Next Article in Journal
Autoimmune Metaplastic Atrophic Gastritis Reporting: Are Pathologists and Endoscopists on the Same Page?
Next Article in Special Issue
Traditional and Modern Predictors of Atherosclerotic Cardiovascular Disease in Patients with T2D and MASLD
Previous Article in Journal
Diffusion Tensor Imaging Along the Perivascular Space (DTI-ALPS) in Ischemic Stroke: A Systematic Review of Diagnostic and Prognostic Performance for Post-Stroke Cognitive Impairment
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Diagnostics
Volume 15
Issue 22
10.3390/diagnostics15222907
diagnostics-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Quantitative Bone SPECT/CT in Diabetic Foot Osteomyelitis: Diagnostic Performance Within-Patient Lesion–Contralateral Separation and Associations with Inflammatory Burden

by
Hulya Peker Yalcin
1,*,
Pınar Akkus Gunduz
1,2,
Mehmet Samsum
3,
Emel Colak Samsum
4,
Aysenur Erol
1,
Umut Mert Turan
1,
Gulsah Gedikli Turgut
1,
Aysun Yalci
5,
Nihal Yesildag
1,
Musa Fatih Yalcin
1 and
Nesibe Zeynep Eryavuz
1
1
Department of Nuclear Medicine, Gulhane Education and Research Hospital, 06010 Ankara, Turkey
2
Department of Nuclear Medicine, Ankara University, 06560 Ankara, Turkey
3
Department of Nuclear Medicine, Etlik Education and Research Hospital, 06170 Ankara, Turkey
4
Directorate General of Health Services, Turkish Ministry of Health, 06800 Ankara, Turkey
5
Department of Infectious Diseases and Clinical Microbiology, Gulhane Educational and Research Hospital, University of Health Sciences, 06010 Ankara, Turkey
*
Author to whom correspondence should be addressed.
Diagnostics 2025, 15(22), 2907; https://doi.org/10.3390/diagnostics15222907
Submission received: 14 October 2025 / Revised: 14 November 2025 / Accepted: 15 November 2025 / Published: 17 November 2025
(This article belongs to the Special Issue Diagnosis and Management of Diabetes Mellitus)
Browse Figures
Versions Notes

Abstract

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–December 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 × 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 ± 7.36 vs. 3.62 ± 1.70; SUVmean 4.38 ± 3.63 vs. 0.93 ± 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 (ρ ≈ 0.25–0.30). The ESR × CRP value correlated most strongly (e.g., with SUVmean ρ = 0.35), and CRP/albumin showed a modest positive association. MCH (ρ ≈ −0.20) and aPTT (ρ ≈ −0.37) were inversely related. Conclusions: Quantitative SPECT/CT provides excellent lesion–contralateral discrimination in DFO. SUVs—particularly SUVmean—track inflammatory burden, supporting their use as practical quantitative adjuncts to clinical and laboratory assessment. Study-specific cut-offs are promising but require local validation.
Keywords: diabetic foot osteomyelitis; bone SPECT/CT; quantitative SPECT; standardized uptake value (SUV); SUVmax; SUVmean; C-reactive protein (CRP); erythrocyte sedimentation rate (ESR) diabetic foot osteomyelitis; bone SPECT/CT; quantitative SPECT; standardized uptake value (SUV); SUVmax; SUVmean; C-reactive protein (CRP); erythrocyte sedimentation rate (ESR)

Share and Cite

MDPI and ACS Style

Yalcin, H.P.; Gunduz, P.A.; Samsum, M.; Samsum, E.C.; Erol, A.; Turan, U.M.; Turgut, G.G.; Yalci, A.; Yesildag, N.; Yalcin, M.F.; et al. Quantitative Bone SPECT/CT in Diabetic Foot Osteomyelitis: Diagnostic Performance Within-Patient Lesion–Contralateral Separation and Associations with Inflammatory Burden. Diagnostics 2025, 15, 2907. https://doi.org/10.3390/diagnostics15222907

AMA Style

Yalcin HP, Gunduz PA, Samsum M, Samsum EC, Erol A, Turan UM, Turgut GG, Yalci A, Yesildag N, Yalcin MF, et al. Quantitative Bone SPECT/CT in Diabetic Foot Osteomyelitis: Diagnostic Performance Within-Patient Lesion–Contralateral Separation and Associations with Inflammatory Burden. Diagnostics. 2025; 15(22):2907. https://doi.org/10.3390/diagnostics15222907

Chicago/Turabian Style

Yalcin, Hulya Peker, Pınar Akkus Gunduz, Mehmet Samsum, Emel Colak Samsum, Aysenur Erol, Umut Mert Turan, Gulsah Gedikli Turgut, Aysun Yalci, Nihal Yesildag, Musa Fatih Yalcin, and et al. 2025. "Quantitative Bone SPECT/CT in Diabetic Foot Osteomyelitis: Diagnostic Performance Within-Patient Lesion–Contralateral Separation and Associations with Inflammatory Burden" Diagnostics 15, no. 22: 2907. https://doi.org/10.3390/diagnostics15222907

APA Style

Yalcin, H. P., Gunduz, P. A., Samsum, M., Samsum, E. C., Erol, A., Turan, U. M., Turgut, G. G., Yalci, A., Yesildag, N., Yalcin, M. F., & Eryavuz, N. Z. (2025). Quantitative Bone SPECT/CT in Diabetic Foot Osteomyelitis: Diagnostic Performance Within-Patient Lesion–Contralateral Separation and Associations with Inflammatory Burden. Diagnostics, 15(22), 2907. https://doi.org/10.3390/diagnostics15222907

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop