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Preoperative imaging of Charcot neuroarthropathy in diabetic patients: comparison of ring PET, hybrid PET, and magnetic resonance imaging.
Foot Ankle Int. 2004 Dec; 25(12):890-5.FA

Abstract

INTRODUCTION

The treatment of Charcot neuroarthropathy in the feet of diabetic patients has undergone fundamental changes in the last few years. Formerly, treatment was almost exclusively limited to nonoperative measures; since the late 1990s, however, current practice has shifted to early, stage-appropriate surgical therapy. The objective of this prospective study was to investigate the value of two types of positron emission tomography (PET) in the preoperative evaluation of diabetic patients with Charcot foot deformities.

MATERIALS AND METHODS

Ring [(18)F]FDG (2-fluoro-2-deoxy-glucose) and hybrid PET were compared to magnetic resonance imaging (MRI). MRI, ring PET, and hybrid PET imaging were used as part of the preoperative evaluation of 16 patients with type II diabetes mellitus. The diagnosis of Charcot neuropathy of the foot requiring operative treatment had been made on the basis of clinical and radiographic criteria.

RESULTS

Of 39 Charcot lesions confirmed at surgery, 37 were detected by ring PET, 30 by hybrid PET, and 31 by MRI.

CONCLUSIONS

PET (ring or hybrid) can be used in the evaluation of patients with metal implants that would compromise the accuracy of MRI. Another advantage of PET is its ability to distinguish between inflammatory and infectious soft-tissue lesions, and between osteomyelitis and Charcot neuroarthropathy. The differentiation between Charcot neuroarthropathy and florid osteomyelitis provides the surgeon with important additional information that often is unavailable from MRI. Because it provides important additional data, ring PET may be preferable to radiography and MRI in the preoperative evaluation of patients with Charcot neuroarthropathy of the foot. Hybrid PET, because of its poorer resolution compared to ring PET, appears less suitable for routine clinical application.

Authors+Show Affiliations

Höpfner S
Department of Radiology, Justus-Liebig-University of Giessen, Klinikstrasse 36, D-35385 Giessen, Germany. stefan.hoepfner@web.de
Krolak C
No affiliation info available
Kessler S
No affiliation info available
Tiling R
No affiliation info available
Brinkbäumer K
No affiliation info available
Hahn K
No affiliation info available
Dresel S
No affiliation info available

MeSH

AgedArthropathy, NeurogenicDiabetes Mellitus, Type 2Diagnosis, DifferentialFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedOsteomyelitisPositron-Emission TomographyProspective StudiesSensitivity and Specificity

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15680102

Citation

Höpfner, Stefan, et al. "Preoperative Imaging of Charcot Neuroarthropathy in Diabetic Patients: Comparison of Ring PET, Hybrid PET, and Magnetic Resonance Imaging." Foot & Ankle International, vol. 25, no. 12, 2004, pp. 890-5.
Höpfner S, Krolak C, Kessler S, et al. Preoperative imaging of Charcot neuroarthropathy in diabetic patients: comparison of ring PET, hybrid PET, and magnetic resonance imaging. Foot Ankle Int. 2004;25(12):890-5.
Höpfner, S., Krolak, C., Kessler, S., Tiling, R., Brinkbäumer, K., Hahn, K., & Dresel, S. (2004). Preoperative imaging of Charcot neuroarthropathy in diabetic patients: comparison of ring PET, hybrid PET, and magnetic resonance imaging. Foot & Ankle International, 25(12), 890-5.
Höpfner S, et al. Preoperative Imaging of Charcot Neuroarthropathy in Diabetic Patients: Comparison of Ring PET, Hybrid PET, and Magnetic Resonance Imaging. Foot Ankle Int. 2004;25(12):890-5. PubMed PMID: 15680102.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preoperative imaging of Charcot neuroarthropathy in diabetic patients: comparison of ring PET, hybrid PET, and magnetic resonance imaging. AU - Höpfner,Stefan, AU - Krolak,Christoph, AU - Kessler,Stefan, AU - Tiling,Reinhold, AU - Brinkbäumer,Kirsten, AU - Hahn,Klaus, AU - Dresel,Stefan, PY - 2005/2/1/pubmed PY - 2005/4/20/medline PY - 2005/2/1/entrez SP - 890 EP - 5 JF - Foot & ankle international JO - Foot Ankle Int VL - 25 IS - 12 N2 - INTRODUCTION: The treatment of Charcot neuroarthropathy in the feet of diabetic patients has undergone fundamental changes in the last few years. Formerly, treatment was almost exclusively limited to nonoperative measures; since the late 1990s, however, current practice has shifted to early, stage-appropriate surgical therapy. The objective of this prospective study was to investigate the value of two types of positron emission tomography (PET) in the preoperative evaluation of diabetic patients with Charcot foot deformities. MATERIALS AND METHODS: Ring [(18)F]FDG (2-fluoro-2-deoxy-glucose) and hybrid PET were compared to magnetic resonance imaging (MRI). MRI, ring PET, and hybrid PET imaging were used as part of the preoperative evaluation of 16 patients with type II diabetes mellitus. The diagnosis of Charcot neuropathy of the foot requiring operative treatment had been made on the basis of clinical and radiographic criteria. RESULTS: Of 39 Charcot lesions confirmed at surgery, 37 were detected by ring PET, 30 by hybrid PET, and 31 by MRI. CONCLUSIONS: PET (ring or hybrid) can be used in the evaluation of patients with metal implants that would compromise the accuracy of MRI. Another advantage of PET is its ability to distinguish between inflammatory and infectious soft-tissue lesions, and between osteomyelitis and Charcot neuroarthropathy. The differentiation between Charcot neuroarthropathy and florid osteomyelitis provides the surgeon with important additional information that often is unavailable from MRI. Because it provides important additional data, ring PET may be preferable to radiography and MRI in the preoperative evaluation of patients with Charcot neuroarthropathy of the foot. Hybrid PET, because of its poorer resolution compared to ring PET, appears less suitable for routine clinical application. SN - 1071-1007 UR - https://www.unboundmedicine.com/medline/citation/15680102/Preoperative_imaging_of_Charcot_neuroarthropathy_in_diabetic_patients:_comparison_of_ring_PET_hybrid_PET_and_magnetic_resonance_imaging_ DB - PRIME DP - Unbound Medicine ER -