironment, have not yet been used, routinely, in oncological clinical practice to monitor treatments. This is due to poor comparability of published studies, due to poor design and methodology, heterogeneous population and prevalence of preclinical studies. Methods: In this systematic review, we described the use of radiopharmaceuticals for evaluation of tumor treatment response by targeting microenvironment. We reviewed studies published from 2000 to 2020, to provide an updated status of research in this topic. Results: There is a growing role of radiopharmaceuticals and nuclear medicine imaging techniques in the management of cancer treatments, especially immunotherapy. Of the 24 papers included, 16 were preclinical studies. Conclusions: New radiopharmaceuticals could have an excellent impact in molecular imaging, leading to better diagnosis and important clinical information for therapy decision making and follow-up of cancer treatments in different solid tumors. Recently developed radiopharmaceuticals may provide great advantage to improve personalized medicine for patients with a great cost-effectiveness ratio.

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