scholarly journals Detection of Osteomyelitis in the Diabetic Foot by Imaging Techniques: A Systematic Review and Meta-analysis Comparing MRI, White Blood Cell Scintigraphy, and FDG-PET

Diabetes Care ◽  
2017 ◽  
Vol 40 (8) ◽  
pp. 1111-1120 ◽  
Author(s):  
Chiara Lauri ◽  
Menno Tamminga ◽  
Andor W.J.M. Glaudemans ◽  
Luis Eduardo Juárez Orozco ◽  
Paola A. Erba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Cell ◽  
White Blood Cell ◽  
Diabetic Foot ◽  
Fdg Pet ◽  
Imaging Techniques ◽  
Meta Analysis ◽  
White Blood Cell Scintigraphy

scholarly journals Comparison of White Blood Cell Scintigraphy, FDG PET/CT and MRI in Suspected Diabetic Foot Infection: Results of a Large Retrospective Multicenter Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1645 ◽  
Author(s):  
Chiara Lauri ◽  
Andor W.J.M. Glaudemans ◽  
Giuseppe Campagna ◽  
Zohar Keidar ◽  
Marina Muchnik Kurash ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Cell ◽  
White Blood Cell ◽  
Diabetic Foot ◽  
Fdg Pet ◽  
Imaging Modality ◽  
Diabetic Foot Infections ◽  
Pet Ct ◽  
White Blood Cell Scintigraphy ◽  
Fdg Pet Ct

Diabetic foot infections (DFIs) represent one of the most frequent and disabling morbidities of longstanding diabetes; therefore, early diagnosis is mandatory. The aim of this multicenter retrospective study was to compare the diagnostic accuracy of white blood cell scintigraphy (WBC), 18F-fluorodeoxyglucose positron emission tomography/computed tomography ((18F) FDG PET/CT), and Magnetic Resonance Imaging (MRI) in patients with suspected DFI. Images and clinical data from 251 patients enrolled by five centers were collected in order to calculate the sensitivity, specificity, and accuracy of WBC, FDG, and MRI in diagnosing osteomyelitis (OM), soft-tissue infection (STI), and Charcot osteoarthropathy. In OM, WBC acquired following the European Society of Nuclear Medicine (EANM) guidelines was more specific and accurate than MRI (91.9% vs. 70.7%, p < 0.0001 and 86.2% vs. 67.1%, p = 0.003, respectively). In STI, both FDG and WBC achieved a significantly higher specificity than MRI (97.9% and 95.7% vs. 83.6%, p = 0.04 and p = 0.018, respectively). In Charcot, both MRI and WBC demonstrated a significantly higher specificity and accuracy than FDG (88.2% and 89.3% vs. 62.5%, p = 0.0009; 80.3% and 87.9% vs. 62.1%, p < 0.02, respectively). Moreover, in Charcot, WBC was more specific than MRI (89.3% vs. 88.2% p < 0.0001). Given the limitations of a retrospective study, WBC using EANM guidelines was shown to be the most reliable imaging modality to differentiate between OM, STI, and Charcot in patients with suspected DFI.

scholarly journals Leukocytosis and thrombosis in essential thrombocythemia and polycythemia vera: a systematic review and meta-analysis

2019 ◽  
Vol 3 (11) ◽  
pp. 1729-1737 ◽  
Author(s):  
Alessandra Carobbio ◽  
Alberto Ferrari ◽  
Arianna Masciulli ◽  
Arianna Ghirardi ◽  
Giovanni Barosi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Cell ◽  
Polycythemia Vera ◽  
White Blood Cell ◽  
Essential Thrombocythemia ◽  
Recurrent Events ◽  
Myeloproliferative Neoplasms ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Cell Counts

Abstract In the last years, a growing amount of evidence has been produced regarding the role of leukocytosis as a risk factor for thrombosis in patients with myeloproliferative neoplasms, predominantly in polycythemia vera (PV) and essential thrombocythemia (ET). Results from epidemiologic studies on this issue, however, are inconclusive. We conducted a systematic review and meta-analysis of articles published in the last 12 years addressing the issue, according to a predefined protocol. Forty-one articles analyzing &gt;30 000 patients met our inclusion criteria and were deemed of acceptable methodologic quality. In addition to data on thrombosis, data were collected on bleeding, hematologic evolution, secondary cancer, and death. The relative risk (RR) of thrombosis in the presence of leukocytosis was 1.59 (95% CI, 1.40-1.80), mainly accounted for by ET (RR, 1.65; 95% CI, 1.43-1.91) and arterial thrombosis (RR, 1.45; 95% CI, 1.13-1.86) subgroups; the effect was not significant in venous thrombosis alone. Sensitivity analyses considering recurrent events as well as white blood cell estimates adjusted or unadjusted for confounding factors confirmed the primary results. In addition, the pooled RR of studies that tested white blood cell counts in time-dependent models suggested a causative effect of leukocytes in the mechanism that triggers thrombosis. The effect of leukocytosis on bleeding (RR, 1.87; 95% CI, 1.26-2.77) and death (RR, 1.89; 95% CI, 1.59-2.23) was confirmed, whereas conclusions on hematologic evolutions and solid tumors were uncertain. To confirm the accuracy of these results, an investigation on individual patient data in a large collective archive of homogeneous patients is warranted.

scholarly journals Leukocyte Imaging of the Diabetic Foot

2018 ◽  
Vol 24 (12) ◽  
pp. 1270-1276 ◽  
Author(s):  
Chiara Lauri ◽  
Andor W.J.M. Glaudemans ◽  
Alberto Signore
Keyword(s):  
Computed Tomography ◽  
Blood Cell ◽  
White Blood Cell ◽  
Diabetic Foot ◽  
Photon Emission ◽  
White Blood Cells ◽  
Diagnostic Methods ◽  
Emission Computed Tomography ◽  
Diabetic Foot Infection ◽  
White Blood Cell Scintigraphy

Background: Diagnosing diabetic foot infection is often difficult, despite several available diagnostic methods. Amongst these, several imaging modalities exist to evaluate the diabetic foot in case of a suspected osteomyelitis. Nuclear Medicine, in particular, offers a variety of radiopharmaceuticals and techniques. Nowadays the gold standard radionuclide procedure, when an osteomyelitis is suspected, is represented by the use of radiolabelled leukocytes with either 99mTc-HMPAO or 111In-oxine. Methods: : In this review, we describe the correct acquisition and interpretation of white blood cell scintigraphy and we provide an overview of the existing literature data of the use of this technique in the infected diabetic foot. If images are correctly acquired, displayed and interpreted, this modality reaches very high diagnostic accuracy (>95%) in detecting osteomyelitis and it allows the differential diagnosis with a soft tissue infection or inflammation. Single-photon emission computed tomography/computed tomography (SPECT/CT) in addition to planar images is mandatory to determine the extent and exact location of the infective process in both fore foot and midhint foot. With the addition of bone marrow scintigraphy using radiolabelled nanocolloids, radiolabelled white blood cell scintigraphy is also able to differentiate between Charcot neuroarthropathy and osteomyelitis, which is a challenge in the evaluation of diabetic foot. Radiolabelled anti-granulocyte monoclonal antibodies and their fragments can also be used instead of white blood cells although there is a limited experience on their usefulness in diabetic foot infection.

scholarly journals Red Blood Cell Distribution Width, Disease Severity, and Mortality in Hospitalized Patients with SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (2) ◽  
pp. 286
Author(s):  
Angelo Zinellu ◽  
Arduino A. Mangoni
Keyword(s):  
Systematic Review ◽  
Blood Cell ◽  
Disease Severity ◽  
Red Blood Cell ◽  
Effect Size ◽  
Meta Analysis ◽  
Severe Illness ◽  
Cell Distribution ◽  
Distribution Width ◽  
Red Blood Cell Distribution

The identification of biomarkers predicting disease severity and outcomes is the focus of intense research in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 infection). Ideally, such biomarkers should be easily derivable from routine tests. We conducted a systematic review and meta-analysis of the predictive role of the red blood cell distribution width (RDW), a routine hematological test, in patients with SARS-CoV-2 infection. We searched the electronic databases PubMed, Web of Science and Scopus, from January 2020 to November 2020, for studies reporting data on the RDW and coronavirus disease 2019 (COVID-19) severity, defined as severe illness or admission to the intensive care unit (ICU), and mortality. Eleven studies in 4901 COVID-19 patients were selected for the meta-analysis. Pooled results showed that the RDW values were significantly higher in patients with severe disease and non-survivors (standard mean difference, SMD = 0.56, 95% CI 0.31 to 0.81, p < 0.001). Heterogeneity between studies was extreme (I2 = 80.6%; p < 0.001). In sensitivity analysis, the effect size was not modified when each study was in turn removed (effect size range, between 0.47 and 0.63). The Begg’s (p = 0.53) and Egger’s tests (p = 0.52) showed no evidence of publication bias. No significant correlations were observed between SMD and age, gender, whole blood count, end point, study geographic area, or design. Our meta-analysis showed that higher RDW values are significantly associated with COVID-19 severity and mortality. This routine parameter might assist with early risk stratification in patients with SARS-CoV-2 infection.

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